To Medicate or To Not Medicate, That is the Question

By Carissa Weber

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One of the most common questions I get when people come into my office is if I think they need medication to help with their depression or anxiety. What people don’t realize is that is a very loaded question. Let me take some time today to explain why.

First things first, please remember I am a therapist by trade, but I am not YOUR therapist. A decision to start a modality of treatment should be made by you with the support of your medical doctor and YOUR OWN THERAPIST. The information provided is to assist in understanding different treatment modalities for the treatment of anxiety and depression.

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An analogy I use in my office when it comes to medications is the use of eye glasses. There are some of us lucky people that don’t need glasses as our vision is 20/20 (A.K.A. – people who have stable mental health and need no adjustments in their life). Then there are some people who need glasses for reading or driving at night (These are the people that need to make some lifestyle changes and healthy coping skills to help us feel better). As we go down the list, there are some of us that need glasses full-time, but we can make out shapes and people without them on(This is a group of people who may need medications for a short time to allow their brain to remember how to use its own neurotransmitters when healthy coping skills are present). Lastly, there are some of us that are blind as bats (this group of people need medications because their brains are not wired to release neurotransmitters like it should).

As mentioned above, some brains need a gentle reminder of how to release neurotransmitters and for other brains, they struggle to produce their own neurotransmitters needed in order to function. Many medications for depression work on keeping serotonin in the synaptic gap in order to help us feel better, gain motivation, and help us sleep. A class of anxiety medications, call benzodiazepines, help calm down the body by drastically reducing the amount of adrenaline and noradrenaline in the body. These medications greatly decrease the discomfort felt by those struggling with anxiety and depression.

Because of genetic make-up, medical conditions, or even other medications you may be on, some people’s brains cannot naturally release neurotransmitters on their own and they require medications. In short, some people absolutely need medications because their neurotransmitters are not working like they should. Pair that with healthy coping skills (and consistent practice) their brains can start to heal, and potentially release the needed neurotransmitters naturally (one day).

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There are some people who like the idea of medications vs. learning coping skills as coping skills are a lot of work (for any of you who have done therapy, you know it is a lot of hard and exhausting work). Does this necessarily mean a person needs medications? Maybe, maybe not. They often find when they start using medications they feel better, but not as good as they thought they would. Why? Because our emotions are trying to tell us something we are trying to ignore.

Things to remember with mental health medications is that it takes weeks to feel their full effect. Try 4 to 6 weeks to be exact. During that build up time, it is common to have headaches, upset stomachs, weight gain, insomnia, drowsiness, sexual dysfunction, appetite changes, even an increase in depression or anxiety symptoms. In some cases, the increase in mental health symptoms can lead to suicidal thoughts. This is because we are introducing neurotransmitters the brain has grown accustom to not having available. Some of these side effects can continue even if your body and brain get used to the medications.

If you have started on mental health medications and are experiencing suicidal thoughts, have developed a suicidal plan, and have the ability to carry that out, REACH OUT! Let someone know ASAP! If you do not have someone safe to talk to, you can call the National Suicide Prevention Lifeline at:

1-800-273-8255

Some mental health medications carry a risk of developing an addiction to them. Even if you use them as your doctor prescribes, your brain builds up a reliance on that medication to release the neurotransmitters needed. Some medications used for treating anxiety (like benzodiazepines) have a higher risk of dependency than others. Many doctors will limit the use of these medications to prevent addiction and future misuse.

The above information may make you scared about taking medications. The truth is, every medication has a side effect (everything from your asthma and allergy medicine to blood pressure and diabetic medications). The real question comes down to are the side effects worth the relief the medication can offer?

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Therapy and medications should be used together as a way to not only help that darn amygdala communicate better with the whole brain, but also to improve your overall quality of life! Changing the pathways in our brain is hard work. In some cases, therapy, lifestyle changes, and coping skills cannot change the brain by itself. In other cases, medications cannot change the brain by itself. In the majority of cases, it is a team effort to help you feel better.

To recap this post:

– Medication and therapy should be used together to help improve your mental health

– Medications come with benefits and risks

– The decision to use medications should be made between you, your doctor, and YOUR therapist

Thank you so much for taking a short minute to invest in you! I know this topic is one of many questions. If you have questions, leave them below! Hopefully it helps you consider all the options out there for your mental health.

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