Mental health: Therapy and medications

If I have a mental health disorder, do I need to take medications, or do I need treatment? Do I have to do both or can I do just one or the other?

Medications are helpful in the treatment of many mental health disorders and therapy is helpful for all of them. The general idea for many disorders is that medications can be helpful to reduce the intensity of symptoms to a level that therapy can then be helpful and a person can then learn new strategies to reduce the intensity and frequency of the symptoms without a long term need medication. Once medication and therapy together have helped to address problematic symptoms, consideration can then be given to reducing medication and/or counseling. Medication and counseling together as a combination are a best practice for several disorders including: Anxiety, major depression, PTSD, ADHD, OCD and bipolar disorder. Treatment for most of these disorders can be considered with just medication or just counseling, but the best chances for success come from a combination of both.

Some of these disorders and particular people will however benefit from long term medication use.

As a provider I generally recommend adding medication to treatment, but do this in discussion with clients, to assess their comfort level, financial situation and other factors. I generally only strongly recommend medications in situations that a person is highly non-functional or dangerous, like if they are so depressed they stay in bed for days at a time or they are self harming.

Some disorders that lend themselves to medication with minimal counseling are things like psychotic disorders such as schizophrenia. Appropriate medication, that is taken the right ways can make a huge difference in how functional a person is and how much support they need to live. Treatment is about education about the disorder, providing support to caregivers and addressing barriers to medication adherence.

Some disorders that generally do not benefit from medications are adjustment disorder, where a person needs support to adjust to some new circumstance in their life, and it has thrown things off for them. Autistic disorder doesn't, strictly speaking, need medication, as treatment revolves around management of the symptoms and again providing support and education for caregivers. That being said, some people with autism are benefited by medication to help to manage symptoms.

I hope this answered some questions about medication vs therapy in treatment of mental health. The last note is that treatment is personalized and should come down to the client and the provider making the decision together about the path forward to better mental health.