Bio-Psycho-Social-Spiritual influences in emotion and behavior
1. What is One – Dimensional Treatment?
Many times when seeking help for emotional problems like depression and anxiety, we are under the impression that these issues are due to a chemical imbalance. Advertising campaigns, primary care physicians, classroom “experts,” and even trusted friends may contribute to the opinion that when emotional problems get serious, the best or most effective thing to do is get a prescription for medication.
Psychotropic medication is sometimes regarded as the mental health “antibiotic,” with the ability to bring about miraculous relief. To be fair, many who have taken medication feel like they have been helped. Many cite that antidepressants or other types of medication have been the solution, where all other efforts have failed. For those who have experienced relief and want to continue this approach, we wish them well.
Unfortunately, many who have embraced a “medication only” treatment approach do not experience long term relief from their emotional problems. The common view of emotional problems has been heavily influenced with research within neurosciences that hope to prove that there is a biological or genetic basis for mental health disorders. However, there is to date no conclusive evidence of a biological marker that connects mental disorders to the brain.
2. What does research reveal?
Many in the field of neuroscience and psychiatry have concluded that emotional disorders are not primarily due to brain-based chemical levels. Elliot Valenstein (1998), a professor of neuroscience at the University of Michigan concluded, “The evidence does not support any of the biochemical theories of mental illness.” Joseph Glenmullen (2000), instructor of psychiatry at Harvard Medical Center also states, “in every instance where such a [chemical] imbalance was thought to be found, it was later proved to be false.” Ronald Pies (2011) writes in Psychiatric Times, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend, never a theory seriously propounded by well-informed psychiatrists.”
An analysis of 52 studies (with 3,623 patients) was done to compare people treated with medication only versus those who also received counseling. The impact of treatment for those receiving the combined approach was twice that of the “medication only” group. The study concluded that counseling and medication together were significantly more effective for major depression, panic disorder, and obsessive-compulsive disorder. In addition, the superior effects of this comprehensive approach had lasted for two years after treatment when follow-up was conducted with the participants.
3. The Multidimensional Approach: Bio-Psycho-Social-Spiritual
At CCA, we seek the best interventions for our patients, including psychiatric interventions when needed. Whether struggling with depression, anxiety, attention deficit disorder, trauma or even major mental illness, we believe the bio-psycho-social-spiritual approach is the best practice.
Many other professional organizations agree with this approach. The American Psychiatric Association and the National Committee for Quality Assurance now specify that psychosocial care is recommended as a first line of treatment for children and adolescents. Many doctors are becoming more cautious of the dangers of overprescribing psychiatric and pain medications.
People are multidimensional. We function physically, psychologically, socially, and spiritually. All of these aspects are part of how we experience life and influence resulting emotional patterns. As we experience painful symptoms, this may indicate that more than one area of our life needs attention. Don’t settle for a medication only approach. Comprehensive treatment addresses the multidimensional nature of emotional problems.
Reflection Point
1. Biological Influences:
What are the physical health events in my life that I suspect may contribute to my emotional well-being?
2. Psychological influences:
What are notable patterns of thoughts (hope, fears, expectations), and emotional responses that have developed over my lifespan?
3. Social Influences:
What are the relationships (family, friend, intimate) patterns in my life? Who are the 5 key people in my life and how have they affected my emotional well-being? What are the 5 key peer or social events that have occurred in my history that affect the way I see myself today?
4. Spiritual Influences:
What are the 5 key faith experiences that you have had in your life? How have these events shaped your emotional well-being?
References:
Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds, C. F. (2014). Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry, 13(1), 56-67. http://doi.org/10.1002/wps.20089
Glenmullen, J. (2000). Prozac Backlash. New York: Simon & Schuster
Pies, R. W. (2011, July 11). Psychiatry’s new brain-mind and the legend of the “chemical imbalance”. Retrieved from Psychiatric Times: http://www.psychiatrictimes.com/blogs/ psychiatry-new-brain-mind-and-legend-chemical-imbalance
Valenstein, W. (1998). Blaming the brain. New York: The Free Press.
