Many people who come to a see me for the first time often also ask about medications for mood or sleep. They want to know things like:
Do medications work? Will I have to take them the rest of my life?
Generally, medications for mood, including the most common line of SSRI medication (Prozac, Zoloft, Wellbutrin) do tend to help individuals suffering with depression or anxiety. However, studies show that for up to 25% of the population, they are not effective or don't work. One of the major problems with figuring out if a medication works is that it takes about a month to reach full effectiveness and get into your system. By that time, many people already stop taking the medication because they have not felt instant relief and think the medication is not working.
It can also take a fair amount of trial and error with each potential medication regimen, which involves patience and being willing to try other medications without losing hope. Again, that can be very difficult when you are feeling depressed or anxious to keep trying, especially if your mind is telling you that you are a lost cause and will never feel better.
If you do find a medication that works, then no, you do not have to take it the rest of your life. Depression and anxiety tend to get worse when we are juggling a lot of different aspects of our lives that are particularly stressful. Medications can be used simply for those stressful episodes in your life that are difficult to manage on your own.
Do I need medications to get better?
Not necessarily. There are certain mental health conditions with more biological components (rather than something stressful in the environment), such as bipolar disorder and schizophrenia, that would require medication on a long term basis and will get little benefit from psychotherapy until their symptoms are under control with medications. That being said, I believe the majority of mental illnesses can get better without medications. Psychotherapy has been shown to be equally effective as medications in numerous studies.
Now being completely bias as a therapist, I would tell you that psychotherapy is also better for you in the long run because it teaches you coping skills and strategies to help you in the future as well, so that the same issue does not keep coming up every time stressful things happen and you need to take medication again. You get confident in your own ability to handle your issues instead of relying on medication. All in all, a combination of both medication and psychotherapy in the research shows the best outcomes for recovery.
Can you prescribe medications for me?
No. Psychologists and other types of therapists (LPC, LCSW, LMFT, etc.) are not medically trained and therefore cannot prescribe medication (In some states Psychologists can prescribe medication under the supervision of a physician, but not Texas). We are trained in psychological theory and how to apply it to human behavior to help with mental health concerns. Psychiatrists (usually MDs or DOs) are medically trained as physicians with specialty training in mental health, therefore can prescribe medication. Primary care physicians can also prescribe different kinds of medication for mental health concerns. We also can work with your physicians to let them know our clinical opinions of if medication is needed or would be helpful.
What if I don't want to take medications?
That's fine too! I can understand why a lot of people get concerned about taking medications for mood or for sleep, and have heard some horror stories from some people about side effects, in addition to the long list you hear from commercials on TV. Just be careful about generalizing one person's experience as you own, because medications affect people so differently.
In an ideal situation, I always like to have clients try a few weeks of psychotherapy with me first to see if they get any relief. If after a month or two things are still really bad, then maybe medication is something to consider to help as well. For example, if the client isn't getting enough sleep, therefore they can't concentrate, work, or function well in daily living, its hard to work on improving yourself in psychotherapy. This is where medication can help if there is a barrier in psychotherapy.
Many times, after medication can help get symptoms to a more manageable state, we can then work on getting you the skills you need in therapy so you won't need to take the medication for a long period of time.
At Flourish, we work with your primary care doctor or psychiatrist to help you make the best choice for you, with or without medication.
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