Many Dawn Farm clients report symptoms of depression, anxiety, or sleep disorders. Dawn Farm takes a conservative approach with diagnosing psychiatric disorders and the use of psychotropic medications for the following reasons:
- Reliable diagnosis of psychiatric disorders in addicts and alcoholics takes weeks or months, rather than the minutes typically spent with the doctor.
- It is our anecdotal experience that psychiatric disorders are over-diagnosed in alcoholics and addicts.
- According to research, most people entering treatment are experiencing symptoms of a mental illness but these symptoms will improve significantly over a period of 3 to 6 weeks without any psychiatric treatment.
- This 3 to 6 week time frame is the same time frame that we would expect psychotropic drugs to take effect.
- If a newly abstinent person is placed on medication and improves in 3 to 6 weeks, we would be unable to determine whether the medication or recovery reduced the symptoms.
- Given the crises that bring people to treatment, profound sadness and anxiety are to be expected. These responses to crisis are not signs of a disorder. Confronting these feelings is an important task in early recovery.
(For a more detailed explanation of those reasons, please refer to Dawn Farm’s Position on Addiction and Mood Disorders‘.)
As a result of the reasons outlined above, all psychiatric diagnoses and medications are reviewed by a psychiatric nurse practitioner who has significant experience working with addictions. Based on this review, you may be asked to discontinue or taper your medications. This decision will be based on an assessment of your safety, symptom severity, the circumstances of prior diagnoses, response to psychiatric treatment, and your ability to participate in treatment.
If you are asked to discontinue or taper medications, this does not mean that we think any symptoms you are having are unimportant or that we are ignoring them. We will continue to address those symptoms with other effective approaches like cognitive behavioral therapy and personal medicine. If your symptoms worsen or fail to improve, we will perform another review to reconsider medications.
If this approach is recommended for you, we understand that you may feel anxious, angry, misunderstood, or unconvinced that this is the best approach. This is a common reaction, but our experience indicates that this often the best approach. We expect that you will work with the treatment team and that we trust each other. Of course, you may also request a referral to another treatment program at any time.