Hey specialists and professionals - what free advice do you give to your family and friends that you wish the world understood and acted on routinely?
I am a pharmacist in behavioral health. Here are three things I would tell everyone:
(1) If you take a sleeping pill every day, you will train your body (a la Pavlov) to have chronic insomnia. (You can unlearn this but it is hard). So, don't start the pills. Learn some simple cognitive and behavioral techniques to deal with bad sleep. Learn the names of planets and stars, take up landscape photography, or do something else creative with your nights when you cannot sleep. Catch up on the sleep tomorrow.
(2) You might have ADHD and only be realizing it now at the age of 40 to 65. On the other hand, that stimulant medication (e.g. Adderall, Vyvanse, or Ritalin) that you want to try has not really been tested long term for safety in people your age, nor with your heart, blood pressure, diabetes, etc. conditions. One day when researchers get around to looking backwards at your generation of ## year olds (one of whom will be you), they may show that stimulants (which accelerate heart rate and elevate blood pressure) had no impact whatsoever on mortality and heart attacks, but I am not willing to take that risk, and neither should you. Alternative to taking that stimulant? Look back on all the ways you learned to function with ADHD, and without taking a drug. Keep doing those things, and invest in learning additional techniques. Kick some ass and keep your heart and brain working the old-fashioned way.
(3) According the the World Health Organization, anxiety affects something like 25% of workers worldwide (not sure how many REs). The choice of treatment for anxiety has been undergoing change. Old-school types are still using benzodiazepines like alprazolam, lorazepam, clonazepam and diazepam. (You can bring your anxiety from doctor to doctor and eventually one will offer you lots and lots of these pills.) BUT - benzodiazepines are not so great. In addition to shutting down anxiety, they shut down lots of other parts of your brain. In fact they work on GABA, a diffusely spread neurotransmitter whose primary role everywhere in the cortex is to turn stuff off. Benzodiazepines are a dimmer switch for your brain. When you dim your brain, you lose the ability to learn, to grow and to move past the anxiety. People on benzodiazepines are more likely to have motor vehicle accidents and old people on these drugs fall over and get hurt 3-4x more often then old people not on these drugs. So what is the alternative? I would suggest you invest in some solutions by doing about 6 - 10 weekly sessions of manualized cognitive behavioral therapy. If you can't find that or you really want to take a pill, try an anxiolytic antidepressant like Prozac, Zoloft or Effexor. Leave the benzodiazepines out of your medicine cabinet.
Want one more freebie: OK here it is. If you have a mental illness like depression or anxiety or bipolar, you are not doing yourself any favors by drinking booze or smoking pot. Instead of one more trial of a different antidepressant or a new augmenting drug, try giving up the booze and/or the pot. Give it up for 12 weeks and see if the world is a little brighter place. (Pro tip: if you cannot quit for 12 weeks, you should talk to your doctor about whether you have a problem. Double Pro Tip: if you want to really find out if you have a problem, be honest with your doctor and make sure she doesn't have her own substance related problem).
Best wishes all, Ap.
