Psychotherapy and Medication: A Combined Approach to Mental Health

Psychotherapy and Medication: A Combined Approach to Mental Health

Understanding Psychotherapy and Medication: Two Paths to Mental Health

Psychotherapy and psychiatric medications are two approaches for relieving emotional pain. Each can be valuable, and often the combination helps even more.

For many people with troubling anxiety or depression, a typical entry point for mental health care is when they see a primary care doctor (or a pediatrician for youth). They may confide in a provider they already know and trust. Their emotional symptoms may also show up on screening questionnaires, which are now common in these settings.

Why Medications Are Often the First Step

In a medical office or clinic, the first recommendation is usually psychiatric medication. In fact, the great majority of such medicines are prescribed by primary care providers, not psychiatrists. Widely used antidepressants, which are also used to treat chronic anxiety, are inexpensive and relatively safe. They are prescribed liberally in such settings.

The Role of Medication: Symptom Relief Without Lasting Change

Medications strictly treat symptoms. They usually ease troubling feelings such as anxiety and depression but without regard for why those feelings arose. Sometimes that is all that the suffering person wants or needs. Anxiety and low mood can seem “chemical,” unrelated to psychology or relationships. While in the vast majority of cases there is no hard proof that biology causes emotional distress, it can seem that way. Or even if not, a person may choose not to explore the emotional roots of these feelings.

But medications frequently fall short. For one thing, they only work while they’re taken, and don’t lead to lasting change. Also, treating symptoms in isolation may miss the forest for the trees. The medical model sees emotional symptoms as isolated problems to treat one at a time. Yet troubling feelings may be triggered by emotional conflicts, dysfunctional relationships, and many other non-biological factors. The surface symptoms may only be the tip of an iceberg that includes additional troubling feelings, as well as relationship conflicts, career dissatisfaction, and other misery.

How Psychotherapy Addresses the Root Causes of Emotional Distress

Psychotherapy can also relieve symptoms of anxiety and depression. But in contrast to medication, here such symptoms are viewed as nonspecific signs of emotional distress, much as fever is a nonspecific sign of illness. Instead of treating the symptom in isolation, psychotherapy takes the presenting symptom(s) as a starting point, to explore the whole person. When emotional pain is understood in this larger context, the treatment gets to the root of the problem. Yes, the anxiety and/or depression is relieved, but other benefits are common too. A person may feel more productive, happier in relationships, more comfortable in general. And these gains persist, and sometimes even extend, after the treatment has ended.

The Power of Combining Psychotherapy and Medication

Medications and psychotherapy can be useful in combination. Occasionally emotional distress is so severe that the faster symptomatic relief of medication has to come first. Psychotherapy is delayed until the person is better able to sit calmly and talk. More often, medications and psychotherapy can start together, the former relieving immediate symptoms, while the latter puts these symptoms in context, to address them long-term.

Starting Your Journey: What to Expect from Your Primary Care Provider

If a primary care provider prescribes psychiatric medication, they may also refer the patient to a mental health professional for psychotherapy. This is the most common arrangement, and often the most economical way to get both services. Unfortunately, many primary care providers overlook the value of psychotherapy and omit the referral. So be sure to ask if this interests you, or you may wish to pursue it yourself. 

When to Consider Seeing a Psychiatrist for Integrated Care

Alternatively, a psychiatrist can provide both medication and psychotherapy. This integrates all parts of the treatment into a single provider, which brings some theoretical advantages. But it is usually more expensive, so this option may be best for complex medical or medication issues, or when the combination of medication and psychotherapy presents special challenges.

Finding the Right Therapist for Your Needs

To find a licensed psychotherapist near you, see our directory here on Therapy That Sticks.