Development Archives - West County Behavioral Health

06 Jul

July 6, 2023July 6, 2023Jeff Boatman APRN-MHCNS Development, Family, Help with teens, Medication Management

Challenges in Switching Psychiatric Medications

By Jeff Boatman, APRN-MHCNS

We live in a society where we are accustomed to – and expect – instant gratification and results. However, for many of us, the process of finding the correct psychiatric medication can take time and be extremely frustrating. Oftentimes, we have been misdiagnosed or have tried multiple different psychotropic meds over long periods of time – with minimal positive outcomes. Sometimes, we can become so frustrated that we want to “give up” on finding the right medication, and the problems continue or worsen. It is critical for us to have a clear understanding of the process and potential challenges of switching psychiatric medications so that we can understand and be prepared for the experience. Switching psychiatric medications can be a crucial step in managing mental health conditions effectively, and this article aims to share valuable information to consider when transitioning between medications, ensuring a smoother and safer experience.

It is vital to have a good working relationship with a psychiatric provider whom you trust when considering a switch. A provider should involve you, the patient, in the decision-making process and be willing to consider your previous experiences with medications, comorbidities, and other factors that may affect the treatment. As a patient, you have a responsibility to share your concerns, symptoms, and goals to ensure the new medication aligns with YOUR specific needs. The provider should spend an appropriate amount of time educating patients and families about all the dynamics involved in making a switch and allow adequate time for questions to be answered and expectations to be discussed. Here are some important considerations that the provider should address with you.

Understanding Reasons for Switching Psychotropic – Changes to medication may occur due to various reasons. It could be due to inadequate symptom relief, intolerable side effects, lack of response to the current medication, interactions with other medications, cost, or the emergence of new symptoms. Understanding the specific reasons behind the switch can help you and your healthcare provider make informed decisions regarding alternative medications or treatment strategies.

Importance of Gradual Tapering and Titration – Switching psychiatric medications often requires a gradual tapering from the current medication while simultaneously introducing the new one. Abrupt discontinuation can lead to withdrawal symptoms or a sudden worsening of symptoms. Follow your healthcare provider’s instructions carefully regarding the tapering and titration schedule. It may take several weeks or longer to transition fully, as this allows your body to adjust to the new medication while minimizing potential adverse effects. In addition, patients need to be educated about possible withdrawal symptoms that may occur. Some people may experience withdrawal symptoms when switching from one psychotropic drug to another. These symptoms can include anxiety, depression, insomnia, and irritability.

Potential Interactions: The provider should explain to the patient and family any potential interactions between the new medication and other medications that the patient is taking. You should also be advised on any food or beverages to avoid when taking the new medication.

Potential Side Effects and Monitoring. Different psychiatric medications can have varying side effects. Your healthcare provider should inform you about potential side effects associated with the new medication. Common side effects may include gastrointestinal discomfort, dizziness, drowsiness, changes in appetite, weight gain, lethargy, changes in sleep patterns, or sexual dysfunction. Be aware of these possibilities but remember that not everyone experiences them. Regular check-ins and follow-up appointments with your psychiatric provider are crucial during the transition phase to monitor your response to the new medication and address any concerns or side effects that may arise.

A clear understanding of the new medication: The provider should explain the new medication, including its name (generic and name brand), action, dosage, scheduling if it should be taken with or without food, possible side effects to look for, and what the realistic expectations should be.

Plan for monitoring: The provider should explain how you will be monitored during the transition to the new medication. This may include a phone call, a text to a provider with an update, more frequent follow-up appointments, and possible blood tests. It is important that there is a plan for the patient to reach out if experiencing issues.

Switching psychiatric medications can be challenging, and it is essential to remain patient throughout the process. It may take time to find the right medication and dosage that works best for you. Changing medications requires careful consideration, open communication with healthcare providers, and patience. By understanding the reasons behind the switch, following gradual tapering and titration protocols, being aware of potential side effects, and maintaining regular communication with your healthcare provider, you can navigate the transition process more effectively and improve your mental health outcomes. Remember, you are not alone—seek the support you need to ensure a successful switch.

21 Sep

September 21, 2022November 21, 2022Tony Tramelli, LPC Development, Help with teens, Teen Stress

The Business of Play: Youth Sports in America

By Tony Tramelli, LPC

The culture of youth sports in America has changed dramatically over the past decade. Not too long ago youth sports were for the most part community-based organizations which did their best to give every child the opportunity to be part of a team, to get some much-needed physical activity, and to learn the many valuable skills that come with competition. In the past ten years or so we have seen youth sports move away from this model and develop into a $17 billion industry, which makes it larger than the business of professional baseball and the same size as the NFL.

This financial boom has occurred not with the increase in participation but with a significant decrease in children’s participation in sports. Going back to 2008, regular participation in youth sports is down in almost every category. One would think that the decline in youth sports is a result of the sedentary, technology-dominated lives of young people. Children are certainly prioritizing screens overplay, but this is not the primary driver for the decrease in participation. To explain this phenomenon, we have to look at income inequality.

Among wealthier families, youth participation is rising, and among the poorest households, it is trending significantly downward. According to a report from TD Ameritrade most American families whose children are involved in sports spend about $500 a month for each child to play, about twenty percent spend $1000, and roughly ten percent spend upwards of $2000 a month. These costs have made it impossible for thousands of children to participate in sports. There are also many cases in which families, who are struggling financially, to go into debt or make other financial sacrifices with the dream of their investment paying off down the road in the form of college scholarships or even professional careers. The fact is however that youth sports are a seriously flawed investment. Only two percent of high school athletes are awarded financial scholarships and only two percent of college athletes go on to professional careers.

Even with these dire statistics, we have seen an explosion in the pay-to-play travel team model of youth sports. Expensive travel leagues take talented young athletes from well-off families, leaving behind local leagues with fewer players, fewer involved parents, and fewer resources. When kids move from community teams to elite travel teams, it sends the message to the kids that didn’t make the team or whose family couldn’t afford it, that they don’t have a place in sports. The American system of youth sports, serving only a select few, at the expense of so many, has destroyed an institution that once prided itself on the values of participation, teamwork, character development, and physical exercise. Youth sports has become, like so many institutions in this country, a business.

The lack of access to youth sports for so many kids is only one of many consequences of this culture around sports. We also must look at how this culture is affecting the athletes and families who do have the opportunity to be part of these teams. Because parents are investing so much financially with the rare chance of a future payout, naturally more pressure is put on the athlete to perform. Kids are experiencing a tremendous amount of pressure and expectations from parents, coaches, and peers alike. At the heart of this pressure is a fear of failure; if they don’t perform well, they fear that something bad will happen to them (even if this is objectively untrue).

Based on the research of thousands of young athletes participating in elite sports the most common causes of fear include;

– Disappointing their parents

– Being rejected by peers

– The end of their sports dreams

– That it will all have been a waste of time

– Failure in sports means the child is a failure

These beliefs produce;

– Negativity, worry, doubt

– Fear, anxiety, stress

– Muscle tension, increased heart rate, adrenaline pumps

– Self-sabotage and avoidance behaviors

These beliefs and fears are why so many children are dropping out of sports by their early teens. About seventy percent of kids are giving up organized sports by the time they reach high school.

Kids are also experiencing pressure to play a certain sport and even a certain position within the sport based on the probability that it will land them a college scholarship. More and more kids are becoming single-sport athletes, playing their select sport all year round, which leads to physical deterioration and burnout. The irony in this is that most college recruiters are looking for athletes who play multiple sports throughout the year. Some kids are even being told to ignore defense in favor of scoring because it is easier to get recognized that way.

With all of this pressure being put on these children, one would think that success at a young age is a valid predictor of future success, but this simply is not the case. Unless a child is one of the rarest prodigies in their sport, results at a young age do not predict later success. What matters in youth sports in regard to future success in sports are not the results, but rather the passion and willingness to work hard to improve one’s skills, developing the resiliency necessary to manage loss and failure, and to develop physically and technically.

We also see family systems affected due to the current culture of youth sports. For many families, life revolves around the team; practices, games, private coaching, out-of-town tournaments, fundraisers, etc. The extent to which and how families are affected by this of course depends on the family, but for many, no time is left for anything but the sport. This leaves families without opportunities for family dinners, vacations, downtime, and social lives outside of the team. We also know of many families in which resources or talent allows only for specific children to participate in sports. This leaves the other child or children to feel left out and less than.

Youth sports could and should be a powerful and healthy developmental opportunity for children. In a healthy sports culture, children develop resiliency, commitment, teamwork, sportsmanship, and have an opportunity to get some much-needed physical activity. We, as parents of young athletes, need to do a better job of encouraging this type of culture. We do this by changing our family’s culture around sports. We do it by reminding ourselves why we have our kids in sports in the first place and by removing our focus from the results and putting it on the effort that our kids display. We do it by making sure that all children have the opportunity to participate no matter what their skill level or family’s financial situation may be.