Why consider seeing a psychiatrist and taking medication?

Let me be clear: I am not a shill for the pharmaceutical industry. Indeed, I strongly agree with the psychiatrist blogger who said: “Psychopharmacology without therapy is like treating an infection with Tylenol”.  We clearly agree that medications do not cure a “psychiatric disease” and that psychiatrists are “not even sure what the disease actually is”.  

            So why take a medication then? When clients first see me I find that somes have chosen me as a psychologist because they know that a psychologist can't prescribe psychiatric medications and might even share their bias against the use of drugs.  Such clients may even start out saying: I don't want to take any drugs. And they often have very clear and understandable reasons for this a priori decision. As I see it, there is usually no need for medications and so no need to argue over this. But when it becomes clear that medications might be useful or even necessary, then I must answer this question if we are to move forward towards a successful outcome.

     The whole point of taking medications is symptom reduction. Reduced symptoms or a respite from their intensity can give my client an opportunity to look at their situation without feeling overwhelmed with symptoms; allowing space, time and energy for understanding and learning a new point of view and new more helpful behaviors.  In my book that’s the point of medications. 

            For instance, treating depression with an antidepressant is not the solution. But consider, one prominent symptom of depression involves a feeling of having lost or not having enough energy. Other symptoms include a lack of concentration, sleep, and self-care, and any of these can make new learning more difficult than it needs to be. The correct medication(s) can help with these while you figure out how to handle depression in the long run.

            Change almost always requires learning new ways of interpreting and coping with one’s environment. According to Acceptance & Commitment Therapy (ACT) depression can involve, amongst other problems, both a lack or loss of focus on what life-directions one regards as important and the commitment to pursue those valued directions despite those discomforts which we often regard as uncomfortable symptoms of depression.

            This may not hold true for all depressive symptoms. Bipolar disorders appear to have a strong biological component with symptoms that result from biology or chemical imbalance. A lifetime commitment to taking medications may result in a significantly better life as I've seen repeatedly in my years of practice.

    Does that mean that medications are always required? There is evidence that changing behavior can lead to changes in brain chemistry similar to those linked to taking medications, so in the long run medications are not always required for a lifetime. And even when ongoing medication is necessary, as in the case of bipolar disorder, medication without other support is a bad choice.

            Of course the choice of whether or not to even consider taking medications temporarily is ultimately yours, but well informed consideration may prove more helpful than blind prejudice. For this reason I have written this little essay inviting you to weigh out the pros and cons of your decision, and to honestly discuss the decision with the people in one’s life who know who your moods and behavior impact your life as well as a qualified professional.