To Take or Not To Take Antidepressants is the Question
Here’s a no brainer–antidepressants are widely prescribed. It’s been described as a national epidemic! Research has provided both pros and cons of taking the medication, including serious side effects, like weight gain.
Researching antidepressant medication vs. psychotherapy is easily accomplished with your health care providers and on the internet. The National Institute of Health offers a particularly extensive review. The more we delve into depression, the more obvious the complexity of treatment and diagnosis.
A Therapist’s View
Clinical depression is far more than being down over life events. Diagnosis goes beyond short periods when things are not to our liking. Often, it takes professionals to see the difference. Some symptoms may be a matter of degree and extensiveness. Here, the discussion is not intended to address the popular “Bipolar” diagnosis. Clarity in diagnosis is critical, and therapy is also a good adjunct to Bipolar treatment. It is true that depression suggests a biochemical change. Remember, changing thoughts can change the chemistry, too.
This author’s mind body proclivity leans toward not taking a pill to solve life’s problems, and using cognitive and behavioral resources before jumping into medication. Mind body research and supporters tout that the body can heal itself by immersing in emotional and mental resources and making changes. Meds relieve symptoms, but don’t cure the problem.
Inevitably, a therapy client shows up who actively tries cognitive/behavioral treatment to resolve a downward spiral, only to find no relief. Or the fight has been carried on for so long by the client that the detrimental effects of stress and problems have settled into permanent physiological–and negative– changes and clinical depression. Then, the body may need medical help (medication) to reduce the symptoms of depression while learning new coping skills.
Easy Answers May not Come Even to Professionals
Treating Depression is not so simple. Professionals must juggle much information and come out with clear understandings and treatment decisions. That takes experience and insight. Among health care providers, the dilemma of helping clients change emotional reactions by medical (medication) vs. cognitive/behavioral means has brought healthy debate for many years. Research supports the efficacy of both cognitive therapy and antidepressants equally, although only therapy leads to future prevention.
Some of us read the research against or for meds and rally behind it because of the scientific/measurable effects. Then, there are we practitioners who struggle with helping clients, put our hearts into therapy change, encourage, cajole, challenge clients to making actual changes and, voila, depression is conquered!
Or we may, after much angst, find medication as an adjunct and see results, too. Medications may make the immediate symptoms less intense, while the client is learning new behavioral styles.
As I see it, there are so many physiological and behavioral variables. When in doubt, it’s appropriate to direct the client to a physician or prescribing psychologist for a medication evaluation. Two heads seem better than one. However, if cognitive/behavioral change is working, don’t fix something that isn’t broken!
A Window of Opportunity
Always, the hope is that 6 to 12 months on a medication will provide a window of opportunity during which the client makes significant behavioral change while the devastating emotions are held at bay by the antidepressant. However, some clients may need much longer treatment with medication.
Again, the mind body focus. Take away the nose to nose madness of depression and anxiety long enough for the person to find new directions and coping skills which will prohibit depression in the future and uncover joy as a way of life now. Cognitive/behavioral therapy does have a good record with maintaining treatment gains vs. medications, because of the healthy lifestyle and cognitive changes that therapy requires.
We Must be Ever Vigilant!
Therapy: such hope, such a pragmatic view, the only real “cure”! At times, such a risk to not seek medication evaluation when keeping symptoms at bay with meds needs to be part of the treatment! The ravages of depression may have gone on too long. Suicide lurks and pushes in during the darkest moments when we as therapists or loved ones can’t reach the mind. Or, the thinking has deteriorated so badly that the client’s brain is not rational, maybe the mind is obsessively preoccupied with death. Suicidal thoughts and irrational thinking are always big red flags for getting mental health providers in the mix immediately.
The Middle Ground Emerges as the Rational Choice.
If we can fight through to a positive result, don’t knock the means, providing, of course, therapy or medication do no harm. That is the essence of the debate–harmful effects of putting pills into your body or not using medical resources when symptoms need to be calmed.
It is important that we don’t base our medication decisions on Aunt Thelma’s reported experiences or that we don’t let friend John’s ideas prohibit a clear research into medications. Friends and family opinions should carry no weight compared to good health care advice.
Psychological and medication treatments together offer the best we have at this time. Often they should both be a part of the treatment regimen. Successful therapists know therapy is still an art that must respect meds when needed.
The least you need to know:
1. Depression treatment is complex, both therapy and antidepressants have research support. Cognitive behavioral therapy will give long lasting effects. Meds don’t “cure” the problem.
2. Always get advice from health care professionals.
2. When suicide is a risk, never take chances. Get help!
The mission, should you decide to accept, requires:
1. Exploring treatment options with health care providers.
2. Doing your own research on the pros and cons of meds, but let your physician make the medication choice.
3. Change is most always required of the person, but it doesn’t need to be that difficult. The need has probably been a long time coming, and therapy is the answer.
