[darkside8]

Have any of your T's ever discussed or suggested medication (for anxiety/depression/low mood)?

If so, when did they, and why? At what point would a therapist suggest medication? What if a client brought it up?

How do we truly know that both medication and therapy is required to support progress?

[SlumberKitty]

Hi Darkside8, I see you are pretty new to PC. I hope you are finding your way around the forums and getting support.

Now to your questions....for me, it was actually my PCP that requested a psych evaluation which led me to being put on medications. I've always let my T's (therapists) know what meds I am taking and when the PDOC (psychiatrist) changes them, because I feel that it's important to know that aspect of my treatment even if they do not have intimate knowledge of it.


For me, both medication and therapy has been helpful. It took a long time (years and years) to find the right combination of medications that keep me stable (for me that is an anti-depressant, ADHD medicine, anti-psychotic, anti-anxiety medication, and a medicine for sleep since the ADHD medicine makes me have seriously bad insomnia). There were times when the therapy was keeping me alive because the medications weren't at the right doses or I wasn't at the right levels or the right meds. But now that I'm on the right meds (I feel) then therapy can truly be more beneficial because it's not just crises management. So for me, medication and therapy both are required to support progress.


I can't answer your other questions because like I said, it was my PCP that brought up me going to a PDOC, that was before I had ever started therapy. I hope you get some support and answers. Kit.

My second T in our very first session, in my case regarding anxiety and bipolarish patterns. Not explicitly suggesting meds to me but he talked about his beliefs regarding psych meds and mentioned that he works closely with a psychiatrist and they have clients that both of them see and discuss the combination treatment together. I ended up not taking meds but I really liked that my T had a strong scientific bent (he used to work in neuroscience like I do) and was not at all anti-meds or anti-diagnoses like many (often more old-fashioned) therapists. I brought up the medication topic also many times while I was seeing him.

I don't think anyone really knows with certainty that both meds and therapy would be required but there are certain conditions (and severity of certain conditions) where many years of research and data support an indication that perhaps meds would be helpful. Things like psychosis, severe depressive episode or chronic depression, mania etc. Especially if the client's state is not easily explained by life conditions. I personally would not want to work with a T who is very anti-meds, anti-diagnoses and anti-science even if I decide not to use meds.

To really know, one needs to try the meds and see from experience. The brain, all the individual variations and how it might be affected by meds (and what kind of meds) is just way too complex to make accurate predictions.

Originally Posted by darkside8

Have any of your T's ever discussed or suggested medication (for anxiety/depression/low mood)?

If so, when did they, and why? At what point would a therapist suggest medication? What if a client brought it up?

How do we truly know that both medication and therapy is required to support progress?

In the beginning. T suggested anti depression pills. But I was already in then so she suggested I really to my gp about changing then.
She added that they might, might, help lift my mood enough for the work to proceed.
She admits, she isn't a gp and doesnt pretend to know what I should or shouldn't take.

[nottrustin]

T and I frequently discussed medications. She was a firm believer that therapy and medications often work hand and hand especially for my depression. Before I would go to an appointment with psych NP I would check to see what she thought. She had a pretty good at reading where I was. So we would discuss if she thought any changes. She also tried to stay updated on medications so she was able to give ideas. Also, I would usually tell her when I stopped taking my medications which happens frequently. She would be frustrated but accepted my need to do it and help me watch for signs that I was slipping and need to go back on. She also helped me tease out my depression were in fact chemical or situational. Both T and psych np respected each others k knowledge and work. Np would ask me what T thought as she knew I saw T a lot more often than her. It was a huge help to have T to discuss this with.

EMDR T jas very little knowledge about medication. She believes in taking them if really needed. She also believes that they can effect a person's therapy in a negative way. She feels they can block emotions and so somebody like me who wants to block emotions and needs to learn to express them appropriately, the medications can work against us. It is hard that I cant work through with her the need for meds. Especially since psych np qas out on medical leave.

[darkside8]

Originally Posted by Xynesthesia

My second T in our very first session, in my case regarding anxiety and bipolarish patterns. Not explicitly suggesting meds to me but he talked about his beliefs regarding psych meds and mentioned that he works closely with a psychiatrist and they have clients that both of them see and discuss the combination treatment together. I ended up not taking meds but I really liked that my T had a strong scientific bent (he used to work in neuroscience like I do) and was not at all anti-meds or anti-diagnoses like many (often more old-fashioned) therapists. I brought up the medication topic also many times while I was seeing him.

I don't think anyone really knows with certainty that both meds and therapy would be required but there are certain conditions (and severity of certain conditions) where many years of research and data support an indication that perhaps meds would be helpful. Things like psychosis, severe depressive episode or chronic depression, mania etc. Especially if the client's state is not easily explained by life conditions. I personally would not want to work with a T who is very anti-meds, anti-diagnoses and anti-science even if I decide not to use meds.

To really know, one needs to try the meds and see from experience. The brain, all the individual variations and how it might be affected by meds (and what kind of meds) is just way too complex to make accurate predictions.

So would you say it's usually, or perhaps only, when there's a chemical imbalance resulting in depression etc that medication is necessary?
If someone has been low for years, perhaps due to different circumstances in their life, then medication should not be an option because it's more situational?

Originally Posted by darkside8

So would you say it's usually, or perhaps only, when there's a chemical imbalance resulting in depression etc that medication is necessary?
If someone has been low for years, perhaps due to different circumstances in their life, then medication should not be an option because it's more situational?

No I don't think there is any case where it should not be an option. I just mentioned those more acutely severe states because those are clearly due to things in the brain "acting up". I personally believe every mental health issue is due to changes in the brain, it is just very complex and individual, sometimes subtle other times more severe. Even conditions that develop primarily as a response to a situation - they persist because there are effects in the brain. If you are interested in trying meds, why not? Are there contraindications? My personal view is that if it is a relatively minor and manageable issue that is likely to respond to lifestyle changes, I would explore the lifestyle first, but it's just a personal preference. That is how I "treat" myself. But if ones makes changes and still no improvement, and if there are medical options and willingness to try and no contraindication, why not? Also, sometimes a chemical help first can elicit just enough improvement that the self-help becomes more effective or possible. I would discuss all these with a doctor and T if you are seeing one, there is no need to wait for them to bring it up.

I don't take meds because my symptoms in the past several years have been relatively minor, manageable and not frequent, even though when I actually have symptoms, it can feel quite unpleasant. I had one time in my life that I would describe as a severe major depressive episode and I am pretty certain if it happened again, I would not wait for it to resolve naturally, it was pretty debilitating. Some people are against meds also because they don't like the idea of blunted emotions. But if it is exactly the extreme emotional states that cause suffering and block progress... I am not sure what good they do to anyone? What often happens is that people get very used to living with negative, destructive emotions or low-grade depression and feel they would not be themselves otherwise. That it's those emotions that make the deep or something. That can be a very challenging perception to change from all I know. I think it is also sometimes associated with personalities. For example, if someone self-identifies with their emotions a lot, it is not surprising that they don't want to lose/change them much.

[daisydid]

I had an interesting conversation once with my I think he's a former therapist but I don't know. My pdoc had just prescribed Ativan, so T went on this whole diatribe about why benzos are Satan because they're abused and quickly can lead to dependency and an inability to regulate or tolerate normal levels of anxiety. Blah blah etc.

It's been...3 or 4 months since then and I haven't even finished the first script of it.

[piggy momma]

My last T would not see me unless I was on medication. He helped figure out what meds to take and what dosage, and suggested adjustments as needed. He was really knowledgeable in that area.

My current T doesn't want me on any meds, so I've been off them since April.

[MoxieDoxie]

Mine just suggested it today after a few weeks ago saying they would not help me because they only worked form those with a real chemical imbalance issue. Now he changed his tune after seeing me today because my H is on furrow for the government shut down, our landlord told us we had to be out by the end of March as he is selling and my business just tanked so you know I want to get hit by a bus and die.

[BudFox]

One therapist brought up antidepressants just as a discussion point. This meant nothing to me because -- she knew very little about health, and everyone talks about antidepressants because of societal brainwashing.

Medication and therapy are never required. Neither has any real evidence base. And both involve considerable risk of long term damage. Ask for compelling evidence that outweighs the risks and see what you get. Also, if you are being pushed toward meds on the basis that you have some "chemical imbalance", then it would be reasonable to expect that a test be run to confirm this and to find out what kind of imbalance. There is no such test, so don't bother. I would not trust a therapist, psychiatrist, or physician with my brain chemistry. Ok, off my soapbox...

[ChickenNoodleSoup]

Yes, my T, a psychiatrist, has suggested I start taking an SSRI for anxiety.

My T brought up the possibility of medication twice. The first time I was gone from home for a while and had trouble sleeping. Due to the situation being temporary, he suggested sleep meds once or twice. He didn't ever put me on any though.

The second time was recently. After he came back from a vacation, I was a complete mess, panicked about everything under the sun. I one time came in and sat on the floor crying. We increased the frequency of sessions to twice a week, but nothing really improved from that anxiety-wise (though other issues got better). He then started suggesting that I could take something for it. He mentioned it twice before asking whether I'd like to maybe try it, then discussed all the possible effects with me during multiple sessions, before prescribing me something to try.

I feel before I started taking medication, I was so emotional and absorbed by fear, I couldn't concentrate properly on what my T was telling me anymore. I couldn't do the work I normally do to get better on my own.
I'm not sure how you'd tell whether somebody would have to go off a med (besides side effects or wanting to do

[GeekyOne]

I was on meds before I started with my current T. In fact, my pdoc referred me to current T. I discuss my meds regularly with T, who is married to a pdoc (not my pdoc), so has more understanding than some others in her position. She has helped me figure out my feelings about cocktail changes, and fully supports meds in addition to therapy. T and my pdoc work at the same office and consult with each other about me, which has been helpful.

[ArtleyWilkins]

My therapists never really had to bring it up; I was well aware when I needed additional help through medications. My depression at times was extremely severe and life-threatening, and medications at that point were really the only means to get me out of those severe depressive states in any kind of a timely manner.

I had a great psychiatrist who found the right meds that worked fastest with the least side effects, and he was supportive of reducing meds when the necessity wasn’t as strong.

I know when I was severely depressed, therapy was not effective because it was like thinking through quicksand. During those times, my therapist really served the role of keeping an eye on my safety until I stabilized; no real therapy was going on. Meds stabilized me, usually within a few weeks, and then therapy became productive again.

Once I was stable (and I’ve been stable for quite a few years now), my psychiatrist and therapist were highly supportive in my decision to get completely off of medications.

[sarahsweets]

Originally Posted by BudFox

One therapist brought up antidepressants just as a discussion point. This meant nothing to me because -- she knew very little about health, and everyone talks about antidepressants because of societal brainwashing.

Are all the patients that have been helped by medication brainwashed by society as well?

Medication and therapy are never required.

Nothing is required but looking at the long term you have a better shot with at least one of these.

Neither has any real evidence base. And both involve considerable risk of long term damage. Ask for compelling evidence that outweighs the risks and see what you get.

I strongly disagree but I am not going to dig for the right links now (although I suspect that anything I could manage you might say is invalid). There are thousands and thousands of patient studies, peer reviewed literature, university medical studies in addition to the statistics I am sure exist supporting the use of medication and therapy.Or one or the other at a time. Usually when I discuss this with people that think Big Pharma rules the world or that society is the problem and not brain chemistry- I am told that all the studies OF COURSE will be favorable towards medication because they are all funded by big pharma, rich CEO's, or a government that wants to control its citizens for some nefarious purposes. But that is not the case and if people truly understood what it takes to get a drug successfully studied and brought to market maybe they would give a few of them some sort of leeway. And it is true for all drugs. Are their abuses and mark ups and artificial shortages? Yes because there are greedy people where there is money to be made. Are there side effects? Yes, in fact whole parts of studies get dedicated to specifically studying side effects. Read the side effects profile for tylenol and aleve. Google their relationship to blood pressure problems and how that info is almost never shared while the doctor's toss tylenol at you.
i do not think meds should ever be pushed or required and I know many people that have made it off meds. But extreme anti-med information is just as detrimental as extreme pro-med information. I do not think either side should be discounted based on misinformation.

Also, if you are being pushed toward meds on the basis that you have some "chemical imbalance", then it would be reasonable to expect that a test be run to confirm this and to find out what kind of imbalance. There is no such test, so don't bother. I would not trust a therapist, psychiatrist, or physician with my brain chemistry. Ok, off my soapbox...

Again, the science says otherwise and this goes way beyond psyche meds and mental health. My 22 year year old had a stroke and we have seen a zillion specialists and I have been fortunate enough to pick the brain of some very cool neurologists. Chemical imbalances do exist and there are ways to detect this. You do not have to trust a therapist, physician or even psychiatrist if you do not want to but I 100% trust a research Neurologist in the 7th year of his residency.

[BudFox]

Originally Posted by sarahsweets

Chemical imbalances do exist and there are ways to detect this.

Psych drugs create chemical imbalances. That's how they work.

Pushing everyone with a depressed mood toward brain-disrupting drugs and/or a paid relationship, to the near total exclusion of everything else... that ain't medicine. It's abject laziness and shameless profiteering and it's a seriously scary sort of social engineering. That's my take after extensive interaction with conventional healthcare and a lot of research.

[annielovesbacon]

At the end of my very first therapy session (they called in an 'intake session') my T basically summed up her view of things: she said my experiences could suggest bipolar disorder and said if I wanted, medicine could help. I said yes and then she referred me to a psychiatrist.

My T now every so often will ask what I'm taking but really I discuss my medicine mostly just with my psychiatrist. The only time T and I really discuss my medication is if I relapse with my eating disorder because one medicine I take could become dangerous.

[annielovesbacon]

Originally Posted by BudFox

Psych drugs create chemical imbalances. That's how they work.

Pushing everyone with a depressed mood toward brain-disrupting drugs and/or a paid relationship, to the near total exclusion of everything else... that ain't medicine. It's abject laziness and shameless profiteering and it's a seriously scary sort of social engineering. That's my take after extensive interaction with conventional healthcare and a lot of research.

I respect your opinion and don't wish to argue. I just wanted to add that without my medicine, I would literally be dead. No one pushed me to take medicine, it was my choice. I hope you will keep in mind that that is true for many other people as well.

I secretly think my antidepressants haven't saved my life.
Therapy has helped me maintain a liveable life.
I've been on Ad's for 16yrs. I'm pretty sure I'd feel the same if I stopped them.
I'm dx with major depression.
The first week of taking them I felt like Jesus. Everythinnng felt great!
After that I've just settled into a mediocre mood. I take them coz they help with sleep they at least do that.

[BudFox]

Originally Posted by annielovesbacon

I respect your opinion and don't wish to argue. I just wanted to add that without my medicine, I would literally be dead. No one pushed me to take medicine, it was my choice. I hope you will keep in mind that that is true for many other people as well.

Drug pushing and coercion can be indirect or implied.

Try getting social security disability in the US without evidence of a formal diagnosis and compliance with the recommended drugging.

Or, refuse drugs prescribed by a doc or recommended by a therapist and you might be labeled paranoid, resistant, disordered, etc.

Drugs are heavily subsidized by insurance plans, therapy too but less so. The list goes on.

Plus, we are indoctrinated from birth to believe in the sanctity and necessity of drugs, especially for depression, and mass media/culture is a mindless echo chamber for this.

It all tends to make people think there are no options besides drugs/therapy... as evidenced by the original post. I've experienced it firsthand.

[mcl6136]

I have never seen a T who has the ability to write a prescription, nor have any of them urged me to get any meds.

I guess I've gravitated to the kind who don't have that kind of educational background, and I'm glad, because I am the type of person who can get drunk from two beers and sleep 12 hours after taking a single Benadryl. The truth is, I'm afraid of medication.

[susannahsays]

Originally Posted by BudFox

One therapist brought up antidepressants just as a discussion point. This meant nothing to me because -- she knew very little about health, and everyone talks about antidepressants because of societal brainwashing.

Medication and therapy are never required. Neither has any real evidence base. And both involve considerable risk of long term damage. Ask for compelling evidence that outweighs the risks and see what you get. Also, if you are being pushed toward meds on the basis that you have some "chemical imbalance", then it would be reasonable to expect that a test be run to confirm this and to find out what kind of imbalance. There is no such test, so don't bother. I would not trust a therapist, psychiatrist, or physician with my brain chemistry. Ok, off my soapbox...

I understand your skepticism, given how little is known about the mechanisms behind the purported effects of psychotropics. However, I really have to disagree with your assertion that medication is never necessary. Take the case of a schizophrenic person, for example. Schizophrenia itself can be extremely traumatic, and even with treatment, many schizophrenics do not attain a normal level of functioning. However, without the use of antipsychotics, they would be even worse off and most likely require institutionalization or frequent hospitalizations.

I myself can also attest to the efficacy of antidepressants in treating depression. Prior to being prescribed, I had attempted suicide several times. I do believe I have a "chemical imbalance" or something similar that I was born with. Mental illness (depression and schizophrenia) runs in my family. I realize this evidence is purely anecdotal, yet I also know that if I were to go off of my antidepressant, my condition would deteriorate and I would once more attempt suicide.

I think that a lack of evidence of the etiology of mental illness and the similar lack of a full understanding of why/how psychotropics treat it is simply that: a lack of knowledge. That does not disprove anything.

How would you know this?
I'm just curious.
I've attempted suicide 3 times in the past. Haven't since I started taking Ad's.
But I am not sure I would attempt again if I stopped.
I don't think I'm in that same place. I carry on taking Ad's because, well. I don't know.

.... his evidence is purely anecdotal, yet I also know that if I were to go off of my antidepressant, my condition would deteriorate and I would once more attempt suicide.

[ArtleyWilkins]

Originally Posted by Jessica11

How would you know this?
I'm just curious.
I've attempted suicide 3 times in the past. Haven't since I started taking Ad's.
But I am not sure I would attempt again if I stopped.
I don't think I'm in that same place. I carry on taking Ad's because, well. I don't know.

.... his evidence is purely anecdotal, yet I also know that if I were to go off of my antidepressant, my condition would deteriorate and I would once more attempt suicide.

Perhaps the poster knows the level of her depression and is discussing her previous pattern of response to going off of medication.

I agree, though, that the pattern can change as we change. I went through about a decade where I repeatedly fell into suicidal depression and medication would keep me stable enough to stay out of those depressions. I know, sort of innately, that my depression was partially due to being completely out of whack (my technical term LOL) both physically and mentally. Something was terribly wrong the in state of Denmark and there was no "therapy-ing or working my way through that physical and emotional volatility at the time.

When I started truly stabilizing, I also knew, rather innately, that I had finally reached a place where I wasn't going to need medication to keep me stable -- I could finally do that for myself. Why? Partially it was that I reached a place mentally/psychologically where I was more internally healed. I was more able to handle what life threw at me. Partially it was that I could simply feel internally a change in my physical reaction to stress. I don't know how to explain that, but I know my physical response to emotional and situational pain and stress was no longer out of control. Something internal, both physically and emotionally stabilized, and I knew at the point that I no longer needed the medication (or the therapy actually).

I don't have a scientific explanation for that, but I know it to be true for my experience. Both my therapist and my psychiatrist at the time saw it happen and trusted my instinct about myself and that change. They supported my move to stop medication and I have, thus far, managed some 5 years without any need now for medication or therapy.

I know had I tried to survive without medication before that point, it would have resulted, once again, in extreme suicidality and hospitalization. I also know now that the chances of me ever becoming that suicidal and that unstable again are slim. How do I know? I can't describe it except to say I can feel an actual change within me, emotionally AND physically. I am a different person today than I was during that period in my life.

[BudFox]

Originally Posted by susannahsays

I think that a lack of evidence of the etiology of mental illness and the similar lack of a full understanding of why/how psychotropics treat it is simply that: a lack of knowledge. That does not disprove anything.

Burden of proof is on those who assert the necessity or legitimacy of brain altering drugs. This includes a therapist who encourages a client to start popping pills. Also if you look at long term outcomes, people on drugs tend to fare badly.

If doctors are drugging people without knowing etiology, with no objective tests, and with drugs they do not understand... then it ought to be acknowledged that a massive and dangerous -- and immensely profitable -- social experiment is being carried out on the brains of millions of children and adults.

BTW, there are plenty of known factors in the etiology of mental afflictions but mainstream healthcare is set up to overlook such things.