There are those who believe medication is the cure to mental health, and those who are deeply opposed. Who should take medication? I believe that it is a deeply personal decision. Everyone and anyone has the right to self-determine if medication is for them. There are a lot of potential side effects and it's not a one-size fits all industry. This means that even though there are specific and multiple medications aimed to treat depression, what works for one person may not work for another. And therefore, someone may have to go through several trials of various medications to identify the one that works best. This, and potential side effects can make this route overwhelming, and unpleasant. For example, medications can cause dry mouth, a low sex drive, and shaky hands, or jittery legs. This may be so uncomfortable that someone chooses to live with their mental health symptoms. It reminds me of the mantra "my body, my choice". As long as someone is not suicidal or homicidal, I believe that decision should be theirs.
As a helping professional, my perspective has shifted over the years. Once upon a time, I was not one to recommend meds to clients unless they were part of the SPMI population - seriously, persistently mentally ill, ie: schizophrenic, bipolar. Hearing voices and being manic are not something one can work on in therapy. However, there are many other disorders from depression to anxiety to attention-deficit disorder that can make functioning extremely difficult. So why not alleviate the pain? If you have a headache, you take an aspirin. I know we are a society that emphasizes medication, if not pushes it. I'm not saying it's a lifetime solution. But, I have come to believe that if functioning is impaired, and medication can help to reduce symptoms and activate functioning, it can be very useful... in conjunction with therapy. Otherwise, the medication is a band-aid that can become the cure-all for a lifetime. It can be healthier (medically and mentally) to learn coping mechanisms and techniques to address the symptoms of disorders. Now, if we look at those disorders that are physiological (due to brain chemistry), then this is another reason why medication may be helpful. But it doesn't mean those feelings can't be addressed in other ways. Let's focus on anxiety and depression as examples. These are two mental health diagnoses that can be bio-chemically based or situationally ignited. Either way, medication can be useful. In the case of situational anxiety or depression, perhaps there should be a period of time before medication is considered the key determinant. But also the intensity of anxiety or depression should be considered. Even if it's a short duration (3 months; 6 months), but it is hindering functioning (ie: difficulty getting out of bed; unable to control crying at work; panic attacks; paralyzing anxiety), medication may take off the "edge" enough to be able to address coping skills in therapy. When someone is so consumed by difficult emotions (ie: obsessional thoughts), sometimes the therapy does not help if the "work" can't be done.
Concrete skills, shifting thought patterns; and behavioral interventions can be a powerful tool as an alternative to medication. I work from a psychodynamic lens. This means that I tend to focus on how we developed; our parenting; our environment; our experiences; and how that has shaped who we are, how we think the way we do, and how we behave and relate the way we do. I also believe that clients should be given feedback, and that they learn and can change how they relate in the world, by becoming aware of how they are relating to the therapist. We can learn a lot about someone from the client-therapist relationship. Psychodynamic therapists also do a lot of re-parenting. And, with the understanding of where the client's emotions and perceptions come from, we can work on healing those emotions and shifting those perspectives. That being said, working on shifting irrational thought processes and working with concrete interventions is important. And, if medication is needed as a supplemental tool, it is something to be discussed. With always in mind, the client is the captain of the ship.
What is the conclusion on medication?
- Do your own research; learn about side effects and the risk/reward ratio
- Consult with your therapist
- A medical doctor will prescribe medication but is not trained in emotions; so consider who will be monitoring your meds
- Consider alternate ways of working on your issue/disorder and determine what you are most at ease with
- This is your decision to make
If you want to hear more about this subject, tune in to episode #20 of "What Would Dr. Meyers Do?" on apple, google, or spotify... or this website under the tab "podcast".