In my years of working as a therapist, I have found the topic of combining medication and therapy to be polarizing. People tend to be divided into two camps. There are those who resort to medication to address the symptom(s) but do not believe that therapy would be helpful, and there are those who work diligently in therapy but do not consider medication as an option. There is a number of individual reasons for this medication vs. therapy polarization. Upon exploration, these reasons typically fall into three categories:
Institutional trauma
It makes a lot of sense that people who were mandated (in extreme cases) or pressured (which is more common) to take medication would experience being medicated as an imposition on their agency and autonomy. Examples of being pressured to take medications range from taking ADHD medication as a child to the extreme cases, like being subjected to involuntary psychiatric hospitalization. Institutional trauma is also a result of experiences in counseling. For example, people who were mandated into counseling may have reservations about starting therapy. Institutional trauma is most common in the communities of color, but it spans all populations.
Stigma
When considering medication or therapy, many people say “I just don’t want to do it” or “This is not for me,” despite experiencing difficulties in day-to-day functioning. When I hear this, I get curious about the meaning they make about being in therapy or taking medication. Let’s face it: the stigma of mental illness is rampant in many communities. This stigma has to do with the self-perception of being marked by weakness or inadequacy from needing therapy or medication. Some of these beliefs can be culturally reinforced.
Bad experiences in the past
It also makes a lot of sense that people feel resistance to starting therapy or taking medication if they tried it in the past without a positive outcome. Unfortunately, it is possible to have a bad experience in therapy. That is why it’s important to approach a search for a therapist with care. It is also possible to experience bad side effects from a prescribed medication, which is why it’s important to work with a prescriber that would take your discomfort seriously.
Research has found that the best treatment outcome is achieved through a combination of therapy and medication. As a relational and body-centered therapist, I view my client’s physical experience as intrinsic to their emotional and cognitive functioning. In other words, the state of a person’s nervous system, and its capacity to self-regulate determines the emotional and cognitive climate this person lives in. Just like the weather, a person’s mood can fluctuate, but it typically stays within the range that the climate allows. For example, if a person functions in a state of ongoing agitation and overwhelm, it is expected that this person may eventually start feeling hopeless. In instances like these, medication management can be life-changing and of crucial importance to support the possibility of therapeutic change.
Read more: Finding the Right Therapist
Here are some reasons why it is important to be in therapy while taking medication:
Medication makes symptoms manageable
Medication that is prescribed by a trained professional can create a buffer, in which the intensity of symptoms are mitigated and the capacity for self-regulation is enhanced. This is true for symptoms of depression, anxiety, traumatic flashbacks, mood swings, agitation, difficulty concentrating, and more.
With symptoms managed, it is easier to address the core issues
With the intensity of symptoms managed by the medication, it is easier to access, explore, and reintegrate the problematic beliefs and behaviors that were caused by the symptoms and/or have perpetuated the symptoms.
Awareness and support give choice
Therapy heightens awareness. Medication can offer chemical support for the nervous system. Together, therapy and medication can increase a sense of agency and manageability of one’s life. That, in turn, can help a person to make new choices and seek new experiences, creating a sense of expansion in life.
The choice is yours
Once you start, you get to choose when to stop. By the time many people choose to stop taking medication, their cognitive and behavioral toolbox is expanded.
If you are starting medication management, it is important to also be in therapy. While medication helps reduce the intensity of symptoms and provides a chemical support to the nervous system, work in therapy is focused on increasing awareness of maladaptive behavioral and thought patterns. When used together, medication and therapy can be powerful and transformative tools for positive change.
What is your relationship with therapy and medication?
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4 comments
This is such a great blog, Elena! The stigma on mental health is very strong in many communities. It is extremely challenging for people in many communities to reach out for help when they are struggling with their mental health. The thought of psychotropic medication increases the barrier to mental wellness exponentially. My hope is that people will read this blog and realize that it is okay to be fearful and that it is necessary to have a safe space to express those fears. In my experience, when people expressed their fears about psychotropic medication and therapy, I allow the space to process those thoughts and feelings. In many cases once the fear is reduced the idea is usually accepted. I strongly believe that if someone is taking psychotropic medication(s) therapy needs to be included with treatment.
I love this blog post and particularly appreciate that it addresses the stigma that can come with seeking mental health help, whether it be therapy or medication. I also love the way you characterize medication as a “buffer” that helps to reduce symptoms and makes it easier to develop skills and tools to manage the symptoms once the medication is removed. I know many of my clients struggle with asking for help and so I really admire them for pushing through that and coming to therapy!
This is a great post, Elena! I love how your post normalizes both therapy and medication as viable tools for working through the kinds of struggles that most people go through. I particularly like the way you say that therapy heightens awareness, while medication supports the nervous system. As a therapist, I am a strong believer that both therapy and medication can be incredibly helpful, but I also encounter people struggling with that stigma every day. I appreciate this blog so much–thanks for writing it!
Great blog, Elena! This is such an important topic that people have very strong feelings about. Your descriptions about why people typically have feelings about taking medications makes a lot of sense. I love your analogy about weather and climate – I will share that with clients in the future for sure!