Rise of Opiate Use Is Not the Answer to Relive Stress

By Eve Pearce

According to figures from the Centers for Disease Control and Prevention, in 2010 12 million people in the US used opiate drugs for purposes other than pain relief.

Abuse of prescription drugs such as morphine, oxycodone and codeine is a far bigger problem than use of heroin and many people are turning to opiates as a way to help them deal with stress. Prescription opiates are able to do this, as although they take longer to reach the brain than injected heroin, once there they exert similar effects. In the central nervous system these drugs bind to opioid receptors which not only aids pain relief but triggers feelings of pleasure, calm and well-being as well. However, they are not the answer for stress relief, as their use is associated with a number of adverse consequences. Only by addressing the root of the problem and developing appropriate strategies can stress be safely and successfully managed. Continue reading →

Shall I Begin Psychiatry or Counseling?

While often misidentified as the same, psychiatry and counseling are actually quite different. To begin, let me try and differentiate psychiatry from counseling.

Counseling is traditionally focused on the practice of “talk therapy,” or “psychotherapy.” That is, the process of working through problem/life issues by talking them through with a professional counselor. Such a professional will help clients to process their emotions, thoughts, and behaviors, and will help clients to build strategies for improving their moods, lives and relationships.

Psychiatry (with some exceptions) is generally focused on helping individuals to overcome specific problem issues with medication.

Medication in Psychiatry Treatment

Psychiatric medications get their fair share of criticism. Critics, from licensed mental health professionals to Tom Cruise, have voiced their distrust and displeasure with psychiatric medications. Some claim that psychiatric meds are over prescribed, such as in the case of medicating to treat ADHD (Attention Deficit Hyperactivity Disorder) in children. Others claim that psychiatric medications are unhealthy, or even addictive. Still, others suggest that psychiatric medications are no more effective than a placebo!

Criticisms are so widespread and diverse that, in fact, it is logically impossible for them all to be true (a medication can’t be both highly-addictive and a placebo).

A Balanced Approach to Psychiatry

Many persons battling with life challenges, such as anxiety and depression, do not require medication. Even many psychiatrists will attest that it’s best practice for a person to try and work through such issues with counseling, and without psychiatric meds (and, to blur things a little, some psychiatrists will provide counseling or “talk therapy” in addition to psychiatric services).

However, medications are helpful in some situations. For instance, medications may be helpful in the case of a chronic problem, one in which counseling has been tried but hasn’t provided adequate relief: Chronic depression or unmanageable symptoms of ADHD, OCD (Obsessive Compulsive Disorder), or serious mental illnesses are just a few issues that can greatly benefit from psychiatry.

Second, medications can be helpful during the acute onset of severe symptoms; very commonly depression or anxiety. For instance, medication can be helpful after the loss of a loved one, or immediately following a personal tragedy or trauma, or during instances when a client/patient is so distraught that he or she cannot participate in counseling, and/or function in his or her daily life. At times like these, psychiatric medications (such as anti-depressants and anti-anxiety meds) can be of great help and relief to a client.

Getting Started

We hope this article was helpful to you, and helped you to learn a little more about psychiatry and counseling, and what differentiates the two. Buck Black LCSW wrote a good article titled “Medication Vs. Counseling,” which is available in this blog. Mr. Black also provides Online Counseling to clients across the USA. This article was written by staff writers at Thrive Boston Counseling, 872 Massachusetts Ave, Ste 2-2, Cambridge, MA 02139, a counseling practice that also offers psychiatry services. Learn more at: http://www.thriveboston.com/boston-psychiatry.html

What to Expect from Counseling

Many people are afraid to come to a counseling session because they find it too intimidating. I can’t blame them. Heck, I find it difficult to go to the doctor when I am feeling sick and can’t go to work. So, it is a new experience and often provokes some natural anxiety.

Your first session is the hardest and it gets easier from there!

Here are some of the questions I’ve been asked:

* Am I any less of a man for coming to counseling?
No. If counseling weren’t manly, I wouldn’t be doing it! I’ll tell you that its much more manly to deal with your problems, compared to being too proud and trying to handle everything yourself. This way of thinking usually makes things a lot worse.

* Are you trying to find a mental illness?
No, I’m not. I want to talk with you in order to gain an understanding of both the problems you want to work on, where those problems are coming from, and what is going RIGHT in on your life. Yes, its important to talk about the successes in your life and not just dwell on the negatives.

* Will you want to spend all the time discussing my childhood.
No, I want to help you work on what you came here to address. I find it to usually be a waste of time to have an emphasis on the past. It is over and done with. There may be times that it needs to be understood, but having a primary focus on the past is often frustrating on the client and does little good. Lets focus on the here and now, which will likely help you feel better quickly!

* Do I have to be mentally ill in order to go to Counseling?
What? No. Counseling is to help people work though problems. If you had to be mentally ill to have a problem, then we’d all be crazy as loons. There is no shame in seeking an outsider’s view on a problem you have. Actually, its a sign of good mental hygiene!

* How long will this take? Will I be in therapy for years?
Most people finish up their counseling sessions within 10 sessions or less. This is because we focus on the here and now. I also give homework assignments, so people can get more value out of their counseling. That is, they are able to work on their counseling when they are outside my office. This means that you will obtain quicker results and have less money invested. If you happen to take more than 10 sessions, don’t worry about it. It goes back to how everybody is different and not everyone moves at the same pace.

* Are you a mind-reader?
No. I wish I was! You’ll have to tell me why you are coming in and a little bit about yourself. 🙂

* Is this confidential?
Yes. What we discuss does not go beyond you and I, unless you give written permission for me to disclose information about your sessions, such as if you are referred by probation, a lawyer, and so on. The only time I can tell anyone your business is if you are going to kill yourself, you are going to hurt someone, there is child abuse, or a judge orders me to disclose your information.

* Is this anonymous?
No. Others may see you walk into my office. So, you could be seen. No one would know your business, though. If you feel that you could not risk being see at my office, some coaching via telephone or email is an option. That is pretty anonymous.

* What types of counseling do you do?
I specialize in anger management, anxiety, and sexuality of various types (such as transgender, sexual orientation, sexual dysfunction, sexual harassment, sexual addiction, and sexual questions in general). However, I also work with depression, bipolar disorder and a variety of issues. I do individual, group, family, and couples counseling.

* Do I need medication?
Counseling is the primary focus. A high number of people get better by therapy alone. Changing your thinking and your behavior usually is enough for people to return to functional lives. However, if therapy is not working, then we will discuss referring you to have a medication evaluation. Medication alone often masks symptoms and does not get at the root of the problem.

* Will you fix me?
No, I will not. However, I will help you fix yourself. I can give you ideas, you can bounce things off me, we can work together to find solutions. However, I cannot make things better for you. Remember, you are the one who needs to do the hard work and I can help.

* What is your primary focus on therapy?
I want to talk about what is on your mind. You are the one that guides the conversation. I can provide some information and direction and information, if needed. However, I really want you to be the one who is running the show.

Do you have any additional questions that I have not answered? Leave a comment and I’ll respond.

Medication vs. Counseling

There is seldom a day that goes past where I don’t have a client who comes to me with a great concern that their medications are not working. Often, when I ask what they are doing for themselves, they develop a rather puzzled look on their face. Most of the time, they say that they just wait for the medication to take effect.

More and more, society is putting focus on medications while ignoring how people can change their mood and overall health with a few behavior changes. It is very easy to blame a chemical imbalance in the brain when one has a low and negative mood, or when a person does not have enough motivation to get a job or leave the house. When people have these problems, an overwhelming number of them focus on the perceived need for medications and then are displeased to find that these medications often do not fix the problem. Really, I can’t blame a person for feeling that they should take a medication when they have such a problem. We have a society that has a huge focus on medications and there are frequent prescription drug commercials on TV.

I want everyone to realize there is a need for medication in some cases. The current prescription medications are helpful for many people and lets them function. I think it is important to point out that people who take meds also need to take care of their mental health by looking at their thinking, how they interact with others, and their level of physical activity, as well as other lifestyle factors.

If people continue to place themselves in stressful environments, isolate themselves, have a great deal of negative thinking, and get little exercise, they will likely have minimal benefit from a medication only approach. How can one attain significant changes if they do not change their thinking and behaviors?

What does counseling have to offer that medication does not? Well, medication helps to decrease symptoms so that a person can function. Counseling helps a person identify the causes of these symptoms. Often, these causes are a result of some sort of a relationship problem. Sometimes feelings of depression and anger are stemming from ourselves because we concentrate on negative things and continue to be ourselves up. How can a person feel good if there is continued negative self talk and continued relationship problems which cause very stressful environments?

I want everyone to realize that there are chemical and behavioral (thinking and doing) sides to our problems. Not everyone needs medication. Many people can manage their emotions by participating in therapy and changing their thinking and behaviors.

I urge everyone to first give therapy a try. If that doesn’t work, or has little success, then there may be a need for medication in addition to therapy.

Prescription Sex Enhancing Drugs

Drugs = better sex?? When we watch TV, we get this message. If we subscribe to much of the popular culture, we get this message. Is it true? Well, I don’t subscribe to this philosophy. Of course drugs can enhance sex, but it often does not work and certainly has its drawbacks.

I see many people in my office who are having some sort of sex problem…like lack of desire, impotence, or just boring sex. Often, they have turned to prescription sex enhancing drugs to help them. Usually, they are quite surprised when these drugs do not work as advertised. Other times, I get couples who use illegal drugs to enhance their sexual experiences. Again, they end up falling short. It might work fantastically at first and then quickly lose its effects. Many drugs, especially cocaine, end up having a negative effect on the sex life after time.

So you may be wondering why I say these drugs often do not work. If there is simply a physical problem, then these sex-enhancing drugs often do the trick. Here is the kicker—Many people rely on drugs to help their sex life because they have emotional and communication difficulties that make sex very difficult. No matter the issue, if a person relies on drugs to help them with a problem with communicating, thinking, or behavior, it will not work unless they also make changes in their attitude and lifestyle. People who rely on drugs alone often have little benefit.

I want everyone who is using a drug to enhance their sex life to really look at why they are choosing this as a “remedy.” Is it a result of difficulty talking about sex, feelings of guilt or nervousness during sex, maybe it is the fact that you are angry with your partner and this is making it difficult to perform. Would you believe that some people take sex-enhancing drugs because they have so much anger towards their partner that they are unable to become aroused without chemical help? I know this exists because I have talked with several who admit this problem.

I am urging everyone who uses these sexual enhancing drugs to think about the emotional side of sex and ask themselves if this is impacting the actual mechanics of sex. Of course, if there is a physical or hormonal problem causing sexual difficulty, then sex-enhancing drugs are often beneficial.