ADHD

Treatment for attention deficit hyperactivity disorder (ADHD or ADD) isn’t just about taking medication. There are many other effective treatments that can help kids with ADHD improve their ability to pay attention, control impulsive behavior, and curb hyperactivity.

Nutritious meals, play and exercise, learning new coping skills, and improving social skills are all part of a balanced treatment plan that can improve your child’s performance at school, bolster their relationships with others, and decrease stress and frustration—for them and for your whole family.
Stimulants such as Ritalin and Adderall are often prescribed for ADHD, but they might not be the best option for your child—and they’re certainly not the only treatment.

Anxiety disorders?

Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

Autism

There are no medications that can cure ASD or treat the core symptoms. However, there are medications that can help some people with ASD function better. For example, medication might help manage high energy levels, inability to focus, depression, or seizures.

Medications might not affect all children in the same way. It is important to work with a health care professional who has experience in treating children with ASD. Parents and health care professionals must closely monitor a child’s progress and reactions while he or she is taking a medication to be sure that any negative side effects of the treatment do not outweigh the benefits.

It is also important to remember that children with ASD can get sick or injured just like children without ASD. Regular medical and dental exams should be part of a child’s treatment plan. Often it is hard to tell if a child’s behavior is related to the ASD or is caused by a separate health condition. For instance, head banging could be a symptom of the ASD, or it could be a sign that the child is having headaches. In those cases, a thorough physical exam is needed. Monitoring healthy development means not only paying attention to symptoms related to ASD, but also to the child’s physical and mental health, as well.

Types of Treatments

There are many different types of treatments available. For example, auditory training, discrete trial training, vitamin therapy, anti-yeast therapy, facilitated communication, music therapy, occupational therapy, physical therapy, and sensory integration.

The different types of treatments can generally be broken down into the following categories: 

          * Behavior and Communication Approaches 
          * Dietary Approaches 
          * Medication 
          * Complementary and Alternative Medicine

Bipolar Disorder

Treatment is best guided by a medical doctor who specializes in diagnosing and treating mental health conditions (psychiatrist) who is skilled in treating bipolar and related disorders. You may have a treatment team that also includes a psychologist, social worker and psychiatric nurse.

Bipolar disorder is a lifelong condition. Treatment is directed at managing symptoms. Depending on your needs, treatment may include:

Medications. Often, you'll need to start taking medications to balance your moods right away. 
Continued treatment. Bipolar disorder requires lifelong treatment with medications, even during periods when you feel better. People who skip maintenance treatment are at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression. 
Day treatment programs. Your doctor may recommend a day treatment program. These programs provide the support and counseling you need while you get symptoms under control. 
Substance abuse treatment. If you have problems with alcohol or drugs, you'll also need substance abuse treatment. Otherwise, it can be very difficult to manage bipolar disorder. 
Hospitalization. Your doctor may recommend hospitalization if you're behaving dangerously, you feel suicidal or you become detached from reality (psychotic). Getting psychiatric treatment at a hospital can help keep you calm and safe and stabilize your mood, whether you're having a manic or major depressive episode. 

The primary treatments for bipolar disorder include medications and psychological counseling (psychotherapy) to control symptoms, and also may include education and support groups.

Borderline Personality Disorder

There are good long-term outcomes for people experiencing BPD who engage in a comprehensive treatment plan. Most experience the best results using a combination of psychotherapy, peer and family support and medications (when indicated) to address their symptoms. People with BPD often have other co-occurring conditions and their treatment plan should address these as well.

Work with your treatment team to understand the risks and benefits of each of these individual courses of action as well as how they work with each other.

Psychotherapy

Psychotherapy is considered the cornerstone for treating BPD because it aims to address the emotional dysregulation associated with the condition. A hallmark of effective treatment is learning to master dysregulation with coping skills, insight and acceptance. There are several types of psychotherapy that have shown to be effective in doing this:

Dialectical behavioral therapy (DBT) focuses on teaching coping skills to combat counterproductive urges, regulate emotions and improve relationships. Involving individual and group work, DBT encourages practicing mindfulness techniques such as meditation, regulated breathing and self-soothing. DBT has been shown to be effective in reducing suicidal behavior, psychiatric hospitalization, treatment dropout, substance abuse, anger and interpersonal difficulties.
Cognitive behavioral therapy (CBT) helps address the negative thinking and behaviors associated with BPD. The goal of this therapy is to recognize negative thoughts and learn effective coping strategies.
Mentalization-based therapy (MBT) teaches people how to become conscious of their internal states and how to develop empathy for other people’s experiences. This treatment is also used to explore emotions and develop alternative explanations for negative interactions with others.

Medications

There is no singular medication designed to specifically treat the core symptoms of BPD. Medications can be useful in treating certain symptoms associated with BPD, such as depression and anxiety. They can also be used to help increase a person’s ability to engage in psychotherapy.

Level Of Care.

While most people can live in the community during their treatment (outpatient), higher levels of care may be useful at moments when more intensive clinical support is needed. For example, a hospital inpatient unit can provide a safe environment for a person with BPD who is actively suicidal.
In the DBT framework, the goal is usually to learn coping skills while in the community; it is not organized around inpatient care. Though, there are some facilities that have a DBT track in inpatient-partial hospital program, which is a model where you sleep at home and attend during the day. It’s important to determine the level of care you or your loved one might require before engaging in (and throughout the duration of) treatment.

Depression

Although depressive disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts. After an assessment rules out medical and other possible causes, a patient-centered treatment plans can include any or a combination of the following:

Psychotherapy including cognitive behavioral therapy, family-focused therapy and interpersonal therapy.
Medications including antidepressants, mood stabilizers and antipsychotic medications.
Exercise can help with prevention and mild-to-moderate symptoms.
Brain stimulation therapies can be tried if psychotherapy and/or medication are not effective. These include electroconvulsive therapy (ECT) for depressive disorder with psychosis or repetitive transcranial magnetic stimulation (rTMS) for severe depression.
Light therapy, which uses a light box to expose a person to full spectrum light in an effort to regulate the hormone melatonin.
Alternative approaches including acupuncture, meditation, faith and nutrition can be part of a comprehensive treatment plan.

Dissociative Disorders

The goals of treatment for dissociative disorders are to help the patient safely recall and process painful memories, develop coping skills, and, in the case of dissociative identity disorder, to integrate the different identities into one functional person. It is important to note that there is no medication that deals directly with treating dissociation itself. Rather, medications are used to combat additional symptoms that commonly occur with dissociative disorders.

Psychotherapy

Different psychotherapies are used to treat dissociative episodes to decrease symptom frequency and improve coping strategies for the experience of dissociation. Some of the more common therapies include:

Cognitive behavioral therapy (CBT) helps change the negative thinking and behavior associated with depression. The goal of this therapy is to recognize negative thoughts and to teach coping strategies.
Dialectical behavioral therapy (DBT) focuses on teaching coping skills to combat destructive urges, regulate emotions and improve relationships while adding validation. Involving individual and group work, DBT encourages practicing mindfulness techniques such as meditation, regulated breathing and self-soothing.
Eye movement desensitization and reprocessing (EMDR) is designed to alleviate the distress associated with traumatic memories. It combines the CBT techniques of re-learning thought patterns with visual stimulation exercises to access traumatic memories and replace the associated negative beliefs with positive ones. .

Early Psychosis and Psychosis

The most effective treatment for early psychosis is Coordinated Specialty Care (CSC). The earlier a person experiencing psychosis receives CSC, the better his or her quality of life becomes. CSC’s team-based approach encourages the individual experiencing early psychosis to share in decisions about treatment and recovery goals.

CSC programs have six components:.

Case management—helping the individual develop problem-solving skills, manage medication and coordinate services
Family support and education—giving families information and skills to support a loved one’s treatment and recovery
Psychotherapy—learning to focus on resiliency, managing the condition, promoting wellness and developing coping skills
Medication management—finding the best medication at the lowest possible dose
Supported education and employment—supporting someone to continue or return to school or work
Peer support—connecting the person with others who have been through similar experiences

Each component is provided by a team of specially trained healthcare professionals who help individuals get their lives back on track and realize their goals, such as finishing school or returning to work.

A total of 270 CSC programs were operating across the U.S. as of 2018. Youth, young adults and families can find helpful resources about these programs from the Early Assessment and Support Alliance (EASA), Strong 365 (a project of the One Mind Institute), or from local university medical schools.

Psychosis Treatment

Treatment for psychosis often involves a combination of psychotherapy and medication. Several types of therapy can help individuals learn to manage their condition, while medication targets symptoms and helps to reduce their impact. How well treatment works depends on the cause(s) of the psychosis, its severity and its duration.

Psychotherapy

Therapy is essential in treating psychosis. Common therapies include the following:
Cognitive behavioral therapy (CBT)—teaches people to observe and change ineffective patterns of thinking. For psychosis, CBT teaches someone to critically evaluate an experience to determine whether or not the experience is real.
Supportive psychotherapy—teaches a person to cope with developing and living with psychosis. The therapist attempts to reinforce a person’s healthy ways of thinking and reduce internal conflict.
Cognitive enhancement therapy (CET)—builds brain capacity through the use of computer exercises and group work. Increasing cognitive functions, such as the ability to organize thoughts, is the ultimate goal.
Family psychoeducation and support—gives families skills and support to help a loved one reach recovery. NAMI Basics, NAMI Family-To-Family and NAMI Family Support Groups are examples of programs the help people develop skills in collaboration, problem-solving and recovery support.
Peer support and support—connects people with others who have been through similar experiences. NAMI Peer-To-Peer and NAMI Connection are examples of peer-led programs that equip individuals with the tools they need to realize recovery while building supportive, caring relationships.

Eating Disorders

Each person’s treatment will depend on the type of eating disorder, but generally it will include psychotherapy along with medical monitoring and nutritional counseling. Family-based treatment is especially important for families with children and adolescents because it enlists the families’ help to better insure healthy eating patterns and increases awareness and support.

Many people receive treatment for an eating disorder without needing an intensive treatment setting. However, for some people, an inpatient or residential eating disorder treatment center or partial hospital setting is best when they begin treatment. Others may need hospitalization to treat serious problems caused by poor nutrition or for care if they are very underweight.

Support groups, nutrition counseling and medications are also helpful to some individuals.

Psychotherapy should be provided by a mental health professional with experience in treating eating disorders. Because of the complexity, therapy needs to address both the symptoms and a person’s psychological, interpersonal and cultural influences which contributed to the disorder.

Cognitive behavioral therapy (CBT) is often successfully used in the treatment of eating disorders because it helps people understand the relationship between their thoughts, feelings and behaviors. CBT that is developed for the treatment of bulimia is very effective at changing the binge-purge behaviors and eating attitudes.

Wellness and Nutrition Counseling involves professionals helping a patient return to a normal weight. Dietitians and other health care providers can help change old habits and beliefs about food, dieting and exercise with healthy nutrition and eating information and planning. Sometimes planning and monitoring responsibilities are shared with mental health professionals or family members.

Obsessive-Compulsive Disorder

For many, a combination of medicine and therapy is superior to either approach alone. While medicine may work directly on the brain, the therapies are believed help to retrain the brain to recognize "false threats."

Psychotherapy

There are two types of psychotherapies that are helpful for treating OCD:

Exposure and response therapy exposes a person to the cause of their anxiety. For example, a person with a fear of germs may be asked by a doctor or therapist to put their hand on something considered dirty, such as a doorknob. Afterwards, they will refrain from washing their hands. The length of time between touching the doorknob and washing hands becomes longer and longer. Ultimately, when the person realizes that not washing right away does not cause a deadly reaction, the compulsion to wash fades.

Cognitive behavioral therapy focuses on the thoughts that are causing distress, and changing the negative thinking and behavior associated them. For obsessive-compulsive disorder, the goal of this therapy is to recognize negative thoughts and, with practice, gradually lessen their intensity to the point of harmlessness.

Medication

The most common type of medication used to treat OCD are antidepressants. Treating OCD with antidepressants often takes longer to take effect than treating depression. Also, these medicines must sometimes be given in larger doses and for a longer period of time than for depression.

Complementary Health Approaches

Aerobic exercise is a key complimentary intervention that can work to improve the quality of life for people with OCD. Exercise can work to naturally reduce the baseline level of anxiety a person experiences.

Posttraumatic Stress Disorder

When people experience trauma, their biological and psychological responses can be intense and painful. Many people will continue with their lives with few or no symptoms, but for some, the intensity and pain remain. It can be difficult to make the decision to seek help since it's common to feel like we should just "get over" the experience.

There are several well-studied treatment approaches to address the symptoms of PTSD. The best treatment plan should include your preferences while also addressing any other co-existing conditions you may have.

Medications alone are unlikely to heal the psychological wounds of trauma and may also create side effects. Most people find a combination of two approaches—psychotherapy and medication—yields the best results.

Receiving support and compassion immediately after a traumatic event is also critical. Some people will want to talk about the event, while others will find it troubling and overwhelming. It’s not helpful to force anyone to discuss a traumatic event until they are ready.

Psychotherapy

There are many different types of psychotherapy. Some psychotherapy approaches involve returning your attention to the traumatic event and can be provocative and challenging. However, when they are done well as part of a coordinated treatment approach they often result in fewer symptoms.

Research indicates that there are several therapeutic approaches that are more effective than others in addressing the symptoms of PTSD:

Cognitive Processing Therapy is a type of cognitive behavioral therapy (CBT) that works to address the negative thinking and self-blame symptoms that may come with having PTSD . There is specific training for the psychotherapist and materials to guide this treatment.
Eye Movement Desensitization and Reprocessing (EMDR) was specifically designed to treat trauma. This therapy uses measured exposure to traumatic memories with alternating stimuli (eye movements are one of several options) in structured sessions with a health care professional certified to perform EMDR.
Exposure Therapy is a type of psychotherapy that enables a skilled practitioner to help people safely face what they find traumatizing so they can learn to cope effectively. One technique used in exposure therapy involves virtual reality programs that allow a person to experience the situation in which they experienced trauma to help process it.
Group Therapy with others who have similar experiences can help build resilience when someone feels alone and isolated. Group therapy helps lessen shame and provide support, as well as reduce feelings of helplessness. Groups for survivors of sexual assault and combat experiences frequently have members living with PTSD and related symptoms.

Ask yourone of the SAMHC therapist if they are familiar with, or have been trained in, these specific techniques. If their answer is no, ask what approach they use in trauma psychotherapy. There are other effective approaches, but it is helpful to understand your health care professional’s experience in addressing PTSD. Consider asking your therapist, primary care doctor or health plan provider for a referral to a specialist in these treatments if you conclude they are the best match for you.

Medications

There is no one medication that treats all the symptoms of PTSD, yet some medications can help with some symptoms and also increase the effectiveness of psychotherapy. When selecting a medication, you should also consider the presence of any other conditions such as depression or anxiety and how they may be impacted.

Antidepressants can be useful to help reduce symptoms of PTSD. Some serotonin reuptake inhibitors (SSRIs) have been approved by the FDA for the treatment of PTSD in adults and are often the first line of treatment. Be sure to be informed about medication uses and side effects, and ask your doctor about the latest research in this field.
Other medication approaches are also available, although some are not FDA-approved specifically for the treatment of PTSD symptoms. Ask your doctor for more information about all medication options available.
Other biological interventions. Many states that have legalized marijuana for medical use, and it includes an indication for PTSD. To date, there has not been a randomized controlled trial on the effectiveness of marijuana for PTSD, so it’s difficult to assess its potential viability as a treatment. Research is also underway to assess the potential use of Methylenedioxymethamphetamine (MDMA) to augment psychotherapy for PTSD. MDMA is currently not legal in the U.S.

Complementary Health Approaches

Recently, many health care professionals have begun to include complementary and alternative methods into treatment regimens. Some methods that have been used for PTSD include:

          * Yoga
          * Aqua therapy
          * Acupuncture
          * Mindfulness and meditation strategies and practices

Service dogs are another option for non-traditional therapy for people experiencing PTSD. A service dog is by a person’s side 24 hours a day to help navigate daily stressors. Most animals come to the person pre-trained with a set of commands. The owner can rely upon the dog for help and as a reality grounding tool, which can help prevent a re-experience or other symptoms. These animals can also serve as a social buffer, an incentive to exercise and a de-escalation tool during times of stress.

Schizoaffective Disorder

People with schizoaffective disorder are often treated with a combination of medications and psychotherapy. How well treatment works depends on the type of schizoaffective disorder, its severity and its duration.

Medications

Doctors and other mental health professionals will often prescribe medications to relieve symptoms of psychosis, stabilize mood and treat depression. The only medication approved by the FDA to treat schizoaffective disorder is the antipsychotic drug paliperidone (Invega).

However, some medications approved for the treatment of other mental health conditions may be helpful for schizoaffective disorder. These medications include:

Antipsychotics. A health care provider will prescribe antipsychotics to relieve symptoms of psychosis, such as delusions and hallucinations.
Antidepressants. When schizoaffective disorder is depressive-type antidepressants can alleviate feelings of sadness, despair and trouble concentrating.
Mood stabilizers. When bipolar disorder is the underlying mood disorder, mood stabilizers can help stabilize the highs and lows.

Psychotherapy

Family involvement, psychosocial strategies, self-care peer support, psychotherapy and integrated care for co-occurring substance abuse can all be part of an individual support plan.

Cognitive behavioral therapy (CBT) helps change the negative thinking and behavior associated with feelings of depression. The goal of this therapy is to recognize negative thoughts and to teach coping strategies. With conditions like schizoaffective disorder that have symptoms of psychosis, additional cognitive therapy is added to basic CBT (CBTp). CBTp helps people develop coping strategies for persistent symptoms that do not respond to medicine.

Alternative Treatment Options

For cases where medication and psychotherapy do not work for a person with schizoaffective disorder, ECT may be worth considering. ECT involves transmitting short electrical impulses into the brain. Although ECT is a highly effective treatment for severe depression, it is not the first choice in treating schizoaffective disorder.

Cultural Considerations

Research has shown that African Americans and Latinos are more likely to be misdiagnosed with schizoaffective disorder, so people who have been diagnosed should make sure that their mental health professional understands their background and shares their expectations for treatment.

Schizophrenia

With medication, psychosocial rehabilitation, and family support, the symptoms of schizophrenia can be reduced. People with schizophrenia should get treatment as soon as the illness starts showing, because early detection can reduce the severity of their symptoms.

Recovery while living with schizophrenia is often seen over time, and involves a variety of factors including self-learning, peer support, school and work and finding the right supports and treatment.

Medication

Typically, a health care provider will prescribe antipsychotics to relieve symptoms of psychosis, such as delusions and hallucinations. Due to lack of awareness of having an illness and the serious side effects of medication used to treat schizophrenia, people who have been prescribed them are often hesitant to take them.

First Generation (Typical) Antipsychotics

These medications can cause serious movement problems that can be short (dystonia) or long term (called tardive dyskinesia), and also muscle stiffness. Other side effects can also occur.

Chlorpromazine (Thorazine)
Fluphenazine (Proxlixin)
Haloperidol (Haldol)
Loxapine (Loxitane)
Perphenazine (Trilafon)
Thiothixene (Navane)
Trifluoperazine (Stelazine)

Second Generation (Atypical) Antipsychotics

These medications are called atypical because they are less likely to block dopamine and cause movement disorders. They do, however, increase the risk of weight gain and diabetes. Changes in nutrition and exercise, and possibly medication intervention, can help address these side effects.

Aripiprazole (Abilify)
Asenapine (Saphris)
Clozapine (Clozaril)
Iloperidone (Fanapt)
Lurasidone (Latuda)
Olanzapine (Zyprexa)
Paliperidone (Invega)
Risperidone (Risperdal)
Quetiapine (Seroquel)
Ziprasidone (Geodon)

One unique second generation antipsychotic medication is called clozapine. It is the only FDA approved antipsychotic medication for the treatment of refractory schizophrenia and has been the only one indicated to reduce thoughts of suicide. However, it does have multiple medical risks in addition to these benefits.

Psychotherapy

Cognitive behavioral therapy (CBT) is an effective treatment for some people with affective disorders. With more serious conditions, including those with psychosis, additional cognitive therapy is added to basic CBT (CBTp). CBTp helps people develop coping strategies for persistent symptoms that do not respond to medicine.

Supportive psychotherapy is used to help a person process his experience and to support him in coping while living with schizophrenia. It is not designed to uncover childhood experiences or activate traumatic experiences, but is rather focused on the here and now.

Cognitive Enhancement Therapy (CET) works to promote cognitive functioning and confidence in one’s cognitive ability. CET involves a combination of computer based brain training and group sessions. This is an active area of research in the field at this time.

Psychosocial Treatments

People who engage in therapeutic interventions often see improvement, and experience greater mental stability. Psychosocial treatments enable people to compensate for or eliminate the barriers caused by their schizophrenia and learn to live successfully. If a person participates in psychosocial rehabilitation, she is more likely to continue taking their medication and less likely to relapse. Some of the more common psychosocial treatments include:

Assertive Community Treatment (ACT) provides comprehensive treatment for people with serious mental illnesses, such as schizophrenia. Unlike other community-based programs that connect people with mental health or other services, ACT provides highly individualized services directly to people with mental illness. Professionals work with people with schizophrenia and help them meet the challenges of daily life. ACT professionals also address

Peer support groups like NAMI Peer-to-Peer encourage people’s involvement in their recovery by helping them work on social skills with others.

Complementary Health Approaches

Complementary and alternative health approaches including acupuncture, meditation, and nutrition interventions can be part of a comprehensive treatment plan. For example, Omega-3 fatty acids, commonly found in fish oil, have shown some promise for treating and managing schizophrenia. Some researchers believe that omega-3 may help treat mental illness because of its ability to help replenish neurons and connections in affected areas of the brain.

Additional Concerns

Physical Health. People with schizophrenia are subject to many medical risks, including diabetes and cardiovascular problems, and also smoking and lung disease. For this reason, coordinated and active attention to medical risks is essential.

Substance Use. People with schizophrenia are at an increased risk for misusing drugs or alcohol. Substance use can make the treatments for schizophrenia less effective, make people less likely to follow their treatment plans, and even worsen their symptoms.