Highlights from Jonathan Otto's interview with Dr. Daniel Binus, for the Depression & Anxiety Series. Dr. Binus discusses the place of medication within mental health treatment. He discusses how it can be a helpful tool, but they can create chronic issues if overused. Watch to find out how.
Daniel Binus: 03:26 So, this is an interesting sort of answer as far as how medications impact mental health. The first thing to understand is that medications never heal illness. That doesn't mean I never use medications. I do believe they have their place, but ideally in the short term use. The reason for that is because what they do is they help to suppress symptoms, but then the brain actually pushes back. In other words, if you give somebody a prescription for anxiety for example, like Xanax or Valium, well it helps to decrease the amount of neuronal activity in the brain, so that slows everything down. It makes you feel calmer. But then what the brain does is it pushes back, and essentially, it actually upregulates the amount of excitability in the brain to counterbalance that. So pretty soon, if you're not dealing with the underlying issue, you end up with actually just as much anxiety, but now you're on a medication that your tolerant and dependent on.
Daniel Binus: 04:33 And so then over time what happens is, your symptoms actually get worse and worse, but now you have the medication, plus you have the side effects of the medication. So what they're seeing is that, for example with anxiety medications, it can create long-term chronic anxiety. With antidepressant medications, it can create long-term chronic refractory depression. With antipsychotic medications, it actually makes the brain super sensitive to dopamine, which means that they're going to tend to actually have more chronic episodes of psychosis. Not only that, it actually makes people, both antipsychotics and antidepressants, it actually makes them apathetic, meaning they don't really care about things anymore. It makes them have problems with mental processing, like memory and that sort of thing. It also starts impairing frontal lobe function, which is important for logic and self-control and that sort of thing.
Daniel Binus: 05:34 And so, what I deal with a lot, and I talk with patients when they're on these medications long-term, first of all, it's very difficult for them to get off. And secondly, they actually start missing out on the joy of life, and they say things like, "You know, I'm not really even in touch with who I am anymore or my feelings. And yes, I'm not depressed, but I'm also not happy. I'm not really fulfilled." And so, you can start to understand how these medications, even though they might help the symptoms short-term, in the long-term can actually cause more harm.
Daniel Binus: 06:32 Yeah. It's a great question, because a lot of people point it to genetics, but that's only a small part of the story. Actually, there's a lot of environmental factors that have changed over the last 70 years that are contributing to increasing rates of depression and anxiety. One of the big ones that I really believe is that we've had a shift in the value system of our culture. You know, back in the 1950s, we'll say World War II and before then, most people had this idea that, "I have to live by certain principles, and even if I feel differently, regardless of what my feelings are telling me, I need to adhere to those principles."
Daniel Binus: 07:13 But in recent years, in the last 70 years or so, there's more of an idea that we need to actually feel good all the time. In other words, we should be driven more and make more decisions on what makes us the happiest. That really, I believe, has been driven largely by consumerism. In other words, you know in the 1950s you had the advent of television on a big scale. For example, in 1947 you had about 7,000 TVs that were sold in the United States. Three years later, it was an explosion. Seven million TV sets were sold, which gives you an idea.
Daniel Binus: 07:53 So what started happening is, you started to have this mass media emerging in the culture. And so, people started to actually become indoctrinated with this idea that, through commercials and advertising, that I can't be happy unless I have the latest and greatest. So really what started developing is this idea of consumerism, which again, it changed the value system in our culture to be more materialistic, and also more driven on what feels good in the moment, rather than the long-term concern about, "Well, is this in harmony with my principles and values?" That feel good in the moment instant gratification sort of mindset then translated into a lot of other problems, which are the root causes for anxiety and depression.
Daniel Binus: 08:43 For example, it started translating to more indulgence in the way we eat, so nutritional factors are a big problem. But, it's not just that we're choosing the wrong things. We want to understand why. And again, it goes back to that instant gratification principle. Also, exercise for example. Well, I'd rather just sit and watch TV, 'cause again, we don't have the principle of wanting to take care of ourselves as much, and the self-control to say no to maybe indulging ourselves and just sitting on the couch and watching TV.
Daniel Binus: 09:16 So, there's numerous lifestyle factors that actually have come out of this idea of instant gratification. Personally, I think the most important aspect is that it's really disconnected us from one another; because we've now gotten so focused on what makes me feel good right now, rather than ... so in other words, my world, like iPhone, iPad, everything around me, rather than focusing on creating relationships and connections with one another. We know from mental health that the most important thing for people to actually be happy and healthy is to feel connected with one another in healthy relationships.
Jonathan Otto: 16:41 Incredible. Now, Dr. Binus, if you could help me to understand ... The people that I've been interviewing, a lot of them have had some incredible results, but people that had all these kind of social challenges, divorces, various health challenges, and seeing these people turn around their lives. Seeing them achieve happiness and what they were looking for. What did they do? I'm talking that vaguely. I mean what do you people do in your program? If you could give me the protocol so that anybody that's home could say, "Okay, I could do that today." Could you give me the formula, the hack? What do we do?
Dr. Binus: 17:24 That's a great question. To me, the first step of actually getting help and getting well is recognizing that we have a problem. A lot of people are really in denial and they're like, "Okay. Everyone else is sick, everyone else has their problems, but not me." Recognizing that we have an issue and being willing to get help. That's the first step. The second step is engaging with somebody, ideally somebody that has more of holistic mindset to try to understand, "What could some of these root causes of my problems be?"
Dr. Binus: 17:58 There's certainly resources out there to help do that, but we want to understand, is it a media addiction? Do I have a lack of exercise? Am I eating the right things? Is my sleep just all out of whack? Do I have a genetic predisposition? What are my relationships like? Is there a lot of chaos? Is there a lot of stress? In general, what about my job stress? What about my financial situation? How do I spend my free time?
Dr. Binus: 18:31 All of these things you want to start looking at, what could the root causes be and then address those one at a time where they focus ... I really encourage people not do it by themselves. Because if you try to do it by yourself without the support and the accountability you can get discouraged and then you want to give up, but if you have support, if you have accountability to do it becomes a whole lot easier and actually can become a lot more fun too.