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What is the right therapy?

Mental Health

Who do you believe? Who do you go to for help?

Mental illness or a mood disorder strikes you, a relative, a friend — and you ask yourself these questions, hoping your answer will bring harmony and cure to a hurting condition.

Three broad options will soon become apparent to you.

You may feel that a psychiatrist is the best resource. After all, a person in this profession has a medical degree as well as years of specialist training. Also, you may be culturally conditioned to think that the resolution to mental health problems lurks somewhere in the deep body of psychiatric/medical knowledge and experience available.

But maybe you are not so easy with the doctoring profession. You may have had a difficult experience with a physician, or you may have heard that psychiatrists are a little too quick to use the prescription pad.

Fair enough. We hear lots of things and have our own unique responses to medical intervention.

You may, then, consider a psychologist.

Although lacking in medical training, the psychologist has typically spent many years studying human behaviour in all its manifestations. The body of knowledge and understanding embodied in the field of psychology is as old as human time — unlike modern psychiatry, which is a relatively new field.

Perhaps an appeal to this “softer” approach might be best. Possibly, you may feel, that without the license to prescribe medicine, admit patients to hospital, or to treat mental illness as a medical disorder, a psychologist is a better choice — that “talking things through” in a guided way can get to the root of the issue.

Then again, maybe not.

Maybe you have an aversion to any academically rooted view of mood and mental processes. Maybe it is your opinion that the solutions to mental health problems offered by the psychiatric/psychological professions are self-serving — that (as Kurt Vonnegut might have said) they are cures in search of a disease.

So, you may opt for a social worker.

Social work is a street-level, practical, fluid, and unpredictable endeavor.

Typically, social workers have studied sociology, anthropology, psychology, and criminology. They (along with law enforcement) are most often the first people to deal with folks suffering mental health issues. Social workers are intensely hands-on and, though poorly paid, are highly dedicated.

Maybe you have a respect for the social work profession and appreciate the ground-level support and guidance it provides.

So, there you are, stewing, with a big decision to make.

But is it so big, after all?

Just as there is no single spice in your pantry to make a drab meal tasty, so too is there no single approach to mood disorders and mental illness.

The three broad choices I have outlined are not either/or propositions. They are simply the major, conventional approaches; they can mix, mingle, combine, or contradict each other.

I should also mention that there is a multitude of other “unconventional” (and often superbly successful) ways to approach mental illness.

This column is the first in a series, and much depends on you, the reader.

Please go to the comments section below this article and record your experience, thoughts, and suggestions or you can email me directly at

As a community, let’s really get this discussion going.

Next month we will talk about the psychiatric profession.

Editor’s note: Hugh Macaulay is vice president of the Arrowhead Clubhouse in Sechelt. He writes monthly about mental health issues with a focus on the Sunshine Coast.