Thursday, 3 March 2011

Medical, Disease or Behavioural.

I had a days training today on alcohol. I was sort of hoping some would be involved. I was disappointed! I had driven anyway.
So. We spent a lot of time on something that I have actually been thinking a lot recently. I think I have blogged about it, if not I talked about it on SF. About me. I want medicating. If I can be medicated, it is medical, it can be fixed and it is easy. Bish Bash's some medication, you'll feel better in a few weeks. I want medication. I want to try 2 antidepressants at the same time.

This is obviously the medical approach to my not so sane-y-ness. I don't know what to call it. I feel it's more than depression as I am having delusional thoughts. Issues? But then issues doesn't quite fit in with my approach really does it? If you look at it with alcohol you are focusing on the physical conditions. With me...what I think to be hormone in balance, genetics (but then I have arguments against this also especially if you take in to account Broffenbremmer's work on this) as there have been a lot of people who have had mental health problems... my grand dad was sectioned...this was just after the 2nd world war and it was because he tried to kill himself. He suffered a lot with PTSD.

My Dad certainly has issues. I don't know what. But there is def some issues going on there. My aunty has issues also. This is just on my Dad's side (pretty screwed up family really...there's a whole story around that but I wont go in to it). But on my mums side my Nan had problems with depression. Never when I knew her. I say that though my mum said after my Grand dad died (I was only 1 so I don't remember him or what it was like when he was alive) my Nan was never the same. My mum said she became withdrawn. I loved her for who she was. I wished I had known the party animal side to her that I have heard of but I knew her and I adored her for who she was. Anyway, she also had problems with depression. This was before my Grand dad died.

Genetics also is taken in to account in the disease side. The disease approach says it is an addiction. This was told about the alcohol but self harm can be an addiction also can't it. I have been told my way in which I self harm can show that there is an addiction to it.

If both these approaches are taken with it and with myself it is an ideal of how I like to view it, then I suppose it takes ownership away from me. And to be honest that is how I want it. If it is disease or medical then there is nothing I can do about it. There is nothing I could have done to change the outcome. It was out of my control. I had no choice.

And then we have behavioural. This is where I am split. Here I am going to do my worst patient thing again, remove myself, and look at it from a professional capacity and not listen to professional advice.

So. Treatment. With both alcohol, drugs, self harm, what ever you want, I believe a behavioural approach needs to be taken when it comes to treatment. So you have an alcoholic, a drug addict, a self harmer; in the beginning there was some element of choice. That person chose to have a drink, they chose to go to the shop and buy that alcohol with the intention of getting pissed. I am not saying they chose to get addicted but initially they had some behavioural patterns that were through choice.

With the drug addict, that person made a choice somewhere down the line. Now people may have a go at me here. I understand that this is an area that people will not always agree on. My own head hurts because of it and thinking about it all day. I believe though somewhere along the way if the person had chosen differently then they could possibly have avoided the situation they are in now. Perhaps taking the drugs was the easy option because so much shit was going on it blocks it out. Perhaps a choice they made is that they don't want to deal with reality so they would prefer to be high on drugs. Who knows?

Self harm. There was a choice. Speak to someone about it. Speak to someone about how you feel and open up. Or self harm. It's a mislearnt coping mechanism. It is a behaviour you have learnt.
BUT... it goes past that part where you made those choices doesn't it?

So in treatment, medicating is all well and good but the underlying issue is not being treated. So while medication may be a quick fix. Is it not better to spend the money initially to save money in the future. If we just think about alcoholism (as it is what I have been doing about today), there is something that has gone on in that persons life that has made them turn to drink as a coping mechanism. They may not be aware of it, but something has occurred and they have taken to drinking in excess. So what is better to do? The medical and disease one says medicate them until they don't drink anymore. Fair enough. A quick fix. They now are drink free and the medical problems that occurred as of excess alcohol can be treated or made as though they don't have such a negative effect on this person's life. But how long does this last for? How long before you have this person drinking again. They have learnt that maladaptive coping mechanism. So how long before they have another drink again? This person is more than likely to start drinking again because the underlying issue wasn't addressed. I believe you need to combine all approaches and use a holistic one to get the best benefits.

Nurseman Mike is obviously of the behavioural camp. He keeps saying to me you made a choice, you decide what you want to do. You have the power of those decisions. Honestly, I don't think I do anymore. Maybe at first it was learnt behaviours. When I was feeling bad and I self harmed I got a release. I felt better. I learnt that by acting out the behaviour of cutting, drinking shit loads, and all my self harm behaviours I got release. I use it as a coping mechanism. So I suppose it's all well and good pumping me full of drugs but really am I going to get better unless I look more at the behavioural side. Learn new coping mechanisms, learn to talk to people so I don't keep everything to my self. But, is there a genetic/medical thing in me which meant that I was having distorted thoughts which led to the self harm.

It's what came first...the chicken or the egg.

Yet knowing all this. I knew it before today and it was weird that we went in to a lot of detail about it when it's been going through my mind a lot anyway. I still want to take the medical approach with me. I want it to be out of my control. It's more acceptable in a way isn't it? If someone has for example broken leg. It's treated medically. It was an accident and there was nothing they could have done about it. Yet with mental health, and my mental health I am ashamed by it. I won't admit to it. I won't talk to anyone about it.

I know this has been a bit of a boring blog. But it's stuff that has been going through my mind a lot and I wanted to talk about how it has been bothering me as i don't get to talk to anyone about it.

If anyone has read this far I would love to hear your comments on this...

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