Medication and Therapy

Medication and therapy are two of the most common treatments for mental health concerns. Some people seek therapy alone, others use medication alone, and many benefit most from a combination of the two. The right approach depends on factors such as your symptoms, their severity, how long they have been affecting you, and your medical history. In some cases, medication may also make it easier for you to participate in therapy and use the skills you learn there.

In this article, we explain what you need to know about medication and therapy, what to consider when deciding which treatment approach may be right for you, and what type of mental health professional you should see.

How do I know if I need medication?

Mental health medications, sometimes called psychotropic medications, include antidepressants, anti-anxiety medications, mood stabilizers, stimulants, and antipsychotic medications. These medications can have various effects on the brain and body, but they broadly influence mood, attention, anxiety, sleep, and other symptoms.

Medication can be used to treat a wide range of mental health conditions and symptoms. Depending on the situation, it may be considered for conditions such as depression, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and psychotic disorders.

When deciding whether medication is appropriate, a provider may consider:

• Severity of your symptoms
• How long you have been experiencing symptoms
• How much your symptoms interfere with your everyday life (e.g., school, work, relationships, etc.)
• Whether therapy or other supports have helped
• Your physical health and other medications you take

Who can prescribe mental health medications?

Mental health prescriptions are usually written by medical professionals, including psychiatrists (MDs and DOs) and nurse practitioners. In some cases, primary care physicians (PCPs) may also prescribe medication, especially if there are shortages of psychiatric professionals in your area.

Therapists, including counselors, clinical social workers, and marriage and family therapists, generally provide psychotherapy but do not prescribe medication. Most psychologists (therapists with a PhD or PsyD) can also not usually prescribe medication, with the exception of a small number of U.S. states in which some psychologists with special training may do so.

However, while they can’t prescribe medication, many therapists can refer you to a prescribing professional, such as a psychiatrist, for a consultation. The therapist may also share with the prescriber recommendations, concerns, or other information regarding your treatment, which can help inform the prescriber’s medication-related decisions.

Do I need both a therapist and a psychiatrist?

Not necessarily. Some people see only a therapist or a prescribing professional, while others work with both. If you use medication alongside therapy, each provider generally plays a different role in your treatment, and you may find it helpful to see both since there are some key differences between the focus of each appointment.

Medication appointments are typically shorter, often around 20 to 30 minutes, and focus on how well the medication is working, side effects, and whether adjustments are needed. In contrast, therapy sessions are typically longer, often around 50 to 60 minutes, and allow more time to work through symptoms, behaviors, and coping strategies. Therapy may also continue more regularly or for a longer period of time than medication-management appointments.

What should I expect when starting medication?

When starting a mental health medication, your prescriber will typically discuss what the medication is intended to treat, how to take it, possible side effects, and how long it may take to notice a benefit. Some medications begin working relatively quickly, while others may take several weeks before their full effects become clear. Your prescriber will typically schedule follow-up appointments to assess whether your symptoms are improving, ask about side effects, and determine whether any changes are needed.

Importantly, finding an effective medication can involve some trial and adjustment, since people can respond differently to the same medication. After your first prescription, your prescriber may recommend continuing the same dose, adjusting the dose, or trying a different medication. Do not stop taking or change the dose of a psychiatric medication without first discussing it with your prescriber, as some medications can cause withdrawal symptoms or other problems if stopped suddenly.

What should I do if I am unsure whether I need medication?

It is common to have mixed feelings about starting a psychiatric medication. You may be concerned about side effects, becoming dependent on medication, changes to your personality, how long you might need treatment, or what taking medication means about your mental health. Speaking with both your prescribing professional (e.g., psychiatrist) and your therapist about these concerns can be a good first step.

Your prescriber should explain what the medication is intended to treat, how and when to take it, common side effects, important risks, and what you should do if you experience problems. Remember that an ethical therapist will never require that you take medications and should be responsive to your concerns.