Medication: My Role as a Therapist
Clients frequently ask me what I think about psychotropic medications: whether they should take them, what kind I would recommend, and so on. So, I thought I'd share a few thoughts on the subject.
Pills for your mental health or your peace of mind?
First, I'd like you to know about my role when it comes to medication.
I am a licensed marriage and family therapist, not a medical doctor. I do not prescribe medication, and I do not make prescribing recommendations. Deciding whether to take medication, and which medication might be appropriate, requires consultation with a qualified medical prescriber.
My role is different. I can explore your concerns with you, what matters to you, brainstorm your options, and help you come to some useful conclusion. If you're thinking about medication, I encourage you to discuss the potential benefits and risks with your prescriber so you can make an informed decision.
A supervisor of mine once told me that clients have to be in the room for me to help them.
Physical presence alone isn't enough. For therapy to be useful, we need to be able to connect, communicate, and learn from one another. Intense pain, whether physical or emotional, can reduce or even prevent you from participating in your explorations and experimentations. The pain that’s overwhelming your system also forfeits your capacity to add the pain of risking the unknown and unpredictable.
When your mind is in the fight-flight mode, you seek safety and comfort and the fastest way possible. Comfort food, drugs and alcohol, exercise, mindfulness meditation, medication, or chatting with friends—we seek comfort in so many ways, some healthier than others. While our brain also sends little bursts of pleasure to reward us for curiosity and discovering something new, these signals are usually overwhelmed by signals of safety needs. You need to feel safe to leave the well-trotted path and be creative: experiment with alternatives.
Medication can be one way to reduce pain and distress signals in the brain and body so you can refocus on nurturing your creativity. However, it’s rather a complex set of questions than a simple single answer. One of the many variables to consider is finding a qualified medical prescriber with whom you can connect and trust. You want someone who looks at your personal familial and physiological makeup as well as the personality of the medication.
I suggest seeking a psychiatrist rather than relying completely on your PCP, esp. if you anticipate complex situations.
Psychiatrists have more training and experience in the specialty of mental health than a generalist. If you had a heart condition, would you seek a cardiologist or just stay with your PCP? If you’d choose a specialist for treating your heart, why would you not do the same when your mental health is in question? You need someone who spends time with you, looks at the context of your mental health and family history, considers a wide variety of medication options, answers all your questions, and would not rush you to make decisions before you are ready.
It’s good to know that medications have “personality profiles” of their own, just like the patients who take them do. The meds that work for one may not work for another for the same condition, regardless of how good friends the two of you are. Lots of different kinds of meds work for the same condition and the same meds can be prescribed for different conditions. You want to work with someone who has extensive knowledge in the field.
It’s imperative that you communicate with your prescriber. Your psychiatrist’s expertise on the meds does not guarantee that they know how the meds effect you. Share your concerns with them. Don’t mistaken the outcome with the specialist’s intentions or knowledge. If the meds don’t work, it doesn’t mean that your doctor either meant to hurt you or that they don’t know what they are doing. You have to find someone who works with you and doesn’t want you to blindly trust their “insights”. It is your body and your life and you have the last word in what you are willing to take. Consider pros and cons of each option, seek independent consult if you’d like, before you agree. Ask your doctor about how the meds would interact with your other meds or effect other conditions in your body.
Do Medications Cure Mental Health Disorders?
It depends what you mean by being ‘cured” or how you define mental health, or your understanding of the cause of mental health or its disorders. If you believe that any anomaly is caused by chemical imbalance, you are more likely to settle with meds than if you believe that is perception and adaptation to the environment that can result in mind-crippling conditions, in which case you are more likely to seek to explore your perspective on life and try behavior modification.
If you accept a symptom-free life healthy and fit, then meds are more likely be your cure. If you think that a healthy mind is free to question the status quo any time anywhere and create alternative realities then you may seek something more besides, or even instead, psychotropic medication.
I don’t know if meds cure a disorder but they may treat certain symptoms. Many people end up taking psychotropic meds for years or even a life time, depending on the condition. It works for some while others prefer to stay away and try other approaches such as behavior change. Others find that a combination of meds and therapy is best for them.
When we consider medication use I think we are really considering pain management. Some people find meaning in pain which helps them embrace and direct it. People’s sensitivity to pain and pain tolerance also varies. People with lower threshold (high sensitivity) and low pain tolerance may find it most useful to take psychotropic meds while people with high threshold (low sensitivity) and high pain tolerance who can find meaning in pain may fear better with enduring the depression, anxiety, or whatever meatal health condition they find themselves in. Of course, none of these categories are absolutes or answer your question about taking or not taking meds absolutes. But these can be some of those questions you want to ponder when deciding.
And there’s also a good chance that taking meds alone will not answer your questions on how to improve your relationships or whether to leave it altogether. It won’t find meaning to your life or a “cure” for your suffering in an unfulfilling job. Adapting well to situations that are crippling your freedom-seeking mind with the help of medication by reducing the pain is not what I’d call a successful application of medication.
Explore Your Options and Find the Support That's Right for You
Deciding how to care for your mental health is a personal process, and you don't have to navigate it alone. Whether you're considering medication, exploring therapy, or simply looking for greater clarity and understanding, individual therapy can provide a supportive space to explore your concerns, better understand yourself, and discover what works for you. Reach out today to explore how therapy can support your emotional well-being and personal growth.
I’d love to hear what you’re thinking about these topics. If you have questions or would like to discuss something you’ve read, please get in touch.
This article is an update of a blog that was originally published on https://majapsychotherapy.com
Marianna Jakucska is a licensed marriage and family therapist in Sacramento, CA. She does psychotherapy online across California, in a setting that is variably called telehealth, video therapy or therapy-over-the-internet. She specializes in collaborative working with highly perceptive/sensitive people, the creative and the “misfit” to assist them in building a fulfilling life. Her clinical focus is on developmental trauma, depression, anxiety, cultural adjustment, and people single over 30; CBT, DBT, Existential and Eclectic approaches. She is bilingual in Hungarian and brings a broad cultural perspective into her therapeutic work. She is supportive of the LGBTQ Community and people who are seeking spiritual as well as mundane meaning to their life.