While I see the humor in this, The main goal of most psychiatrists in the cases of mental issues that can be managed through healthy behaviors is to prescribe drugs to get you to a point where you can do all those things and then keep you in that state as stably as possible.
The described routine of personal care is a common set of behaviors in the management and recovery of depression and conditions with depressive symptoms or certain conditions effecting social functioning.
If you go to a psychiatrist because you have emotions and symptoms impacting your life and you are not already doing these things- there is a general assumption that can be made that you are presently incapable of doing those things or finding the ability to do them- otherwise you’d be doing them right?
There is a relatively small sub set of the population who needs to be told to perform basic care and wouldn’t think to do so on their own if they were being impacted by it. In fact, not doing these things can also be a symptom of conditions that affect your thought processes. So getting you into a routine of self care is often a priority, but if you have depression or anxiety or self destructive thought processes etc. hindering you in doing these things, medication can help some people reach a stable baseline to begin making changes that often help
In changing mood and habit through routine and results and thusly can directly and indirectly alleviate symptoms and even the underlying conditions causing issues for them.
Of course once you have started such behaviors and may be feeling a little or much better, that doesn’t necessarily mean it is advisable to discontinue medication.
This is seen all the time in medicine. People often stop taking antibiotics when they feel or notice a difference but if you don’t finish the entire course the infection can return.
Or think of it this way- say you had surgery and are bed ridden with pain. The first day doctors give you some pain medicine. It takes time to work but your pain becomes manageable. You feel better and can get back to life a bit. You’re out doing and living. The doctor said take a pill every 4 hours but you feel fine so you toss the meds. But when that last dose wears off, the pain all comes back, and now you are bedridden and suffering again.
This is how most long term psych meds work. Things like antidepressants and such can take a month to even start working and months to reach their full effect. “Cycling” or “yo-yo-ing” are very common in patients on these meds because they may take them and not feel better right away so then stop or start taking them on random schedules; or they feel better and are functioning well in their lives and meeting goals so they decide to stop. Then when the meds wear off they suffer symptoms of the condition the meds are meant to treat and start again, but it takes time for the meds to work. In the interim time their thought and behavior processes can cause issues in their personal lives and careers, and friends and family or coworkers who don’t have a full picture may be seeing erratic swings from happy or outgoing and reliable to sad, withdrawn, erratic etc.
It’s also the case that while you may be “flying high” and things in your life are going well and you are excited and motivated or determined so you’re making those positive changes; that over time that can shift. Almost everyone can relate to starting something strong and with enthusiasm but as times goes on losing that steam.
If your underlying mental state is such that without some sort of motivator or assistance that you can’t bring yourself to do “basic” self care tasks, when that steam runs out or you face challenges in life and things aren’t all feeling like they are on rails moving to a better place, people can crash or even become a danger to themselves.
The key factor is that many psychological conditions are both chronic and unstable. Kanye West was overall doing fine and then… he wasn’t. He decided to stop taking his meds and… well, we have very publicly seen this effect his behavior and mental state as well as watching him get divorced, lose work, and all sorts of things as related consequences.
You can have long spells of being “fine” or showing little to no symptoms of a chronic mental health condition for years or decades even without treatment. In most cases of common conditions you might get weeks or months with episodes of various lengths in between.
So part of the goal of medication in these cases is stability. If you have a manageable condition and the proper medications and doses have been found to help manage your condition(s), sometimes keeping you on the medications even when you are “Doing good” is wise. Sometimes stopping them has high likelihood of you regressing. Long term and depending on the condition and person, you can use a combination of drugs and behavioral therapy and tools as well as lifestyle changes to get away from the drugs by building your ability to have tools for identifying and stopping regressions and to have support systems and resiliency and routines and habits.
Generally you shouldn’t just stop taking those types of meds as there can be mental and physical harm or complications if you do not properly taper off or “wean” yourself off, usually through slowly decreasing the dosage over a safe period of time to allow your body to adjust to the drugs not being in your system and having to self regulate again. This period can also help get some idea of chances for management without the drugs. As you taper down your dosage, you may start to feel differently and your behaviors and resolve may change. If you start to find that your state isn’t manageable as you taper, that can be a sign that you may be best to continue the medication but perhaps at a reduced dose or perhaps the original dose.
For the most part your psychologist just wants you to be able to live happily and productively and safely as possible. The biggest concerns in mental health are mitigating people harming themselves and others, and after that the next biggest concerns are quality of life and possible recovery.
Not all mental conditions are chronic. You can have depression or even manic depressive episodes, anxiety, even psychosis or more as temporary states. You can be fine for 20,40+ years and have a period or episode of severe mental impact, and then you can never have such an issue again for the rest of your life.
You can wake up every day and have those issues for as long as anyone can remember and never be rid of them completely. You can have those issues on and off again.
You can be in therapy and on medication and functioning and thriving and still walk around every day with depression or suicidal and self destructive thoughts and urges, anxiety, impending sense of doom, hearing voices…
Mental health is not one size fits all. The big secret is that there is no “normal.” There isn’t a single human being to point at as an example of what “normal” should look like. Our best go to for “healthy” is a person who is happy or content, has a good survival instinct, and fits in well to a society and is able to function and thrive socially and economically etc. while contributing to a community or larger society in positive ways. It’s a broad and subjective criteria.
most people would say someone who believes a bird is actually Satan and is telling them to burn buildings or they will steal their soul- most people would say that person had something wrong in the head. But… the person taking to the bird? Good odds they might not see that same conclusion. They may think they are the picture of mental health.
A depressed person might say something like “no one likes me…” but you can logically and concretely show that isn’t true. They can have 100 texts from people wanting to hang out, invites to parties and dinners and more- and you can show them and they will usually reject it all. “They don’t really like me..” “those people are fake…” “so and so has 200 texts…” some set of circumstances and excuses that reject clear evidence in support of their view they aren’t liked. That’s how many mental conditions work. A manic person might insist that everyone loves their singing even when people are telling them they do not. Many mental conditions make you the unreliable narrator- more so than the average human cognition biases and such.
But strangers can’t tell us how we feel either right? So it’s tough. There is push and pull there but ultimately the whole thing is some balance with the main decider being how you feel. If you go to a psychiatrist voluntarily you obviously weren’t feeling your life and/or mental state were super great. If you’re ready to stop, you either likely don’t feel an improvement from seeing them or you feel like things have improved and you don’t need to see them anymore. Those can both be true and valid or they can be fallacy. Since you are seeing a mental health professional because your ability to think isn’t where you’d want it to be- there is a wisdom in placing some trust in them- or if you can’t, finding someone you can to work with. Ultimately it is your life and you are the one who lives with consequences so you decide and you live with the choices.
Overall though the general goal of medication isn’t to keep you on the medication, it is to get you to a place where you can make Sound and rational decisions and hopefully identify fallacies and other patterns of a condition causing you issues in your life and well being. The human mind is something we still know very little about in the broad sense. Your thoughts and feelings aren’t like enzymes and cells that we can look at and quantify and assign values ranges and follow some mechanical and theoretically predictable process. “Feelings doctors” can’t just put a cast on and expect your feelings to mend like a bone or prescribe a pill that “cures” your anxiety, even if they could it wouldn’t be so simple because there is a question of self- what part of your anxiety is you and what part is illness? Some anxiety os natural and expected. People without clinical conditions can miss chances or underperform etc. due to anxiety. The goal isn’t to eliminate anxiety as far as what we..
.. understand being human to mean. If we could somehow completely rid people of anxiety, sadness, loneliness, so called “negative emotions,” the effect on behavior would be profound. You’d be left with a person that didn’t fit what we know being human to be. Maybe for the better or maybe for the worse or maybe just different- but not the same person. It’s a difficult concept- what does the “YOU” without mental illness look like versus a person that isn’t “YOU” but is still your body and brain? Aspects of Codependency can be seen as kindness but kindness can exist without codependency. One might assume a codependent person is only doing a nice thing because of their codependency but how do we know if they might do that one thing even if they did not have codependency?
The described routine of personal care is a common set of behaviors in the management and recovery of depression and conditions with depressive symptoms or certain conditions effecting social functioning.
If you go to a psychiatrist because you have emotions and symptoms impacting your life and you are not already doing these things- there is a general assumption that can be made that you are presently incapable of doing those things or finding the ability to do them- otherwise you’d be doing them right?
In changing mood and habit through routine and results and thusly can directly and indirectly alleviate symptoms and even the underlying conditions causing issues for them.
This is seen all the time in medicine. People often stop taking antibiotics when they feel or notice a difference but if you don’t finish the entire course the infection can return.
Or think of it this way- say you had surgery and are bed ridden with pain. The first day doctors give you some pain medicine. It takes time to work but your pain becomes manageable. You feel better and can get back to life a bit. You’re out doing and living. The doctor said take a pill every 4 hours but you feel fine so you toss the meds. But when that last dose wears off, the pain all comes back, and now you are bedridden and suffering again.
If your underlying mental state is such that without some sort of motivator or assistance that you can’t bring yourself to do “basic” self care tasks, when that steam runs out or you face challenges in life and things aren’t all feeling like they are on rails moving to a better place, people can crash or even become a danger to themselves.
You can have long spells of being “fine” or showing little to no symptoms of a chronic mental health condition for years or decades even without treatment. In most cases of common conditions you might get weeks or months with episodes of various lengths in between.
Not all mental conditions are chronic. You can have depression or even manic depressive episodes, anxiety, even psychosis or more as temporary states. You can be fine for 20,40+ years and have a period or episode of severe mental impact, and then you can never have such an issue again for the rest of your life.
You can wake up every day and have those issues for as long as anyone can remember and never be rid of them completely. You can have those issues on and off again.
You can be in therapy and on medication and functioning and thriving and still walk around every day with depression or suicidal and self destructive thoughts and urges, anxiety, impending sense of doom, hearing voices…
most people would say someone who believes a bird is actually Satan and is telling them to burn buildings or they will steal their soul- most people would say that person had something wrong in the head. But… the person taking to the bird? Good odds they might not see that same conclusion. They may think they are the picture of mental health.