Dr. Ronsisvalle: Medication may help with your depression and anxiety; here's what to know

Rachel, a middle-aged woman sits nervously in the waiting room of the psychiatrist's office, flipping through outdated magazines and fidgeting with her hair.

Her blue eyes, bloodshot from lack of sleep, reveal the heavy burdens she bears.

After what seems like a lifetime of taking on everyone else’s problems, which have caused endless feelings of depression and anxiety, she has finally found the strength to reach out for help.

But fearing the stigma she felt about having a mental health issue, she avoided asking friends or family for a personal referral.

Instead, she turned to “Dr. Google” and made an appointment with the first psychiatrist she could find who was accepting new patients.

However, she unfortunately endured three months of escalating symptoms as she waited for her new appointment.

Dr. Mike's previous columns:

Meet life head-on: Short-term avoidance of anxiety leads to long-term maintenance

Teens and weed: Parents shouldn't normalize marijuana use among their teens

Grow, don't shut down: Having a 'growth mindset' helps you age with purpose, without depression

After being led back to the psychiatrist’s office to begin her session, things didn’t improve much.

Unlike other medical specialists she had seen in the past, who recommended blood test, X-rays, and various diagnostic procedures, Rachel's psychiatrist began simply by asking her questions.

No physical examinations or poking with instruments; no hospital gown to change into; no blood pressure checks. Instead, the psychiatrist drilled her with what felt like an interrogation, delving into specific details of her life.

“What brought you into the office today? What symptoms have you been experiencing? Tell me about your typical day,” the psychiatrist asked.

Anxiously, Rachel rattled off her symptoms.

“I've been struggling to sleep for nearly a year. Sometimes I have absolutely no appetite, other times I stress eat all day. I avoid spending time with my friends and I have no desire to be intimate with my spouse. I feel overwhelmingly sad, and nothing brings me joy like it used to."

The psychiatrist diagnosed Rachel with depression and anxiety, prescribing a medication called Prozac. Her experience at the psychiatrist’s office wasn't necessarily negative, but it amplified the uncertainty of her mental health journey.

Though she left hopeful, Rachel felt confused about the medication’s effectiveness and potential side effects. She worried that in order to feel like herself again she would need to rely on it indefinitely without a holistic plan to get her life back on track.

Rachel's experience at the psychiatrist’s office is not unusual. The demand for psychiatric help in our culture is enormous, often with a wait of up to six months for an appointment.

Despite the pressures from insurance companies, it is amazing that these medical professionals still make a significant positive impact and do such a tremendous amount of good. They must now manage people in crisis, sometimes billing insurance companies for as little as 15 minutes of face-to-face contact with the patient.

To make matters even more difficult, most psychiatrists often depend solely on patient-reported symptoms for diagnoses and treatment decisions.

There are no tests for a "depression virus" or any biological measurements for a "depression marker." Consequently, the causes, treatments, and outcomes can't fully be defined, explained or measured.

As a psychologist, I greatly admire my psychiatrist colleagues and their investment to our collective mental health.

Having said that, I recognize that seeking help can be overwhelming for many individuals facing mental health issues, particularly when navigating mental health medications.

Rachel's uncertainty is a common experience for those beginning their mental health journey.

It’s crucial that individuals and their loved ones feel well-equipped to make informed decisions about their care.

Drawing from my decades of experience in the mental health care system, I offer the following recommendations for anyone who's ready to get help.

Do research on common mental health medications

Let's start with a very clear fact: psychiatrists are the experts. They have dedicated years to understanding mental health medications and how to prescribe them ethically.

However, this does not absolve us from doing our own research into the benefits and side effects of taking these medications.

Here’s a brief overview of typical medications often prescribed by psychiatrists.

Please understand, this is not intended as medical advice, but rather a snapshot of the medications your psychiatrist or psychiatric nurse practitioner might prescribe.

• Antidepressants: Antidepressants are prescribed to address the symptoms of depression and also utilized for treating conditions like obsessive-compulsive disorder (OCD), anxiety, PTSD, and chronic pain. These medicines work by elevating levels of neurotransmitters, chemicals in the brain linked to mood and emotion, such as serotonin and norepinephrine.

The most commonly prescribed type of antidepressant is the Selective Serotonin Reuptake Inhibitors (SSRIs), including Fluoxetine (Prozac), Citalopram (Celexa), Seratraline (Zoloft), Paroxetine (Paxil), and Escitalopram (Lexapro). Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) are similar to SSRI's with popular examples being Venlafaxine (Effexor) and Duloxetine (Cymbalta).

Other antidepressant medications include tricyclics and monoamine oxidase inhibitors (MAOIs), which are prescribed less frequently because they tend to cause more side effects. Nevertheless, they may work more effectively for some individuals.

• Stimulants: Stimulant medications are often prescribed to treat children, adolescents and adults diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Those prescribed stimulants often report a calming and “focusing” effect. Typical stimulants prescribed by healthcare providers include amphetamines (Adderall) and methylphenidate (Ritalin and Concerta)

• Mood Stabalizers: Mood stabilizers are medications used to treat and prevent the highs (mania) and lows (depression) associated with Bipolar Disorder. They assist individuals in managing their moods, ensuring they don’t interfere with work, school, or relationships. Examples of mood stabilizers include Divalproex (Depakote), Lamotrigine (Lamictal), and Lithium.

• Antipsychotics: Antipsychotic medications primarily treat symptoms and conditions related to psychosis, but taking an antipsychotic drug doesn't always mean you have symptoms of psychosis. They are commonly used to address symptoms of schizophrenia, bipolar disorder, delusional disorder and major depressive disorder with psychotic features. Additionally, providers may prescribe antipsychotics to manage severe agitation, borderline personality disorder, dementia, or even OCD. Examples of antipsychotics include Aripiprazole (Abilify), Quetiapine (Seroquel), and Olanzapine (Zyprexa).

Understand medication is only one tool in the toolbox

Over the years, I’ve encountered countless stories like Rachel’s. Feeling disoriented after being prescribed mental health medication is a common experience. Many fear they won’t fully address or understand the root cause of their symptoms.

Worse yet, some individuals would rather take a “happy pill,“ opting for a quick fix and avoiding the underlying issues.

It's important for anyone struggling with mental health to recognize that medication is just one tool in the toolbox to help you get healthy and stay healthy. To find lasting relief and recovery, gaining insight into the emotional and behavioral root causes is essential. The research bears this out quite effectively.

Decades of research on treatment outcomes for depression and anxiety consistently show that psychotherapy and medication yield better results when combined.

In other words, people recover faster and maintain better health over time with the synergy of antidepressants and trusted therapy.

Most professionals prescribing mental health medications are familiar with this research, but sometimes they feel disheartened by their patients’ lack of follow-through.

At the end of the day, your doctor cannot compel you to call and make an appointment for therapy; taking that step remains in your hands.

If you're wondering why so many people take medications for years, the answer lies in the numbers.

Less than one-third of Americans taking one antidepressant and less than half of those on multiple antidepressants have seen a mental health therapist in the past year.

So the answer is simple: Make sure that you work with a therapist to address the root cause of your issues.

It's important to note that some mental health problems may require long-term medication use, such as schizophrenia, bipolar disorder or severe conditions.

Medications are essential in these cases for a comprehensive treatment plan. But even in those situations, research shows that therapy plays a vital role in helping individuals cultivate healthy behavior patterns for better and sustained well-being.

New technologies are emerging as the first line of defense in treating numerous mental health problems.

For instance, at our LiveWell clinics we’ve developed highly effective treatments for depression, anxiety and trauma that have proven to help people move forward quickly. Engaging in several hours per week of Cognitive Behavioral Therapy over approximately eight weeks, many have found significant alleviation of their symptoms.

Transcranial Magnetic Stimulation (TMS) is a groundbreaking treatment with a significant impact on depression and Obsessive Compulsive Disorder (OCD).

Again, the truth lies in the numbers: only about 50% of those on an antidepressant medication will find recovery from depression. When prescribed multiple medications, just 7% find relief after the third prescription attempt.

In contrast, TMS sees remarkable success, with over 83% of individuals who complete the full TMS treatment cycle seeing a significant decrease in the severity of depression with 62% achieving complete remission of depression, meaning it effectively “goes away."

At LiveWell, we treat patients using the NeuroStar TMS system which has extraordinary results.

So the message is clear: mental health medications play a crucial role, but they are not the sole solution. Educate yourself on the value of psychotherapy, intensive treatments, and emerging treatments like TMS to alleviate concerns about prolonged medication use.

Seek out prescribers you connect with

Rachel's story highlights the unique nature of psychiatry, where the quality of the relationship with the prescribing professional profoundly influences the treatment.

Feeling comfortable with the psychiatrist or psychiatric nurse practitioner is crucial because it fosters openness and honesty during sessions. This helps the provider to glean more information, leading to better clinical decision-making.

This principle guides every hiring decision at LiveWell clinics, seeking medical providers with not only great credentials and experience, but those who lead with a deep sense of empathy and care for their patients. This makes a world of difference in treating mental health.

Additionally, make sure that you connect with your prescribing provider’s medical credentials.

While many primary care physicians and family practice nurse practitioners help those in need by prescribing mental health medication, specialists who do this regularly possess more expertise and training.

For long-term mental health medication needs, it’s essential to visit a psychiatrist or psychiatric nurse practitioner to ensure the best possible treatment.

I'll leave you with one last recommendation: I know the decision to seek help is immensely challenging. If you've been battling mental health issues for a while, disillusionment and hopelessness may engulf you.

However, I encourage you to reach out to a mental health practitioner who can guide you toward a plan to get healthy and stay healthy. Whether through medication, therapy, or innovative treatments like TMS, please know that the professionals at LiveWell Behavioral Health are committed to working with you on your journey to a healthy and fulfilling life.

Dr. Mike Ronsisvalle is a Licensed Psychologist and the President of LiveWell Behavioral Health, a psychological services agency that provides counseling to clients of all ages and addictions treatment to adolescents and adults. You can find him at www.LiveWellbehavioralhealth.com or call 321-259-1662.

This article originally appeared on Florida Today: Here's a breakdown of mental health meds that may be prescribed for you