In Therapy

A user's guide to psychotherapy

Four Things Medication Can't Teach You

Medication and psychotherapy

One pill makes you larger....
One in five Americans take at least one psychotropic medication. That’s about sixty-two million people, for those keeping score at home. Most people with depression, anxiety, or ADHD report feeling some relief from their symptoms when they pop that special pill, even if for reasons we don’t completely understand.

But some people get a prescription from their MD and that's it. They feel better and stop there. Is symptom relief enough, or might something else (say, psychotherapy, for example) drastically improve long-term results? Medications alone are limited because they change how you perceive the world, but they don’t really help you change your world. Beyond your symptoms lie deeper issues that aren't touched by meds. Here are four questions that aren’t answered when professional intervention stops at the pharmacy.

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Why? You’re depressed or anxious. Why? What past experiences, current stressors, unhealthy relationships, poor fitting careers, beliefs about life purpose and meaning, or unhealthy habits have contributed to you feeling this way? Could a few important decisions drastically improve your mental health? Are you curious about this? Medication alone won’t help you with this.

What? Beyond the daily pill, what can you do to combat the issues? What changes to diet, exercise, attitude, thought, perspective, relationship, communication, sleep, and emotional expression might help with anxiety and depression? Ritalin may help your brain focus, but what changes could you make to your schedule, your workload, and your environment? Medication alone won’t teach you any of this.

How? When the symptoms subside, how can you prevent the issue from recurring? How can you structure your life and your mind to help you prevent a return of the negative feelings? How might habits, relationships, and changes to diet, sleep, job, spirituality, expectations, and resources protect you from walking down the same path? Medication alone won’t teach you this.

Who? Who are you? What are you passionate about, what are your limitations, what potential are you able to achieve? Much of our mental health also has to do with the people who surround us each day. Who is holding you back, and who supports your growth? How can you step away from the dead weight, and how will you find the healthy comrades? And why did you keep seeking unhealthy relationships in the first place? Medication alone definitely won’t teach you this.

Alright, no one said medication teaches anything. But people should know that mental health requires a lifetime of growth and learning beyond balancing chemicals. Medication is effective at treating physical and emotional symptoms, but it doesn’t treat the deeper psychological or relational issues. Growth and insight aren't part of the medication repertoire. That’s not its job.

If you want to learn why, what, how, and who, you might want to consider psychotherapy. It’s been shown that medication plus psychotherapy results in a better long-term outcome. In fact, in many cases psychotherapy alone has shown an outcome similar to medication, without the physical side effects and with longer-lasting results.

To be fair, psychotherapy takes more time, effort, and vulnerability than medication. It’s challenging, often unpleasant, and potentially costly. But psychotherapy has a different set of goals. Medication aims to reduce symptoms, while psychotherapy (in my opinion) is two people collaborating to help the client develop a greater understanding of self, increase self-efficacy, gain a higher capacity for intimacy, and accept limitations. Ain't no pill for that.

One pill makes you small....
Again, to avoid the negative comments from pharma-philes, I’m not disparaging the benefits of a properly prescribed medication. I’ve seen miraculous changes from some deeply anxious and depressed clients who were unable to reap the benefits of therapy before medication and were suddenly able to engage in treatment and apply the work. I’m just saying that people gain more by augmenting medication with therapy. And for many people therapy alone is sufficient treatment without physical side effects, potential dependence, and the chemical toll taken on the body. Take a look at this excellent post for other alternative treatments for depression.

Interested in therapy? Check out this guide to finding a therapist first, and once you get started take a look at these tips for therapy clients. When you're a believer in the benefits of therapy, consider joining the über fans of therapy over at National Psychotherapy Day. There's always room for more therapy advocates.

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I invite you to see what therapy offers at my website and facebook page. Warning: may cause nausea, dry mouth, wet mouth, ralph malph, diarrhea, constipation, restless leg syndrome, and/or oily spotting.

Ryan Howes, Ph.D., is a clinical psychologist, writer, musician and professor at Fuller Graduate School of Psychology in Pasadena, California.

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