I have mulled over this topic of – Medications OR Therapy – for quite some time now. However, a question came to the mind of a medical doctor trained in psychiatry. “Why do we even have to talk about this topic?” Nevertheless, I realize after being in the field of psychiatry for more than 10 years now, it is relevant to explain this in common man’s language. Consequently, this is because of the huge stigma that goes with the subject of mental health.
What are the differences?
Moreover, it is important to note the differences or similarities of Medications or Counseling in Mental health or as such General Health care. As such, Counseling is an art. Whereas, Medicine is as much of an art as it is about science. However, both are ways of approach towards a patient that involves speaking with, building rapport and empathizing with the patient’s condition.
Nevertheless, while counseling involves different approaches by way of talk therapy using the mind as the subject and the various processes of the mind such as behavior, intellect, memory, insight, understanding, etc,. In addition, a psychiatrist would use medications in combination with counseling or in isolation depending on the time constraints that the patient load would impose.
While, we know that medications are effective in the treatment of mental health conditions, there is evidence in the scientific world that talk therapy or counseling is as effective for some mental health conditions as medications, if not better.
Depression and anxiety are two such mental health conditions. Whereas medications are helpful in the above conditions, counseling or psychotherapy is as effective. Moreover, the combination of therapy and medication being more effective than either one of them alone or in isolation is proved fact.
However, some do argue that psychotherapy is pseudoscience.
Let us examine as to which ones are on the brink and which kinds of therapy are not useful at all.
There is poor evidence in the scientific literature that therapy like psychoanalysis, dream analysis, narco analysis, and childhood experience analysis. So these are not effective treatments for any mental health condition. However, evidence for placebo or sugar pill being more effective or as effective as the above kinds of therapies exists.
However, these kinds of studies are very difficult to do. This is because each of these therapies are different in their own regard. They maybe even come across as different to different individuals. Therefore, each one can form their own opinions.
We characterize mental health by a sense of purpose or coherence in the widely chaotic world of medications or therapy.
We need to structure either therapy to make sense of this chaos – give some method to the madness. Only exposure to traumatic experiences can develop flexibility and resilience. Therefore, exposure to stress or difficult situations only teaches the human mind how to overcome these stresses or difficult situations. Currently, there is evidence that these ingrained experiences in our DNA are passed on to the next generation. While we know that humans are because of our DNA; we also know – now – that life experiences also contribute to the DNA.
Indeed, “epigenetics” is the name for this novel method of thinking. Although largely genetic, hardiness is also developed by exposure to stress and passed on to the next generation. This would give new meaning to the phrase – “survival of the fittest.”
RCTs or Randomized Controlled Trials give us evidence about the efficacy of medications. This is regarding the efficacy of many psychotropic medications i.e. the medications used in treating mental health conditions.
I also believe that there is a lot of use of these medications routinely. I have used them with patients with mental health disorders for many years. Evidently, I have practiced psychiatry here in INDIA as well as abroad. I was a resident trainee in a couple of post-graduate training programs in the United States.
However, there are cultural variables in the acceptance of these medications. Across time and geographical locations, cultural variables explain the mental health seclusion. Mental health is not a well-accepted pathology. In a sense, mental health was not important till it was recognized most recently to be treatable.
In the past mental health was considered as a curse or as a social malaise. People were institutionalized in penitentiaries or asylums and sometimes even put on the guillotine. However, this fact has rapidly changed with the onset of scientific evidence. The existence of benefits with the use of psychotherapeutic medications is immense.
Finally, now we have concluded. Firstly, therapy – either talk therapy or medication therapy, or a combination of both, is helpful in depression and anxiety. Now let us learn about a few medications used in depression.
When you get a prescription you should:
- Tell the doctor all medications – either from classical medicine or otherwise and vitamin supplements you are already on.
- Remind your doctor about allergies and problems you have had in the past with the use of similar or other medicines.
- Understand how to take the medicine before you start using it and take your medicine as instructed by your doctor.
- Don’t take medicines prescribed for another person or give yours to someone else.
- Call your doctor right away if you have any problems with your medicine. Or if you are worried that it is doing more harm than good. Your doctor may be able to adjust the dose. Or, change your prescription to a different one that may work better for you.
- Inform your Expert about medications and therapy you have taken
- Lastly, your psychiatrist or psychotherapist should know whether you are using only medications. Or, that you are using only therapy. Or, both as the case may be. It sometimes is the case that when one is on therapy for certain conditions. Therefore, one does not need the other kind of therapy.
I also believe that acute psychiatric crises make use of medications to tide over them. In contradiction to the popular notion, they need short-term use of medications. Most people’s belief is that such medications for mental health conditions are used for a lifetime should be changed. Other misinformation is that they cause side effects and are “harmful” to the body. This is NOT entirely true.
One should weigh the risks versus the benefits of the medications. Thus, one should only then ponder over the decision to take them or leave them. In addition, this is true with psychotherapy or talk therapy, or counseling as well. Finally, it may be best to consult your primary health caregiver for deciding what may be best for you.