Do You Need Drugs for a Mental Disorder?

My 26-year-old son has been diagnosed with schizoaffective disorder. He refuses to take medication. Is there any holistic approach or treatment center in the U.S. that treats this without traditional medication?

– January 8, 2004

Schizoaffective disorder is an illness characterized by the severe mood swings associated with manic-depressive illness, and some of the psychotic symptoms of schizophrenia. Most of the time, psychotic symptoms (such as hallucinations and delusions) mix with those of mania and depression, but schizoaffective disorder is marked by periods where psychotic events occur without any manic-depressive symptoms.

During the depressed state, patients may exhibit poor appetite, weight loss, insomnia, agitation, general slowing down, loss of interest in their usual activities, fatigue, feelings of worthlessness, inability to concentrate and suicidal thinking. On the other hand, manic symptoms include increased activity, rapid or racing thoughts, talkativeness, little need for sleep, restlessness, inflated self-esteem, poor judgment and self-destructive behavior.

I asked Dan Shapiro, Ph.D., a psychologist here at the University of Arizona, to address your questions about treatment. He warns that the suicide rate among patients with your son’s condition who don’t take medication is dramatically higher than it is among those who do, and urges your son to reconsider his decision.

Although the available drugs can have unpleasant side effects, Dr. Shapiro says it is often possible to find a combination that minimizes them. Try to find a psychiatrist who can partner with your son to create a therapeutic combination that minimizes side effects.

In addition, Dr. Shapiro recommends that your son increase his intake of omega-3 fatty acids, which can help lift depression. The best sources of omega-3s are salmon, sardines, and other cold water fish, as well as walnuts and flaxseeds. I would also recommend that your son learn ways to identify and effectively deal with stress. Try my breathing techniques and learn how to meditate, practice yoga, exercise or find other ways to relax that are personally appealing.

Best of luck to you both.

Andrew Weil, M.D.

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