Cognitive Behavioral TherapyTag Archives

Ambien should be replaced by talk therapy

Looking around the journals published so far in 2010, it’s clear the research community is finally beginning to challenge the assumption that America should be medicated. If you listen to the pharmaceutical industry and the doctors who are paid to stand up and promote drugs as the best treatment for any disorder, you will hear a consistent pattern of propaganda. All our products have the FDA seal of approval. The clinical trials show our products are safe and effective. The health insurance industry pays most of the price for our products (only a small co-payment element for you). Take our pills and get better. Indeed, when it comes to the top-selling sleeping pills, there are record numbers of prescriptions being written by doctors. The reason? Well, its not hard to suspect stress levels are increasing thanks to the recession. Unemployment is high. Credit levels have been reduced, There are foreclosures in every neighborhood. That’s bound to make sleep more difficult. What’s curious about the new records being set in the number of prescriptions is the additional financial burden this places on families when they can least afford it, and the implied assumption that sleeping pills can cure the underlying social and economic problems causing the stress.

The Journal of the American Medical Association reports talk therapy is more effective than sleeping pills. The research team gave the participants sleeping pills alongside therapy sessions and measured which had the better outcome. Because the talk asked why people were finding it difficult to sleep and discussed ways of resolving problems, people with the therapy sessions had better sleep than those on pills. This follows on research testing the effectiveness of cognitive behavioral therapy (CBT) which teaches people how to change their habit patterns to restore sleep. Therapists encourage people to avoid naps during the day, adopt a set routine for going to bed, and physically change the bedroom to minimize light and noise that might disturb sleep. When combined with techniques to address the cause of stress and relax, CBT has consistently been found to outperform sleeping pills.

When you look at the statistics, there can be little doubt we use too many sleeping pills. Add in the increasing use of online pharmacies which supply drugs without the need for a prescription, and the scale of reliance on sleeping pills is almost certainly worse than we imagine. Why should we care? Because all the sleeping pills on the market can cause dependence. As people continue to take them, tolerance builds and the pills actually become less effective. Increasing the dose confirms the dependence and can lead to unwanted side effects. Yes, ambien is one of the better pills and there are fewer problems with its use, but if your insomnia has been disrupting your life for six months or more, you should consider undergoing therapy first. CBT is clearly the best. To help you focus during this learning period, your doctor may offer the use of a sleeping pill. If you decide to accept, ambien is the best but you should only take it for a few weeks at low dose. The long-term restoration of sleep is going to come from the therapy. Although this is a short-term cost to meet, your life will improve with natural sleep and your finances will be better of without having to buy sleeping pills for the rest of your life.

admin

May 12, 2010

Articles

0 comments

When the xanax kicks in, go for cognitive behavioral therapy

Putting aside all the arguments about whether people should get so anxious, the practical reality is that they do. If this seriously disrupts their ability to lead normal lives, then something should be done. Common humanity requires that society makes reasonable provision for their treatment. The pharmaceutical industry would have us believe drugs are the best answer to all our problems and, when it comes to dealing with anxiety disorders, our doctors have a big choise of them. We start of with antidepressants. Yes, the name apparently suggests their function is limited to treating depression, but they can be just as useful in treating anxiety disorders. So now your doctor decides which medication to try out on you. There are the SSRIs and the tricyclics, and do not forget the MAOIs. Then we get into the anti-anxiety drugs, most often derived from the benzodiazepines. If those do not take your fancy, there are always the beta-blockers. The cabinet in your bathroom can be filled to overflowing (subject to deciding whether all these options are covered by your health plan). But, there is one inconvenient truth. All the independent research evidence (that’s the research not paid for by the pharmaceutical industry) shows psychotherapy to be more effective than medication. The problem with trying to treat an emotional problem with a pill is there cannot be a conversation about why you are feeling the emotion and how you are going to deal with its consequences. Talking through the problems with a mental health specialist has the best success record in restoring quality of life and avoiding a relapse into an anxiety state. For a start, it treats you as a human being. You become the focus of attention. People listen to you and advise you on how to improve the quality of your life. In the current healthcare market, you see your doctor for a few minutes, collect a prescription and pick up the bill on the way out. People respond well when they believe their interests are being taken seriously. Their treatment is progressed rapidly if the advice they receive is seen to be useful. There is no point in advising people out of books. This has to be a hands-on approach to changing each person’s attitudes and habits. The best form of psychotherapy is cognitive behavioral therapy (CBT). “Cognitive” because you want people to understand their emotional responses to different situations. Only if they understand why they feel anxious can they begin the process of changing their responses. “Behavioral” because the therapist will train people to change the way they behave. This means forcing people to confront the situations in which they feel anxious or fearful, and teaching them how to react more positively. CBT usually lasts over a period of about twelve weeks. For most people, it works best on a one-to-one basis but, in cases of social phobia, part of the training can be in groups to help people become more used to social gatherings. Before starting on the course, it is useful for people to take xanax. This brings the anxiety levels down and provides a window of opportunity when they may learn new habits. But, for the majority of people, the use of xanax should be quickly tapered off. The aim is to enable people to respond more confidently without having to rely on a drug. Only then can people actually begin to feel confident about their own abilities rather than as people propped up by pills.

More about pain management

Let’s assume we could talk the health insurance industry into paying for treatment focussed on the patient and not on the profitability of the hospitals and the pharmaceutical industry. What would a pain management department look like and how would it treat its patients? First off, it would concentrate all its energies on two quite different functions. Before you can identify the best treatment for a patient, you must diagnose the underlying cause of the pain. The most experienced diagnosticians in the hospital or clinic must therefore work on each patient, using whatever reasonable tests are necessary to reach a reliable diagnosis. The second function is to switch the emphasis on the types of treatment made available. At present, hospitals are run for profit and so base all their treatment decisions on what generates the most profit. In other countries, there is an evidence-based approach. Researchers identify which treatments are the most cost-effective for relieving the patient’s problem and only those treatments are used regardless of the level of profitability.

Once the hospital has a reliable diagnosis, it moves to the treatment phase. This may be an interventional procedure to repair damage or relieve the cause of pain. In the case of surgery, there are new less invasive methods. Where surgeons have the experience and the evidence shows good outcomes are likely, they should be used. If invasive procedures are not recommended or require follow-up, we move into the area of physical therapy, psychological counseling, cognitive behavioral therapy and general support services. Here the team aims to teach each patient how to cope with the new physical limitations and the reality of persistent pain. All the research both in the US and in the rest of the world shows these services are the most likely to improve the patient’s quality of life. pain management is as much about the patient’s attitude and emotions as it is about the treatment given. Then we get into all the alternative therapies. Again there is excellent research evidence showing that acupuncture and some homeopathic therapies produce excellent results. If there is such evidence available, the hospital or clinic should supply it. Finally, the doctors need to give detailed advice to patients about what drugs to use and when to use them.

In all this, the pain management department is aiming at a simple target. It wants the best long-term result for the patient without relying on the use of drugs. Although there will be some reliance on painkillers like tramadol during the early part of the treatment program, pain management assumes dependence on drugs is a bad thing. People should learn how to make the best of life without relying on pills. So you can buy tramadol online for use in the early stages but be prepared to learn how to management and control your pain without its help. In the long term, this saves you from the continuing cost of having to buy the drugs and it also makes you a stronger person. Ignoring all the stereotypes about the stoic people who live with pain, people with the strength of mind to manage their own feelings and emotions generally make better lives for themselves. People who see a pill bottle as the only solution are weak, passive and rarely make anything of their lives.

Cognitive Behavioral TherapyTag Archives

Ambien should be replaced by talk therapy

When the xanax kicks in, go for cognitive behavioral therapy

More about pain management

Categories

Archives