Psychotropic medications and human functioning.

There is a very good book entitled “The Social Worker and Psychotropic Medication” by Kia Bentley, Shannon Hughes, and Joseph Walsh which attempts to cover what Social Workers should know about psychotropic medications.

When I graduated with my MSW in 1972 psychotropic medications had not yet been formulated and used in the treatment of symptoms of mental health problems. Psychodynamic oriented psychotherapies and custodial care were the predominant treatment strategies. The bio-psycho-social model of assessing problems in functioning was not described until 1977 by Dr. George Engel at the University Of Rochester. The Social Work knowledge base has always focused on what Social Workers called the “person in situation” model. 

Over the course of my 58 year career as a Psychiatric Social Worker I have learned about psychotropic medications and their effects on human functioning from “on the job training” and reading journal articles and books. It is interesting how the predominant treatment of symptoms of mental health problems has shifted from the psychological to the pharmacological. Some of this shift has been beneficial and some of it has been harmful. A good Social Worker is aware and educated about both.

The key question from a Social Work perspective is “How do psychotropic medications affect human functioning?” A corollary question is “what professional discourse is most helpful in assessing how psychotropic medications enhance or detract from human functioning?”

Monitoring effects of psychotropic medications.

As a Psychiatric Social Worker, and not a physician, I still spend a lot of time and energy discussing with my clients their medications, especially their psychotropic ones with them. 

Knowing about the power of the placebo effect I am very cognizant and curious about what my clients think about their medications. Do they think they will help, are skeptical, or have mixed feelings? Will they be compliant and take them as prescribed or “forget” to take them or abuse them?

There is a fine line between medical and psychological effects of taking medications. Many of my clients expect medications to be a “silver bullet” and a “magical key” to ameliorate their symptoms and improve their experience of their quality of life.

Whether medications “work” has as much to do with psychological expectations as well as the pharmacological actions. Whose job is it to monitor the efficacy of the use of medications: the prescriber, the psychotherapist or both? 

Throughout my career as a Psychiatric Social Worker I have increasingly found that it is my job if I want to help my clients improve their functioning. I find myself surprised at the lack of supervision by the prescriber on the psychological dynamics of prescribing medications. They don’t seem to have the time for it or an interest or competence in this aspect of their patients' treatment. They leave it up to the psychotherapist if the patient has one.

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New medication for anxiety about drug prices

Is Zoloft a good medication for depressive bipolar symptoms?

Is Zoloft a good medication for bipolar disorder?

Zoloft can help manage the symptoms of depression for people with bipolar disorder. However, a mood stabilizing drug should be considered the basic treatment with Zoloft added to treat the depressive symptoms during a depressive episode.

Zoloft is one of the drugs in the SSRI category of which there are several. These SSRI drugs can be used to treat symptoms of depression other than the depressed episode of bipolar disorder.

The diagnosis of bipolar disorder has entered the popular culture and most of the people I see who are suffering from depression do not have bipolar disorder. Their depression is caused by other circumstances and factors.

You can read more about Zoloft and bipolar by clicking here.