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Psychotropic Medications 101

5/10/2022

2 Comments

 
In the practice of psychotherapy, therapists learn about and utilize many tools to help our clients find lasting change, improving their overall mental health and wellbeing, and psychotropic medications can be one of those tools.
​It is important to realize that not everyone needs medication to treat their mental health symptoms, and not everyone who needs medication will need it forever. The purpose of this article is to provide basic education about psychotropic medications, because I find that most of my clients who take psychotropic medications are under-educated about them, and many clients who do not take medications are scared to start for the same reason.

How do psychotropic medications affect the brain?

​Mental health disorders (anxiety, depression, bipolar disorder, etc…) are a result of chemical imbalances in the brain, specifically of the neurotransmitters serotonin, norepinephrine and dopamine.  These chemical imbalances can be endogenous (genetic factors, internally caused), exogenous (life events, trauma, external factors), or both.  Psychotropic medications work to create balance in neurotransmitters by adjusting how the receptors in the brain absorb the chemical, effectively reducing negative symptoms.  Different medications work on different neurotransmitters, and it varies individually what each person’s brain needs or will respond to, depending on symptoms and brain chemistry.  
​

What are the types of psychotropic medication?

Anti-Anxiety Medications
  • Benzodiazepines: Work on the GABA receptors in the brain, have the same effect on the brain as alcohol.  Can be addictive and can easily form a dependence resulting in withdrawal if not tapered. Examples: Xanax (Alprazolam), Klonopin (Clonozepam), Ativan (Lorazepam)
  • Anxiolytics: Work on serotonin, dopamine, and noradrenaline receptors. Example: Buspar (Buspirone)
  • Beta-Blockers: Slow down heart rate, reduce adrenaline, and block the physical symptoms of anxiety so the mental ones are easier to manage.  Generally used for short-term, event-related anxiety (public speaking, anxiety attacks, etc…. Example: Hemangeol (Propranolol)
  • Alpha-Blockers: Used to treat high blood pressure, relax blood vessels so blood flows more freely.  This medication has had much success in eliminating nightmares related to anxiety and Post Traumatic Stress Disorder. Example: Minipress (Prazosin)
  • Antihistamines: Affect serotonin and block histamine. Example: Vistaril (Hydroxyzine)
  • Nerve Pain Medications: Slow down brain impulses, stop misfirings in the brain.  Also used for fibromyalgia and seizures.  Examples: Lyrica (Pregablin), Neurontin (Gabapentin)
    ​
Anti-Depressant Medications
  • Selective Serotonin Reuptake Inhibitors (SSRI): Increase serotonin levels, can also be used to treat anxiety. Examples: Celexa (Citalopram), Lexapro (Escitalopram), Zoloft (Sertraline), Paxil (Paroxetine), Prozac (Fluoxetine)
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRI): Increase Serotonin and Norepinephrine.  Can also be used to treat anxiety.  Examples: Strattera (Atomoxetine), Cymbalta (Duloxetine), Effexor (Venlafaxine), Pristiq (Desvenlafaxine)
  • Tricyclics: Increase norepinephrine and serotonin, and block acetylcholine, have a sedative effect.  These are older medications that are not widely prescribed after the advent of SSRI and SNRI medications.  Examples: Amitriptyline, Amoxapine, Tofranil (Imipramine), Pamelor (Nortriptyline)
  • Monoamine Oxidase Inhibitors (MAOI): Limit monoamine oxidase, which removes norepinephrine, serotonin and dopamine.  These are older medications with many diet restrictions and side effects. Examples: Marplan (Isocarboxazid), Nardil (Phenelzine), Parnate (tranylcypromine)
  • Serotonin Antagonist and Reuptake Inhibitors (SARI): Increase serotonin in the brain by blocking a specific receptor, have a sedative effect. Examples: Desyrel (Trazodone)
  • Atypicals: work on serotonin, dopamine, and norepinephrine receptors. Examples: Viibryd (Villazadone), Trintellex (Vortioxetine), Wellbutrin (Bupropion), Remeron (Mirtazapine).​
    ​
Antipsychotic Medications
Used to treat Bipolar Disorder, Schizophrenia, Personality Disorders, Severe Depression and Severe Anxiety.
  • Typical (older) Antipsychotics: Block a specific type of dopamine receptor, have a sedative effect. Examples: Thorazine (Chlorpromazine), Haldol (Haloperidol), Prolixin (Fluphenazine)
  • Atypical (newer) Antipsychotics: Block a specific type of serotonin and dopamine receptor. Examples: Abilify (Aripiprazole), Seroquel (Quetiapine), Geodon (Ziprasidone), Risperdal (Risperidone), Zyprexa (Olanzapine)
    ​
Mood Stabilizers
Used to treat the mood swings of Bipolar Disorder, and sometimes to enhance the effect of other medications when treating Depression. Reduce excitability in the brain, to calm overstimulated and overactive neurons. Many anticonvulsant medications are used as mood stabilizers. Examples: Lithium (Eskalith), Depakote (Divalproex Sodium), Lamictal (Lamotrigine), Tegretol (Carbamazepine), Topamax (Topiramate), Trileptal (Oxcarbazepine)
​
Stimulants
Used to treat Attention Deficit Hyperactivity Disorder (ADHD), increase dopamine and norepinephrine. Can be addictive and can easily form a dependence. Examples: Adderall (Amphetamine), Vyvanse (lisdexamfetamine), Focalin (dexmethylphenidate), Ritalin/Concerta (methylphenidate), Dexedrine (dextroamphetamine)
​

Who can prescribe psychotropic medications?

While a licensed therapist or counselor may be knowledgeable about psychotropic medications, only medical professionals can prescribe them. The medical professionals with the most knowledge and training in prescribing psychoactive medications are Psychiatrists.  Psychiatrists are medical doctors (MD) that have completed residency and training in psychiatry.  Most psychiatrists do not engage in talk therapy; they focus on symptom and medication management in brief (15-20 minute) appointments.
 
Other medical professionals able to prescribe psychotropic medications are Primary Care Physicians (MD/GP), Physician Assistants (PA), Psychiatric/Mental Health Nurse Practitioners (PMHNP), Nurse Practitioners (NP), Certified Nurse Midwives (CNM), and Gynecologists/Obstetricians (OB/GYN).
​

How do I know if I need psychotropic medications?

In my practice, for someone who is not currently taking psychotropic medications, I will generally recommend medications if we seem to continue hitting a wall with ongoing negative symptoms, despite all reasonable efforts to improve them.  If adding structure, recognizing and changing thinking, improving overall physical health, learning emotional identification and expression, and addressing spiritual health doesn’t improve symptoms markedly, this indicates to me that the symptoms are endogenous in nature, and need chemical help to mitigate.
 

What do I need to be aware of if I start taking psychotropic medications?

All medications generally have some risk of side-effects, some more troublesome than others.  Speaking with your prescribing physician and doing your own research are important before starting on any psychotropic medication.  Most common side-effects for psychotropic medications are disturbances in sleep and appetite.  Some of these can be mitigated by adjusting the time of day they are taken (morning if the medication is activating to your brain at night), and taking them with food to reduce nausea.
 
Research has shown that the most effective treatment for mental health disorders is a combination of medication and therapy.  Taking psychotropic medications without including therapy will not result in lasting change and improvement in symptoms.  For real and sustained life change, medications can help provide enough of a lift or relief of symptoms so work can happen in therapy, to prevent recurrence of negative symptoms.
​
 
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Author Jamie Cullen, LCMHC, LMHC, LCPC is a Licensed Clinical Mental Health Counselor and Clinical Coordinator at Banyan Tree Counseling & Wellness specializing in adult and childhood trauma, addictions, disordered eating, grief and loss, and co-occurring disorders. She has experience working with both chemical and process addictions, specifically their root in trauma, and is passionate about helping individuals enter and maintain recovery, utilizing therapy, psychoeducation, and community supports.
References:
http://www.drugs.com
http://www.pdr.net

2 Comments

The Pandemic Isn't Over, Why Mental Health Matters Now More Than Ever

2/25/2021

2 Comments

 

Almost an entire year into a worldwide pandemic, you may be feeling more stressed than ever. COVID-19 has made life different for everyone. From social distancing to virtual learning, everything has changed. Our routine isn’t what we were used to, and that can come with challenges. 


If you find yourself struggling, finding a mental health counselor who can help you through this tough time is essential, even through a screen. 
 
You wouldn’t just brush off a broken arm, would you? So why would you ignore your mental health? Your brain is your most complex and important organ. You have to take care of it. 

The Impact of COVID on Mental Health

The world has been turned upside-down in the last year, from social distancing to having to go through virtual learning. All these changes are making it rougher for mental health than normal everyday life. 
 
It’s no secret that a pandemic is rough on mental health. It’s been documented before that a pandemic will see a rise in mental health issues like anxiety, depression, and even OCD. There has been a rise happening with mental health issues because of the isolation, social distancing, and virtual learning and work. 

Social Distancing & Isolation

One of the first things that happened in many places was the closure of non-essential businesses and schools all over the United States. People were told that staying home and only going out when needed was going to help prevent the spread of the virus. All restaurants were closed to dine-in, and other social gatherings were put on hold till further notices. 
 
There are reported issues that come with social isolation, which is where we are now. People are feeling the adverse effects of what is our new normal. There has been a rise of about 37% in mental health issues ranging from anxiety to depression during this quarantine. 
 
The biggest worry is that of suicidal ideation during this time. Isolation is a risk factor for suicide, and being forced to be in isolation can increase the thoughts that lead to it. This is why talking to a mental health professional is vital. 
 
If you are finding yourself in a dark place, find a counselor in your area. These times are hard, and having someone to talk to is going to be essential. If you aren’t able to contact a counselor, then reach out to your family and friends. You may not be able to see them in person but use FaceTime and Zoom to meet people. Your mental health is so important, and you have to take care of yourself, even in isolation. 

Virtual Learning

There are many children out there that are still doing virtual learning. Your child may be one of them, and you can see them struggling. Many parents are worried about their child falling behind in social and emotional development during this time. 
 
It's a valid worry. Children need to have one another to thrive and grow into adults later on. Zoom classroom isn’t the same as being in a school, but it is better than nothing. Make sure your child is logging into the meetings and participating. This is going to help them in the long run, and if they are struggling, talk to the teacher yourself. For special needs children, this virtual learning is more challenging. IEPs and other learning accommodations aren’t easy when it comes to a virtual classroom. 
 
Now, as children start going back to the building, there are even more worries. For students with social anxiety, it may be heightened after being in isolation for so long. Take it easy on them and try and work with them to know it is okay. This virus is scary but wearing the mask, washing your hands, and staying six feet apart is helping. 
 
Finding a mental health professional that can help with these worries will be vital in helping those who struggle. Being able to talk to someone who understands is going to be helpful in the long run. 

Job Insecurity

Losing a job during COVID-19 has been at an all-time high. This is a tough place to consider that have not only jobs been lost, but also insurance. This takes a toll on anyone’s mental health, not knowing how we can get the help we need. 
 
The less money you make, the worse the impact is when it comes to losing a job. It is a scary place to be when you don’t know how you will afford to take care of your health. 
 
Take the time to research what you can do if you lose your job and insurance. While it isn’t ideal, COBRA is an option if you can afford it. Your mental health should come first when dealing with something as stressful as a pandemic.

Mental Health Check

It is essential to check in on your mental health and those around you. There are many signs to take in, and while some are subtle, others are loud and in your face. Here are some of the signs to look out for that may be signs you need to see a professional. 

  • Sleep or appetite changes: Are you sleeping more or less than usual? Are you eating normally, or do you find yourself eating more or less? 
  • Feeling disconnected: Are you finding yourself in the sense of unreality? 
  • Lacking motivation: Do you feel like you can’t do anything? Or can you not bring yourself to do everyday tasks? 
  • Mood changes: Is your mood fluctuating rapidly or drastically? 
  • Increased anxiety: Do you find yourself worrying more than not lately? 
  • Illogical thinking: Do you feel like the world is out to get you? 
  • Problems thinking: Are you struggling to find your thoughts? Is your memory getting worse? Can you not concentrate on anything? 
 
Those are just some of the signs that you may need to check in with a professional. Remember, your brain sometimes needs some extra help-- it can get "sick" just like any other part of your physical body. This pandemic is taking a toll on everyone, and you shouldn’t have to feel like you are going at it alone. 

It isn’t easy right now in the world. That is clear as day. If you or someone you know is struggling, reach out. It doesn’t mean you are weak or broken-- it means you courageous and you care. We are here to help. Your mental health matters.

Contact us to schedule an appointment with one of our licensed counselors today.
Written by Tia Kitchens for Banyan Tree Counseling & Wellness. Holding a degree in Psychology from Capella University, Tia is a writer with a passion for psychology and learning. In her free time she enjoys being with animals and hopes to work with therapy animals in the future. Ultimately, she aspires to spread awareness about the importance of mental health.
2 Comments

If Your Body Parts Could Talk...

8/17/2020

1 Comment

 

If your body parts could talk, what would they say?

I've used this worksheet with my own children, with students I've taught, and with clients, both children and adults. Teaching kids to "tune in" to their bodies is an essential skill and doesn't always come naturally.

There are so many benefits to learning this skill! One is emotional regulation-- kids who can listen to their body have an easier time managing and coping with their feelings, especially the really big ones, like anger, disappointment, fear, frustration, guilt, sadness.. .

They feel more capable, confident, have a more secure sense of self.

They have less behavioral problems, better social skills with peers, more empathy and supportive relationships...

It's not just a skill for kids., Adults benefit in similar ways, too, with overall mental stability, positive sense of self, solid relationships, increased career satisfaction. 

Take a moment today to tune inward,. Breathe in for 4 seconds, hold for 7, and slowly release for 8. Then scan your body and really listen to what each body part is telling you. Maybe some are silent, while others are screaming!

That's ok, no judgement.

All you have to do is listen.

Click to download the PDF to use at home.
if_body_parts_could_talk.pdf
File Size: 452 kb
File Type: pdf
Download File

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1 Comment

Sacred Space

10/5/2015

1 Comment

 
Some photos of Banyan Tree Counseling's space: Suite 203, 1348 Westgate Center Dr. Winston Salem, NC 27103. There is lots of growing, healing, thriving, playing, and difficult yet joyful work happening in this sacred space... Come join us!
Calling a therapist is often the best thing you can do for yourself, your child, or your family. Our fees are affordable and office is centrally located. We look forward to connecting with you. 
1 Comment

Handing Out Sticks

9/6/2015

0 Comments

 
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From: Boggle the Owl
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    Banyan Tree Counseling & Wellness

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    • Services
    • Psychiatry | Medication Management
    • ADHD
    • Autism Assessments >
      • Book ADOS-2 Assessment
    • Coaching
    • Couples >
      • Gail Herbert, LCMHCA - Couples & Relationship Therapist
      • Yubi Aranda Sandoval, LCMHCA - Couples & Relationship Therapist
      • Angel Joel, LCMHCA - Couples Therapist & UNCG PhD Candidate | Winston-Salem, NC
      • Jennifer Cui, LCSW, Couples & Relationship Therapist
    • Educational Consulting | Special Needs Advocacy >
      • Jordan Peterson, MEd, MA, LCMHCA - Educational Consultant & Advocate
    • Expressive Arts Therapy
    • OCD >
      • Alexa Brenner DeConne, LCSW
      • Hayley McCraw, LCMHCA
    • Groups & Webinars
    • Nutrition >
      • Executive Nutrition & Performance Coaching
    • Parenting + Family Therapy
    • Play Therapy for Children >
      • Alexa Brenner DeConne, LCSW
      • Gregoria Arreola-Meza, LCMHCA
      • Vika Hunter, LCMHCA
      • Yubi Aranda Sandoval, LCMHCA
    • Separation Counseling + Collaborative Parenting
    • Telehealth
    • Therapy for Teachers
    • Trauma
  • Meet Our Team
    • Meet the Whole Team!
    • Abby Olmstead
    • Adrienne Fisher
    • Alexa Brenner DeConne
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    • Andrea Miles
    • Angel Joel
    • Autumn Martin
    • Brittany Proxmire
    • Britt Stewart
    • Bru Ramirez >
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    • Christine Ridley
    • Emily Ortiz Badalamente
    • Emily Rodgers
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    • Gregoria Arreola-Meza >
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    • Hayley McCraw
    • Jared Brinkerhoff
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    • Leandra Ottman
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    • Maggie Latta-Milord
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