Episode #237 - The Balm of Gilead

Is Medication really right for me?  What to consider and what medications are available?

Transcript

Episode #237 – Balm of Gilead.  I am your host Damon Socha.  The Balm of Gilead is mentioned just a few times in the Old and New Testament combined.  It was a body perfume or healing salve, prized for is curative nature.  Whether or not it had true healing powers is not entirely known.  It appears that it was used mostly for wounds and skin conditions.  But it was well-known enough that it became included in the sacred literature as a figure of the healing power of the Savior.  Is there no Balm in Gilead? States the scripture.

Whether we admit it or not we as human beings tend to look for our Balm of Gilead anytime we start to feel run down, sick, or in pain.  When our body is in pain, our mind naturally seeks out relief.  Depending upon the level of pain and suffering, the amount of time it has been experienced, and the intensity it exhibits, the desire to seek our balm increases dramatically.  It can become an all-consuming quest to seek out the desired release from pain and also regain our happiness.  While these two events, relief from pain and the feeling of happiness, most often come simultaneously as we find relief, they do not necessarily coexist.  One can find relief without finding happiness or joy.  And one can have joy without release from pain.  

Today I want to discuss a subject that I have somewhat avoided for a time.  Not that I shy away from any serious discussion, it just has not felt right until now.  Physical medications, such as this Balm of Gilead, have been around for millennia.  Medicine in the physical sense of healing from roots, plants, and various organic chemistry has been a part of life since the world began and man began to bleed.  Physical medications are noted in every book of scripture, including the Old and New Testaments, The Book of Mormon and the Doctrine and Covenants.  In the modern world we are surrounded by physical medications and a plethora of knowledge as to what works and what does not.  All you have to do is open the internet and search mental health medications and you will have far more than you could ever read or study at your finger tips.

For my purposes today, I am going to define medication as any chemical substance that is taken in quantities well above what one would get from a normal diet.  This includes what we refer to as pharmaceuticals and naturopathic medicine.  Essentially naturopathic medication deals with whole plants or extracts that are typically not regulated by the FDA and pharmaceuticals are refined organic substances requiring a doctor’s authorization and oversite.  Although there is bleed over into each definition.  I am not here to argue that definition today as that isn’t my purpose.  Nor am I going to talk about or discuss the arguments between the two types of medications and what is more beneficial.  My intent today is to look at medications as a whole through what I and many others have experienced and to look at when medication may be necessary and maybe when it is not.  I realize that opinions vary greatly about what medications to take and what provides for the greatest benefit.  And I am not going to promote any particular type or method of medication today.

Medication should be a personal and companion decision when it comes to health care in general and more especially when it comes to medications that deal with brain chemistry.  I am not here to tell you the medication you should take but to provide the options that exist and to discuss what makes sense for each person and their family and close associated.  When you deal with mental health issues it is important to include those around you when considering medications, at least those who understand your condition.  The purpose is important.  Because emotions are what we see as reality, when those emotions change we tend also to change with them without noticing those changes.  Meaning we need someone else to evaluated how we are responding to the medication.  More than once I have heard a spouse or parent say that their relationship is significantly different and they have notice significant changes in the life of the afflicted person.  While the afflicted person has stated that they don’t really feel much of a difference but they do notice the side effects.  More often the side effects are physical and so they are easily noticed.  Our emotions change regularly so the emotional change needs to be large for us to feel a difference.  So we tend to notice the side effects and not the emotional changes.  But those around us who know us do notice those changes.  

We also tend to expect medications to entirely work their magic.  Meaning we want to returned to our former days of happiness and freedom from pain.  We want the medication to remove the damage emotionally and physically and to return us to a normal emotional state.  While we don’t say this out loud it is an important concept to remember when dealing with mental health medications.  Medications are rarely a cure.  Most often they treat symptoms of the illness and not the origin of the illness.  I have never found a medication yet that has returned me to my former days and emotions.  It is also important to note that medications rarely cover the entirety of our mental health problems.  Most often they take away the rogue waves and stirred up seas.  If you look at the ocean and the waves that occur during a storm we note that the waves have peaks and valleys and often this is similar to our emotions during mental health episodes.  The medication’s purpose is not to make a glassy sea of water.  The intent is to reduce the high and the low of the emotional swings or to reduce the height and intensity of the illness.  This would be somewhat akin to cutting the top and bottom off the waves.  This doesn’t mean that waves of emotion don’t exist, it means that we have reduced the intensity.  The amount of reduction depends upon a host of variables that we will discuss along with medications themselves.  You are still going to experience and continue to feel mental health issues with medication.  That is reality.  Once you recognize this truth, the medication experience will be far more beneficial and helpful.  When we go into the doctor expecting a cure and receive simply a reduction in symptoms we can feel as though the medication has failed us, when in reality that is not true.  We just expected the medication to do more than it really can.

Now the first question of medication is simple.  When should I consider medications?  While it can be easy to think that depression is depression and anxiety is anxiety and that one bipolar illness is that same as another the truth of the matter is very different.  Mental health episodes and symptoms can vary widely between individuals.  Some individuals manifest more physical symptoms, some more emotional symptoms and some have equal numbers of both.  Depression, anxiety and or bipolar with one person can look entirely different from another in symptoms and intensity.  Symptoms can change with time and circumstances.  They can intensify without any action on our part and they can intensify because we have chosen to add fuel to the fire.  What this means is that depression, anxiety, and bipolarity are general descriptions for illnesses that can be mild to severe in intensity and vary over time, with or without medications and mental health management.  So while each of us suffers with the same general illness our symptoms emotionally and physically might be very different.

Science does believe that we have similar reasons for mental health issues, some of those genetic and others environmental.  We do know what makes things worse and what tends to improve health.  Considering that our illness is truly individual to us the question of medication is going to be a very individual question.  Again with those who know us best.  The question that most individuals use is how the illness is impacting one’s life physically, mentally, socially and most of all spiritually.  How is my mental illness restricting me in my life compared to a more normal individual, physically and spiritually?  What many people in the world do not consider is the spiritual side of life and that is as important as the physical or mortal side.  And so one should consider their life and the restrictions caused by the illness from both a spiritual and physical sense.

There is not one question that can be asked to determine that medication is necessary.  I began using medications in a serious way when I first experience serious suicidal thoughts.  I probably should have started long before that experience but for me it wasn’t entirely possible as medications we now have did not exist.  My first medication was Lithium as I dealt with bipolar early in my life.  I quickly graduated to other medications specific to bipolar and depression.  Since then I have probably used over a dozen different medications although not entirely for mental health as I will explain shortly.  I personally have never felt any concern with using medications, under the guidance of a doctor or expert.  For me, I realized long ago they were necessary for me to even live a long life.  Without them at one time in my life suicide was very real and I realized that I was going to need medication regularly to even function somewhat normally.  One of the realities of medication is that it can provide sufficient help to keep us out of the suicidal thoughts.  When our illness is severe enough, we may not entirely have a choice about medications.  What we most often have to consider is the side effects versus the reduction in symptoms.  One easy way to tell if a medication is not right for you.  If the side effects are far worse than the symptoms than that medication may not be right for you.

This is true for medications of all kinds including naturopathic medications.  The reality of medication is that it can be a personal as the individual.  What I find useful and that provides me necessary relief may not help you at all.  While our bodies have similar chemistries, they are different enough that medications will affect individuals very differently.  And that can be true in families and close knit DNA.  Medications will tend to be more “trial and error” than “one and done”.

So the first question you should ask is regarding suicidal thoughts and tendencies.  If you are having these somewhat regularly or even for the first time, you should consider consulting a doctor.

The second question is always about the restrictions mental illness causes in ones work and social life.  If mental illness is affecting your ability to work and go to work, then medication is likely a good option.

The third question I always ask is about spirituality.  Most of us struggle deeply in this area when it comes to mental illness.  How do we feel about our testimony, church attendance, temple attendance and those family relationships we cherish?  I can tell you that one of the major factors for me in using medications was that it improved my relationship with the Savior and Father.  It doesn’t mean that everything was perfect, it was in fact far from it.  But it did provide me with some capacity that I would not have otherwise had. It mellowed my depression symptoms sufficiently that attendance at church became far more enjoyable. It caused that it could think a little more clearly and feel just a little more of the spirit.  It didn’t remove the symptoms but it most certainly mellowed them.

I know that it mellowed my symptoms because I would at times stop taking the medication because I felt well.  Not fully understanding that I felt well because of the medication, not because I was cured.  My symptoms would return and so would I to my medication.  By the way, this pattern of thinking that you don’t need the medication is chronic among those of us who suffer.  Most of the time, each of us has to go on and off the medications several times before we truly learn to leave it alone.  We don’t like being dependent upon a medication for our emotional control and we feel the side effects everyday, while we being to feel more whole through the effects of the medication.  So the symptoms moderate but the side effects tend to be around and noticeable.  One of the side effects of most medications is an inability to feel more deeply.  The makes sense as it is our feelings and emotions that are causing the issue.  But for many this feeling of numbness is troubling.  Many times I had heard I want to feel again and perhaps even from my own mouth.  The problem is that we remember the good feelings not those that caused us to suffer.  When we are in a more balanced emotional state due to the medications, we tend to feel better.  One thing I have learned about those ugly symptoms is that our brain cannot recall them because it can’t feel them with the medication.  The mind takes this and projects it into an idea that if I go off the medication, I can feel those deep joy and happiness feelings again.  The truth is that those good feelings are only possible because of the medication.  And so many individuals will go on and off of medications suffering the consequences.  I did far too many times to count.  And I still have those tendencies even after taking medications since my early adult life.  What I am really saying is this is going to happen to you.  Those tendencies never really dissipate. 

The fourth question is really not about us.  Every one of us has relationships in our lives that are important and crucial to our success as mortals.  We need each other.  We cannot be successful in this life without our friends and family.  Mental illness in almost every sense causes these celestial bindings to deteriorate.  Mental illness places a large strain upon relationships.  Most often it is the non-afflicted person that carries so much of the relationship weight.  And that takes a very special person.  When we consider medications, we should consider these people who carry us, provide for us and love us unconditionally.  Many times I have continued to take my medications simply because my wife desired that I do so.  She would keep me on track and remind me what happened the last time I did it.  Part of the reason I took them is because I had a love for her.  We should consider others when we consider medications and the help that medication might provide for them.  Again I will repeat that more than once I have seen relationships entirely change when medication is providing some relief.  And more than once I have heard that their relationship is entirely different, when the person suffering doesn’t necessarily feel that anything has changed.  We should always consider those around us when we consider medications.

These four questions are what I would ask myself.  Most often medication is applied to situations where the illness has reached a moderate to severe level.  When the individual has tried, diet, exercise, sleep management, reduction of stress and still symptoms appear that are moderate to severe.  Mild symptoms most often can be sufficiently reduced by addressing environmental concerns that affect our mental health.  This doesn’t mean that one could not consider adding a milder medication such as St. John Wart or 5-HTP.  It simply means that medication cannot be the only option for reducing symptoms.  We need to consider our life as a whole and change not only those environmental conditions but also our spiritual attention to detail.  In addition to the diet and exercise, it is important to maintain a consistent pattern of prayer, scripture reading, temple attendance, church attendance and so forth.  As least as best we can.  We cannot expect that living a health life and taking a mild medication would be the only concern in our lives.  If we know the gospel and do not live it, some of our symptoms could be related to our spiritual development or lack thereof.  We must do what we can even when we may not entirely feel like it.

As are addressing spiritual, physical and environmental concerns, you can start taking a medication and consulting with a doctor.  A medical doctor can prescribe medications for mental health concerns.  One does not need to go to a psychiatrist or psychologist, however, it is recommended.  Psychologists and psychiatrists are better at determining the type of illness and what might make most sense in terms of medication and life style changes.  Sometimes discussions of traumatic events in one’s life including abuse, accidents, severe relationship issues and a host of other concerns can help in the reduction of symptoms.  These individuals know how to train the brain to better deal with external factors.

Now as far as medications, you can most certainly do the research.  You will find more information than you can handle and you are going to find that each person fully believes that their medication and method is the best.  All I can say is to be discerning when you read and investigate.  There currently is no cure for mental illness, only management of the symptoms.  Certainly the illness can change over time and will change and sometimes individuals do mature out of a mental illness but that is rare.  Mental illness will more often run on a spectrum of very troubling suicidal to I just don’t feel right today.  And the management of symptoms is likely going to be trial and error.

As far as medications that I have personally used for my illnesses which have been anxiety, depression and bipolar, I have used both naturopathic and pharmaceutical medicines and a variety of them.  While I have tried others the three naturopathic medications with which I have had success are 5-HTP, St John’s Wart and THC/CBD which are the active components of marijuana. 5-HTP is an amino acid used to create serotonin.  Low levels of serotonin is thought to be the cause for depression and some anxiety.  Basically you are adding building blocks for serotonin hoping your body will make more.  St John’s Wart works similar to the pharmaceuticals in that it causes the serotonin to break down at a slower rate.  THC/CBD seem to mask the effects of anxiety and depression although science is not entirely sure why.

I have had limited success with ST. John’s Wart and 5-HTP.  St’ John’s Wart seems to work under mild depression rather than a more moderate to severe case.  I only saw limited success because my depression was and sometimes is still in the moderate to severe.  Which the 5-HTP worked to boost the serotonin it tended to cause a higher rate of anxiety for me.  Currently the THC/CBD combination along with and SSRI drug seems to be providing the best relief from my symptoms.

SSRI is a type of drug that goes by several names and products but works similarly.  They increase serotonin by decreasing the rate at which serotonin is broke down in the brain.   I have taken several kinds of SSRI drugs and have found that they are trial and error drugs.  One may work great and another not at all.  These drugs are the mainstay of mental health and by far the most common drug prescribed for depression.  The work well and have limited side effects.  They can take time to work fully but I have found for the most part that they work initially very well and then slowly improve over time.  Just a note they can have some problematic side effects for the first few weeks but those tend to wane over time.   These are mostly related to sleepiness and some dizziness.  The body does a good job of moderating these side effects over time that they aren’t felt.

As far as drugs for anxiety, you will find similar drugs work for anxiety and depression although anxiety tends to and another dimension to the problem.  When you deal with anxiety and depression which is quite common, you will need to work with whatever medications that provide for relief from both conditions.  I use a product called duloxetine or Cymbalta for my difficulties.  Interestingly enough this same drug works for neuropathic pain that is caused by my autoimmune conditions.  One thing that is interesting about most depression drugs that are SSRI drugs is that they tend also to treat pain as well and so they can be used for individuals with chronic pain.  The same is also true for the naturopathic medications that I mentioned.  In addition to feeling more emotionally balance, it is likely that you will notice some reduction in pain.

Overall, these medications are safe and effective.  However, they should always be taken under the direction of a professional.

Now before I finish out this podcast today.  I would like to point out some problematic medications when it comes to mental illness.  Opioids use in pain management tend to be very problematic for individuals suffering with mental illness.  I have some limited experience with opioids and pain management and have noticed the problem that all too often engulfs those with mental illness.  Opioids tend to provide relief from pain but also an emotional high.  We can feel bulletproof and for a few hours not concern ourselves with depression, anxiety or bipolar.  The problem here is obvious.  That relief can become terribly addicting to someone suffering with mental illness and this is why you see so many individuals with mental illness also have a drug addiction problem.  It is not that they just want to have fun, it is that they are finding relief from a terribly troubling and painful illness.  Opioids and mental illness do not make good companions.  In fact, in almost every case opioids cause greater issues with mental illness which creates a greater need for the drug addiction.  It is a terrible cycle over which an individual can have little control.  Once into this drug addiction cycle, it takes significant effort on the part of a supporting cast and the individual to walk back the addiction and to treat the mental illness effectively.  And that road is very difficult, even with a good doctor and counselor.  

Addiction of this nature does cause many individuals to pause and ponder whether they want to take medications.  Addiction has taken on such a negative connotation that it is avoided at all cost.  The medications I take are addictive only in the sense that they provide emotional balance and without them I struggle to have that balance.  For me, there exist no negative consequences when taking prescribed medications.  When we consider taking long term medications, we should not consider this an addiction in the same sense as the opioid crisis and problem.  We are simply using chemistry to allow our body to function more normally.  That is not the case for an opioid.  The opioid does not help the body function more normally but simply masks the emotions for a short time.  It provides no real long term benefit but significant long term negative effects.  That is really the difference in an addiction and those medications that provide for positive outcomes.  When the solution causes far more problems than the original illness, it is not helpful to emotional balance. 

The reality of medications is that they can be powerful allies in your fight and management of the illness.  Yes there exist side effects but those side effects are generally mild when compared to the ferocity of mental illness.  I am a proponent of medication for those who are experiencing mental illness and more especially when you are experiencing long term, moderate to severe symptoms.  I personally believe that the Lord has provided good men with scientific understanding to provide aid to us who suffer.  While the science may not be fully baked, the truth is no one really knows or understands mental illness at the brain level.  It is complex, difficult to untangle and can be caused and augmented by so many different sources.  Ultimately, the choice will be between you and the Lord as to how best to address your illness.  I wish I could lay out a definitive plan that shows the entire road you should take but that just isn’t possible.  What I can say is that for millions of people medications have made a significant different in their lives.  The Lord provides for miracles in a variety of ways and I believe that medications are included in those miracles.  Today I am going to end with a quote from Elder Hollands address “Like a broken vessel.”  

“If things continue to be debilitating, seek the advice of reputable people with certified training, professional skills, and good values. Be honest with them about your history and your struggles. Prayerfully and responsibly consider the counsel they give and the solutions they prescribe. If you had appendicitis, God would expect you to seek a priesthood blessing and get the best medical care available. So too with emotional disorders. Our Father in Heaven expects us to use all of the marvelous gifts He has provided in this glorious dispensation.”

Until next week. May you do your part so that the Lord can extend his.