Mental disorders treatment

There are known various mental diseases, and correlatively, lots of treatment methods. Each type of therapy has its characteristics depending on the condition that caused the mental disorder ( e.g., pregnancy or infertility).

Non-pharmacological treatment

Talking therapies

During talking therapies, patients talk about their worries, feelings, and thoughts with a qualified therapist. This process may be one-to-one or with a partner. The two central empirically-based psychotherapeutic interventions for mood disorders are interpersonal psychotherapy (IPT) and cognitive behavioral therapy (CBT). 

Interpersonal therapy(IPT)

Interpersonal therapy (IPT) was initially developed to treat major depression[1]. It aims to help a woman communicate better with others and address problems contributing to her depression. IPT is a time-limited (12-16 weeks) treatment that contains three phases: the beginning (1-3 sessions), the middle, and the finish (3 sessions). 

Treatment usually begins with an interview. The initial phase challenges the therapist to recognize the target diagnosis (e.g., postpartum depression), difficulties facing the woman and select an area of focus.

The middle stage of therapy is likely to address the patient’s ability to declare her needs and wishes in interpersonal counteract, define the patient’s anger as an ordinary sign, and encourage its expression[2]. It also includes weekly monitoring of depressive symptoms. 

In the last phase, treatment gains are evaluated and strengthened, adaptive interpersonal strategies in case of recurrence are analyzed[3].

IPT is not just for depressive disorder. It may also help treat bipolar disorder and anxiety[4].

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) is a well-established, practical type of short-term therapy. It’s based on the relationships between thoughts, feelings, and behaviors and how they cooperate. The goal is to reveal and change false and distressing beliefs and destructive thought patterns such as “over-generalizing” or “catastrophizing”[5]. CBT tries to transform how people think (“cognitive”) and what they do (“behavior”)[6].

There are a few ways in CBT. The therapist will figure out which CBT approach fully satisfies a person’s unique needs. Here are some examples.

  • Journaling. This technique is based on writing a list of negative thoughts that occurred to the patient between sessions and positive reviews that can be chosen instead. A CBT journal can include the time of thinking, its origin, intensity, feedback. This technique helps distinguish our thought patterns and emotional biases, describe them, modify them, or cope with them.
  • Exposure therapy. Exposure therapy can be used to face fears and phobias. The doctor will gradually expose a person to situations that provoke fear or anxiety while supervising how to cope with them at the moment.
    This technique is effective for those who suffer from obsessive-compulsive disorder and can be combined with journaling.
  • Unraveling cognitive distortions and restructuring. This process involves identifying and challenging harmful unconscious beliefs. Once a person is aware of them, she can discover how to reframe those thoughts to be more positive.
    For example: “I can not have kids, and my life has lost its meaning” becomes “I do not have children, but there are a lot of other amusing things in the world.” 
    CBT can be valuable for treating:
    • Depression
    • Anxiety disorders
    • Tokophobia
    • Post-traumatic stress disorder (PTSD)
    • Obsessive-compulsive disorder (OCD)
    • Bipolar disorders
    • Schizophrenia
    • Sexual disorders

Mind/body therapy

Mind-body practices are a vast and diverse treatment technique that expands the mind’s intercourses with the bodily part. Meaning, utilizing movement and engaging your own body can positively influence mental health and healing. Several methods incorporate mind and body.

Yoga

Yoga is an ancient Indian, non-religious mind-body strategy. It intends to boost “happy hormones”, such as oxytocin, which plays a significant role in connection with loved persons, and endorphins that help manage physical pain and negative emotions. Researchers prove that during yoga, melatonin levels are also increased[7].

Combining stretching, meditating, and deep breathing, yoga helps keep calm and cope with stress. Trauma-sensitive yoga can be helpful in people suffering from post-traumatic stress disorder (PTSD). 

Meditation 

A primary tool is to focus on breathing — an exercise called “mindful breathing”. It is a crucial skill to encourage dealing with stress, anxiety and sharpen an ability to concentrate highly.[8]

Mindfulness

We tend to concentrate more and more on the difficulties in our lives instead of focusing on little moments that allow us to appreciate life. Mindfulness is about paying attention to what is happening around us. Find a free space in your day and sit in a comfortable environment, just 10-15 minutes to begin with — emphasizing the here and now without giving labels. Concentrate on sunshine, birds singing, traffic noise. It will help to get in tune with your thoughts and bodily feelings. 

This technique has efficacy in healing depression and anxiety[9].

Biofeedback

Biofeedback is a mind-body procedure that includes using optical or auditory feedback to educate people to identify the physical signs and symptoms of stress and anxiety, such as enhanced heart or respiratory rate, body temperature, muscle tension. Therapists differentiate various categories of this technique, e.g., neurofeedback, thermal feedback, etc. 

Electrical sensors will be attached to specific body areas during a session due to the estimated response type. These sensors will be connected to a measurement device that will subsequently provide feedback on a person’s physical stress reactions. A patient will undergo, under supervision, numerous mental exercises that may involve visualization, meditation, breathing, or relaxation processes.

As the individual conducts this training, he will receive data on his physical response.
This mind-body therapy helps get rid of PTSD signs and decrease chronic pain related to eating disorders, addictions, and depression.

Acupuncture 

Acupuncture is a traditional Chinese medicine technique in which practitioners stimulate particular points on the body by injecting tiny needles through the skin. This method is suitable for healing both physical and mental disorders. Acupuncture can contribute a person’s brain to neuropeptides realizing — molecules that allow neurons and effectors to communicate. In turn, this can enable the body’s self-healing process[10].

Massage

It is well-known that massage is physically relaxing, but it is also beneficial for our mental state. Recent researches recommend it against symptoms of stress, anxiety, and depression[11].

Pharmacological treatment

The kind of medication patients are proposed on:

  • type of mental health condition 
  • symptoms intensity
  • whether a woman is pregnant or breastfeeding 
  • how quickly she becomes unwell after stop taking medication
  • side effects

The most common medications against mental health issues are antidepressants and antipsychotics.

Antidepressants are medications that are used to treat depression symptoms. Here are five main categories:

  1. SSRIs (Selective Serotonin Reuptake Inhibitors)
  2. SNRIs (Serotonin and Noradrenaline Reuptake Inhibitors)
  3. NASSAs (Noradrenaline and Specific Serotonergic Antidepressants)
  4. Tricyclics
  5. MAOIs (Monoamine Oxidase Inhibitors)

Antidepressants are not usually prescribed during pregnancy. However, if a woman is already taking antidepressants, she should not immediately stop it. It is worth discussing with a physician how this might influence her baby. 

Antidepressants are also not usually recommended if a woman is breastfeeding. Nevertheless, there may be cases where the benefits of antidepressants for a female and the advantages of breastfeeding for a child are more significant. 

Antipsychotics are a range of prescribed medications for some types of severe mental distress – mainly schizophrenia and bipolar disorder[12]. They can also effectively struggle with anxiety or depression. 

The question of using antipsychotics during pregnancy is uncertain and controversial among healthcare providers. For pregnancy outcomes of attention, e.g., miscarriage, stillbirth, the available database do not report a clinically significant increased risk[13]. Nevertheless, the decision must be individual. The woman should refer to her therapist if she has a severe mental disease. 

References

  1. Law, R. (2011). Interpersonal psychotherapy for depression. Advances in Psychiatric Treatment, 17(1), 23-31. doi:10.1192/apt.bp.109.007641
  2. Markowitz JC, Weissman MM. Interpersonal psychotherapy: principles and applications. World Psychiatry. 2004 Oct;3(3):136-9. PMID: 16633477; PMCID: PMC1414693.
  3. Pim Cuijpers, Tara Donker, Myrna M. Weissman, Paula Ravitz, and Ioana A. Cristea. Interpersonal Psychotherapy for Mental Health Problems: A Comprehensive Meta-Analysis. American Journal of Psychiatry 2016 173:7, 680-687
  4. Colom F, Vieta E. A perspective on the use of psychoeducation, cognitive-behavioral therapy and interpersonal therapy for bipolar patients. Bipolar Disord. 2004 Dec;6(6):480-6. doi: 10.1111/j.1399-5618.2004.00136.x.
  5. Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Cognitive behavioral therapy. 2013
  6. Fenn K, Byrne M. The key principles of cognitive behavioural therapy. InnovAiT. 2013;6(9):579-585. doi:10.1177/1755738012471029
  7. Harinath K, Malhotra AS, Pal K, Prasad R, Kumar R, Kain TC, Rai L, Sawhney RC. Effects of Hatha yoga and Omkar meditation on cardiorespiratory performance, psychologic profile, and melatonin secretion. J Altern Complement Med. 2004 Apr;10(2):261-8. doi: 10.1089/107555304323062257. 
  8. Harvard Health Publishing. Relaxation techniques: Breath control helps quell errant stress response. 2020
  9. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010 Apr;78(2):169-83. doi: 10.1037/a0018555. 
  10. Bai L, Lao L. Neurobiological foundations of acupuncture: the relevance and future prospect based on neuroimaging evidence. Evid Based Complement Alternat Med. 2013;2013:812568. doi: 10.1155/2013/812568. Epub 2013 May 14. PMID: 23737848; PMCID: PMC3666300.
  11. Nillni YI, Mehralizade A, Mayer L, Milanovic S. Treatment of depression, anxiety, and trauma-related disorders during the perinatal period: A systematic review. Clin Psychol Rev. 2018 Dec;66:136-148. doi: 10.1016/j.cpr.2018.06.004. Epub 2018 Jun 9. PMID: 29935979; PMCID: PMC6637409. 
  12. Fusar-Poli P, Papanastasiou E, Stahl D, Rocchetti M, Carpenter W, Shergill S, McGuire P. Treatments of Negative Symptoms in Schizophrenia: Meta-Analysis of 168 Randomized Placebo-Controlled Trials. Schizophr Bull. 2015 Jul;41(4):892-9. doi: 10.1093/schbul/sbu170.
  13. Damkier P, Videbech P. The Safety of Second-Generation Antipsychotics During Pregnancy: A Clinically Focused Review. CNS Drugs. 2018 Apr;32(4):351-366. doi: 10.1007/s40263-018-0517-5.