How do Psychiatric Medications Actually Work?

In this blog post we will explore how common psychiatric medications work. We will explore this by breaking down the common of class of medications used to treatment common psychiatric conditions. We will also explore the common myths associated with taking a psychiatric medication.

Medications for Depression

Antidepressants are a class of medication used to treat depression, anxiety, and other mental health conditions. They work by affecting the levels of certain chemicals in the brain called neurotransmitters. These chemicals are responsible for transmitting messages between nerve cells in the brain, and imbalances or deficiencies in certain neurotransmitters have been linked to mood disorders.

The most commonly targeted neurotransmitters by antidepressants are serotonin, norepinephrine, and dopamine. Here’s a breakdown of how antidepressants affect each of these neurotransmitters:

1. Serotonin: Many antidepressants work by increasing the availability of serotonin in the brain. Serotonin is a neurotransmitter that helps regulate mood, appetite, and sleep. Low levels of serotonin have been linked to depression and anxiety. Antidepressants that target serotonin include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and atypical antidepressants.

SSRIs work by blocking the reabsorption of serotonin in the brain, which allows more of the neurotransmitter to remain in the brain and enhance its effects. SNRIs work similarly to SSRIs, but also block the reabsorption of norepinephrine, another neurotransmitter that is involved in regulating mood.

1. Norepinephrine: Norepinephrine is another neurotransmitter that is involved in regulating mood, attention, and arousal. Antidepressants that target norepinephrine include SNRIs, tricyclic antidepressants (TCAs), and atypical antidepressants.

SNRIs work by blocking the reabsorption of both serotonin and norepinephrine, which allows more of these neurotransmitters to remain in the brain and enhance their effects. TCAs also work by blocking the reabsorption of norepinephrine and serotonin, but are not used as frequently as they have more side effects. Atypical antidepressants can also affect norepinephrine levels in the brain, but do not specifically target this neurotransmitter.

1. Dopamine: Dopamine is a neurotransmitter that is involved in regulating motivation, reward, and pleasure. Antidepressants that target dopamine include atypical antidepressants and monoamine oxidase inhibitors (MAOIs).

Atypical antidepressants can increase the availability of dopamine in the brain, which can help improve mood and motivation. MAOIs work by blocking an enzyme called monoamine oxidase, which breaks down neurotransmitters like dopamine, serotonin, and norepinephrine.

Antidepressants work by affecting the levels of certain neurotransmitters in the brain, including serotonin, norepinephrine, and dopamine. By enhancing the effects of these neurotransmitters, antidepressants can help improve mood, reduce anxiety, and manage other symptoms of mental health conditions. It is important to work with a healthcare provider to determine the right medication and dosage for you, as well as to monitor for potential side effects.

Medications for Focus

ADHD, or attention deficit hyperactivity disorder, is a neurodevelopmental disorder that affects both children and adults. It is characterized by symptoms such as difficulty concentrating, impulsivity, and hyperactivity. While behavioral therapy can be effective in managing these symptoms, medication is often prescribed as a first-line treatment for ADHD. The most commonly prescribed medications for ADHD are stimulants, which include medications like methylphenidate (Ritalin) and amphetamine (Adderall). Here’s how these medications work:

1. Stimulating the central nervous system: Stimulant medications work by increasing the levels of certain neurotransmitters in the brain, including dopamine and norepinephrine. These neurotransmitters are involved in regulating attention, motivation, and arousal. By increasing the levels of these neurotransmitters, stimulants can help improve concentration and reduce impulsivity and hyperactivity.

2. Improving brain function: ADHD is associated with lower levels of activity in certain parts of the brain that are involved in regulating attention and controlling impulses. Stimulant medications can help increase activity in these regions, which can improve cognitive function and help individuals with ADHD focus better.

3. Adjusting brain chemistry: While the exact mechanism of how stimulants work is not completely understood, it is thought that they may help adjust the balance of neurotransmitters in the brain. This can help individuals with ADHD feel more alert and focused, while also reducing their impulsivity and hyperactivity.

It is important to note that while stimulant medications can be effective in managing symptoms of ADHD, they do come with potential side effects. These can include appetite suppression, difficulty sleeping, and increased heart rate and blood pressure. Additionally, stimulants can be habit-forming, so it is important to work with a healthcare provider to determine the right medication and dosage for you, as well as to monitor for potential side effects. Non-stimulant medications are also available for ADHD, and work by affecting different neurotransmitters in the brain. These include medications like atomoxetine (Strattera) and guanfacine (Intuniv).

Medications for Mood Stabilization

Mood stabilizers are a class of medication commonly used to treat bipolar disorder, a mental health condition characterized by episodes of mania and depression. Mood stabilizers work by regulating the levels of certain chemicals in the brain, including neurotransmitters and ions, that play a role in mood regulation. Here are some of the ways in which mood stabilizers work:

1. Modulating neurotransmitters: Neurotransmitters are chemicals in the brain that transmit signals between nerve cells. Abnormalities in neurotransmitter levels have been linked to mood disorders, including bipolar disorder. Mood stabilizers work by modulating the levels of neurotransmitters such as serotonin, dopamine, and norepinephrine, which are involved in regulating mood, motivation, and pleasure.

2. Regulating ion channels: Mood stabilizers can also work by regulating ion channels in the brain, specifically those that control the flow of ions such as sodium, potassium, and calcium. This can help to stabilize the electrical activity in the brain, which can help to improve mood and reduce symptoms of mania and depression.

3. Protecting neurons: Mood stabilizers can also help to protect neurons in the brain from damage and cell death. This is thought to be due to their ability to increase the production of certain proteins that promote neuronal growth and survival.

4. Reducing inflammation: Inflammation has been linked to mood disorders such as bipolar disorder. Mood stabilizers can help to reduce inflammation in the brain, which may contribute to their ability to improve mood and reduce symptoms of mania and depression.

Examples of mood stabilizers include lithium, valproic acid, carbamazepine, and lamotrigine. These medications are often used in combination with other medications, such as antipsychotics or antidepressants, to help manage symptoms of bipolar disorder. It is important to work with a healthcare provider to determine the right medication and dosage for you, as well as to monitor for potential side effects.

Greg Roussett NP is a board certified psychiatric mental health nurse practitioner offering treatment for anxiety, depression, and mood disorders. He is a cognitive behavioral therapist, psychopharmacologist (prescribing practices similar to a psychiatrist ), and offers a combination of psychotherapy and medication management to individuals experiencing depression. His office is located in Rockridge in Oakland, CA and provides services across the bay area to those residing in cities inclusive of Piedmont, Lafayette, Walnut Creek, Berkeley, and San Francisco. One of his primary specialties is psychopharmacology. To book a free consultation, click here.

Common Myths Associated with Psychiatric Medications

Psychiatric medications have long been the subject of controversy and stigma. Some people are hesitant to take them due to fears of dependency, side effects, or the societal stigma that mental health challenges are not "real" illnesses. However, recent research has shown that psychiatric medications can be a valuable tool in treating mental health disorders, and that many of the fears associated with them are unfounded.

What are some common misconceptions about psychiatric medications?

• Myth 1 : Psychiatric medications are only for people with severe mental health disorders. Reality: Many people with mild to moderate mental health conditions can benefit from medications in efforts to reach their full potential.

• Myth 2: Psychiatric medications are addictive. Reality: While some medications may cause dependence or withdrawal symptoms, the risk of addiction is relatively low and not all categories of psychiatric medications have any risk associated with physiologic or psychological dependence.

• Myth 3: Psychiatric medications will change your personality or make you a different person. Reality: Medications work to alleviate symptoms of mental health disorders, but they do not fundamentally change who you are as a person.

So what are the benefits of psychiatric medications?

• Improved quality of life: For many people, medications can alleviate symptoms of mental health disorders, making it easier to manage daily activities, work, and relationships.

• Reduced risk of self-harm or suicide: Medications have been shown to reduce the risk of self-harm and suicide in people with major depressive disorder and for those who experience suicidal ideation.

• Better outcomes in therapy: Medications can make it easier to engage in therapy, which can lead to better outcomes in the effort you are putting forth in psychotherapy.

While it's true that some medications may have side effects, the benefits of properly prescribed and monitored medications may outweigh the risks. It's important to work with a psychiatric or psychiatric nurse practitioner you trust to determine the best course of treatment for you.

What are the Response Rates of Psychiatric Medications?

Depression:

• Approximately 50-60% of people with depression will respond to antidepressant medication.

• In cases where the first medication does not work, up to 30% of people will respond to a second medication.

• The effectiveness of medication can also vary depending on the severity of the depression.

Anxiety:

• Approximately 60-80% of people with anxiety will respond to medication.

Bipolar Disorder:

• Approximately 60-70% of people with bipolar disorder will respond to medication.

• However, finding the right medication and dosage can be more challenging than with other conditions.

Attention Deficit Hyperactivity Disorder (ADHD)

Approximately 70-80% of children and adults will have a significant improvement in ability to focus with a reduction in hyperactivity symptoms. Both stimulants and non-stimulants can be taken to treat ADHD.

Schizophrenia:

• Approximately 60-80% of people with schizophrenia will respond to medication.

• However, the effectiveness of medication can vary widely depending on the individual's symptoms and subtype of schizophrenia.

It's also worth noting that the stigma associated with mental health disorders and their treatment is gradually decreasing. More people are opening up about their experiences and advocating for better access to care, which will hopefully lead to more acceptance and understanding in the future.

The stigma associated with psychiatric medications is often unfounded, and recent research shows that they can be a valuable tool in treating mental health disorders. It's important to educate ourselves and others about the benefits and risks of medication, and to work with qualified professionals to determine the best course of treatment for each individual. For more resources on how to send stigma associated with mental health, you can visit the Carter Center.

Greg Roussett is a board certified psychiatric mental health nurse practitioner offering treatment for ADHD, panic disorder, depression, other mood disorders, and insomnia. He is a cognitive behavioral therapist, psychopharmacologist (prescribing practices similar to a psychiatrist ), and offers a combination of psychotherapy and medication management to individuals experiencing depression. His office is located in Rockridge in Oakland, CA and provides services across the bay area to those residing in cities inclusive of Piedmont, Lafayette, Walnut Creek, Berkeley, and San Francisco. One of his primary specialties is working with those looking for help with bipolar disorder, other mood disorders, insomnia, panic disorder, and depression. Book a complimentary consultation today here.

How to Find the Right Psychiatrist / Psychiatric Mental Health Nurse Practitioner

Mental health is an essential aspect of overall health, and seeking help from a psychiatrist is a significant step towards improving one's mental well-being. However, finding the right psychiatrist can be a challenging task. With so many options available, it can be overwhelming to know where to begin. In this blog post, we will discuss how to find the right fit psychiatrist for you.

1. Determine your needs

The first step in finding the right fit psychiatrist is to determine your needs. Are you seeking help for a specific condition, such as depression or anxiety, or are you looking for general mental health support? Understanding your needs can help you narrow down your search for a psychiatrist who specializes in treating your specific condition or has experience with the type of support you require.

1. Ask for referrals

Talking to your primary care physician, family members, or friends can be a good starting point when seeking a referral for a psychiatrist. They may know someone who has had positive experiences with a psychiatrist and can recommend them. However, keep in mind that their experience may not necessarily reflect yours, and it's essential to do your research before making a final decision. Another place to find referrals is Psychology Today. You can search by zip code.

1. Check credentials

It's crucial to ensure that the psychiatrist you choose is licensed and has the proper credentials. You can do this by checking with your state's licensing board or searching for the psychiatrist's name on the American Psychiatric Association's website. This will help you ensure that the psychiatrist is qualified to provide mental health treatment.

1. Consider their experience

When choosing a psychiatrist, it's essential to consider their experience. Some psychiatrists specialize in treating specific conditions, such as eating disorders or addiction, while others may have experience working with a broader range of mental health concerns. Consider their experience and how it aligns with your needs.

1. Look for compatibility

Compatibility is crucial when it comes to finding the right psychiatrist. You want to choose someone who you feel comfortable talking to and who understands your concerns. It's essential to feel heard and understood during your sessions. To determine compatibility, you may want to schedule a consultation or initial appointment to get a sense of their approach and communication style.

1. Consider their approach to treatment

There are different approaches to mental health treatment, such as cognitive-behavioral therapy (CBT), psychoanalysis, and medication management. Consider the psychiatrist's approach to treatment and whether it aligns with your preferences and needs. For example, if you prefer a more holistic approach, you may want to choose a psychiatrist who also offers alternative treatments such as mindfulness-based therapy or acupuncture.

1. Evaluate communication

Effective communication between you and your psychiatrist is critical to the success of your treatment. Ensure that the psychiatrist is someone who listens attentively and provides clear and concise information about your diagnosis and treatment plan. You want to feel comfortable asking questions and expressing concerns during your sessions.

1. Check availability

Another important factor to consider is the psychiatrist's availability. Ensure that they have the flexibility to accommodate your schedule and that you can book appointments at a convenient time. Also, consider the frequency of appointments and whether it aligns with your needs.

1. Review patient feedback

Reading patient reviews and feedback can provide valuable insight into the psychiatrist's approach and effectiveness. Look for reviews on their website or other reputable platforms, such as Healthgrades or Zocdoc. However, keep in mind that reviews should be taken with a grain of salt and that individual experiences may vary.

1. Evaluate cost and insurance coverage

Cost and insurance coverage can be significant factors when choosing a psychiatrist. Consider the cost of sessions and whether they fit within your budget.

Remember, finding the right fit in a psychiatrist can take time. I hope that this process can ease that transition to find best fit!

Greg Roussett is a board certified psychiatric mental health nurse practitioner offering treatment for anxiety and insomnia. He is a cognitive behavioral therapist, psychopharmacologist (prescribing practices similar to a psychiatrist ), and offers a combination of psychotherapy and medication management to individuals experiencing depression. His office is located in Rockridge in Oakland, CA and provides services across the bay area to those residing in cities inclusive of Piedmont, Lafayette, Walnut Creek, Berkeley, and San Francisco. One of his primary specialties is working with those looking for help with depression, anxiety, and sleep disturbances. Book a complimentary consultation today here.

What is the Link Between Insomnia and Depression?

Insomnia and depression are two common mental health issues that often co-occur. In fact, insomnia is a common symptom of depression, and individuals with insomnia are more likely to develop depression. The link between insomnia and depression is complex and bidirectional, with each condition contributing to and exacerbating the other.

Insomnia is defined as difficulty falling asleep or staying asleep, or waking up too early and being unable to fall back asleep. Insomnia can be caused by a variety of factors, including stress, anxiety, medications, and medical conditions. Insomnia can also be a symptom of depression, and individuals with depression are more likely to experience insomnia than those without depression.

Depression is a psychiatric disorder characterized by persistent feelings of sadness, hopelessness, and worthlessness, as well as changes in appetite, sleep, and energy levels. Depression can be caused by a combination of genetic, biological, environmental, and psychological factors. Insomnia is a common symptom of depression, with up to 90% of individuals with depression experiencing sleep disturbances.

The relationship between insomnia and depression is bidirectional, with each condition contributing to and exacerbating the other. For example, insomnia can increase the risk of developing depression by disrupting the body's natural circadian rhythm and reducing the amount of restorative sleep. Chronic insomnia can also increase the risk of developing other health problems, such as heart disease, diabetes, and obesity, which can contribute to depression.

Similarly, depression can worsen insomnia by causing changes in the body's levels of hormones and neurotransmitters that regulate sleep. Individuals with depression may also experience racing thoughts, anxiety, and other symptoms that make it difficult to fall asleep or stay asleep. Chronic insomnia can also increase the risk of developing other health problems, such as heart disease, diabetes, and obesity, which can contribute to depression.

Treatment for both insomnia and depression often involves a combination of therapy, medication, and lifestyle changes. Therapy options for depression may include cognitive-behavioral therapy (CBT), which focuses on changing negative thought patterns and behaviors that contribute to depression, and interpersonal therapy (IPT), which focuses on improving interpersonal relationships. Therapy options for insomnia may include sleep hygiene education, which focuses on promoting healthy sleep habits, and cognitive-behavioral therapy for insomnia (CBT-I), which focuses on changing negative thoughts and behaviors that contribute to insomnia.

Medication can also be effective in treating both insomnia and depression. Antidepressant medications can help regulate the levels of neurotransmitters in the brain that regulate mood, which can improve symptoms of depression and insomnia. Sleep aids, such as benzodiazepines and non-benzodiazepine hypnotics, can also be effective in treating insomnia, but they should be used with caution due to the risk of dependence and other side effects.

Lifestyle changes, such as regular exercise, a healthy diet, and stress reduction techniques, can also be effective in treating both insomnia and depression. Regular exercise can improve sleep quality and mood, while a healthy diet can provide the nutrients the body needs to regulate mood and energy levels. Stress reduction techniques, such as meditation and relaxation exercises, can also help improve sleep and mood.

For more information on how to treat insomnia and depression, you may find this workbook helpful: Quiet Your Mind and Get to Sleep: Solutions to Insomnia for Those with Depression, Anxiety, or Chronic Pain

If either insomnia or depression are concerns you have struggled with, speak to your therapist or reach out to a psychiatry provider to explore treatment options.

Be Well and Sleep Well,

Greg Roussett NP

Greg Roussett is a board certified psychiatric mental health nurse practitioner offering treatment for depression. He is a cognitive behavioral therapist, psychopharmacologist, and offers a combination of psychotherapy and medication management to individuals experiencing depression. His office is located in Rockridge in Oakland, CA. One of his primary specialities is working with those looking for help with depression, anxiety, and sleep disturbances. Book a complimentary consultation today here.