Wednesday, March 24, 2021

How to approach pharmacological solutions for mental health


When thinking about pharmacological solutions for folks with mood disorders, I tend to think in terms of “zooming in” and “zooming out” problems rather the the usual “chemical imbalance” theory. 

For folks with excessive zooming in to thoughts and feelings, I tend to think about SSRI’s, SNRIs, Antidepressants in general, Quetiapine, Anitipsychotics etc as “numbing agents” or “detaching agents”.  Interestingly, a few years ago at Griffith Uni, they trialed oral Ketamine for severe depression, which is very “detaching” in action. 

For folks with excessive zooming out from thoughts and feelings, some of the above may make it worse leading to more “dissociative” side effects, so I would use it with a lot of caution. 

One can view ADHD as a lack of zooming in OR “loose anchoring” to various thoughts and feelings, and hence, fleeting from one thought/idea to another perhaps. Hence a “zooming in” agent like Dexamphetamine seems to make sense. 

The challenge is, most mood disorders are not simply a zooming in problem, or a zooming out problem.  Often there is a mix. 

Some people have both extreme zooming in, and extreme zooming out problems, and a single drug is not going to be the whole answer unfortunately. 

There’s no such thing as a “zooming in and zooming out drug according to context” is there?  Not yet anyway...

Hence, many will have to do the hard work of learning how to zoom out on the things that don’t matter, or matter but can’t control, and zoom into the things that truly matter, or things that they can control. 

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