[ChickenNoodleSoup]

I know I have a bit of a different situation than most of you guys in that my T and pdoc are the same person. Still, I think this question applies to everyone here who takes meds as well as does therapy:

How are meds discussed in your sessions, if at all. My T today when I asked for him to renew my prescription briefly asked whether I'd want to get off of it. Somehow, I feel like the whole medication thing gets left out in therapy a bit. At least for me, it would be helpful to say things like "this thing might be less anxiety inducing because of meds rn, let's try to work on that while not being that triggered". I am grateful that my T at least mentions cutting down from time to time, I did also wonder whether you guys have to bring stuff like that up or have to consider it yourself, but of course that's a bit different if your T is separate from your pdoc.

[ElectricManatee]

We talk about my meds occasionally, like a few times a year. My T is a psychologist and not licensed to prescribe meds. She has been around long enough to have a pretty good idea of how pharmaceuticals affect the brain, although she's still careful to say things like, "I wonder if you could talk to your psychiatric nurse practitioner about..." without being too prescriptive (pun intended).

I usually put a note in my calendar to ask for any opinions she has about my mood at the last session before I see the psychiatric NP. It's usually kind of a strategizing conversation, like somewhat recently I mentioned wanting to reduce one med to see if my anxiety would decrease and then add another to compensate for it. I'm not that interested in getting off my meds right now because they're useful without bothersome side effects, but I might try that later when I have more time and space to do the other things that are helpful in lieu of meds. I do usually find that I have to initiate these conversations with my T, but I don't really mind that.

[NP_Complete]

My psychologist just completed a program that allows him to prescribe, although it's only allowed in a handful of states, and not the one we currently live in. Yes, he does sometimes bring up medications and has encouraged me to talk to my doctor about getting back on an AD. While I appreciate the schooling he went through and know that he knows what he's talking about, part of me wishes he wouldn't try to act like a prescriber with me. When he first started his program, he was going to move out of state and end our relationship and I took it very hard. This all happened in 2020 and they kept allowing distance learning and the date for his leaving kept changing and I never knew when he was going to actually leave. It was awful not knowing if or when this person who was my literal lifeline was going to end our relationship. So I get a little resentful when he brings up meds with me. I'm not sure if he realizes this or not. I should probably work on not being that way about it. He's still here, by the way. Graduated, possibly taking an exam soon, although he hasn't mentioned it in a while. He signed a two-year lease on a new office, so I honestly have no idea what his long-term plans are and I'm trying to not be so vigilant about it. I do worry, however, that I have let my guard down too much and I'm going to get crushed again someday.

[zoiecat]

My trauma T is big on DBT among other things so I have to turn in a diary card every session which includes what meds I took each day. I sometimes try to stop my meds when I am feeling better and he has a fit because I eventually go the hole. I take a total of 5 pills a day and I hate being reliant on them. T says that I will eventually be able to reduce meds but in the meantime they are helping me keep symptoms down while we continue to process all the trauma through EMDR. He always wants to be updated whenever I see the Pdoc. So yes, we discuss meds on a regular basis in session.

[AliceKate]

My T initially pushed me to take an AD. Aside from that, I discuss it only with my PDoc, and even that only very infrequently. Largely, I feel put in charge of this myself, which is fine. Last time I saw my PDoc I asked for my medication to be reduced and he was fine with it. In 3 months, I see him again, and plan to ask for the same thing, as I feel okayish most days. That will be in march, so I may be off of them entirely sometime in the summer, or I may take a lower dose all throughout 2023 and stop taking any entirely when the days get longer in 2024. I haven't fully decided yet. But yeah in therapy, it's not discussed really. But I think the need for that may well depend on the type of medication prescribed.

[ScarletPimpernel]

L and I don't really talk about meds unless I'm in a crisis and she feels I should yake a benzo. Otherwise, she knows I'm med compliant and can advocate for myself when I need a med change.

[Soupe du jour]

I only once had a pdoc that was also providing my therapy. In my case, the therapy part was a separate day and group therapy. However, if you do the therapy and med management privately and on the same day, I think you should set aside a little time to talk about the meds, if needed. If you have nothing to discuss about the meds, then why discuss? You may need to take the lead when you want to. Or, a solution could always be that you ask your pdoc to start with "med management" talk at the very beginning of each session. It could be 10 mins or so. Then shift into therapy mode. Just an idea.

You CAN take the lead on these things.

[ArtleyWilkins]

My last therapist was very knowledgeable about medications. He had gone through a program on psychopharmacology. It was incredibly helpful because if I was noticing an issue, he was able to point me in the right direction. He knew whether something going on was a therapy thing or a med thing. He could converse and consult knowledgeably with the psychiatrist he worked with and with my own psychiatrist. It became one of the most helpful aspects of having him as my therapist.

[LonesomeTonight]

My T isn't a prescriber, and he only brings up meds very rarely. I'm not currently on any psych meds, though was for a long time in the past. At one point maybe a year ago, he asked me if I was taking any psych medication. It was a session where I'd been particularly emotional (crying), and I got upset, thinking he would rather me be medicated so he wouldn't have to deal with such strong emotions. He said no, that he just wanted to make sure I was getting the support I needed, or something. He has not brought it up since.

[steelmagnolia65]

I usually tell my therapist if one of my medications has changed, or if my psychiatrist has recommended something..........

My therapist really wants me to try either TMS or ketamine therapy, but unfortunately I cannot afford either one, and she understands that.

[Victoria'smom]

I talk about medicine quite often because I tend to be non-compliance. Especially in episode. Often it ends with a deal that I take my medicine until next session.

[Lostislost]

I've tried different meds many times, but they have either done nothing or made me worse.

There are studies that show the basic anxiety and depression meds are no more effective than placebos. My T is not a prescriber and he seems to think meds are not useful....I don't think he brings them up ever!