Is Medication necessary for treating Depression and Anxiety?
A controversial subject for sure. I will say up front that I have a bias against taking medications and am frequently appalled at some of the ways institutions pressure people to take medications for emotional challenges. I say this not only as a therapist but also as someone who has dealt with my own depression and anxiety at times in my life. I never took medications nor did I approach any doctor for medications. I began to seek therapy in my mid 20’s and credit this process with helping me to move out of the ongoing inertia and anxiety that was a constant companion. Thankfully I no longer suffer from the debilitating and numbing effects of depression and have gradually come alive to life’s joy and challenges.
Lot’s of clients I work with either take medications or are struggling with whether to or not. Whenever a client asks me if I think it is a good idea for them to take medication, I do not tell them what they should do. I try and support them in thinking through the options and the consequences of taking medications. Despite my opinions, I also understand the appeal of taking a pill to feel better.
In answer to whether it is necessary or not, I can clearly say it is not necessary. I can clearly say that you can heal from depression and anxiety without medication. The emphasis here on necessary. The research gives no clear answer to its effectiveness and there is no clear cause that would indicate the necessity of medication.
If you choose to take medication to help you deal with the symptoms of depression and anxiety, I can understand how that is appealing. My issue is that very often the alternative is not fully explored or encouraged by the medical profession or the person themselves.
It saddens me that there is such a prevalence of prescribing pills to deal with emotional struggles. It is rarely questioned. I want to question it and hopefully give you some pause for concern rather than an automatic acceptance of the authority of the medical profession.
Advantages and Disadvantages of taking medication.
Relieving symptoms. The main effect of medication that I hear from most people is that ‘it takes the edge off’. Whether that is calming down racing thoughts, or elevating mood slightly, or helping to sleep better. All compelling reasons to take medication. I think if you have been struggling for a long time and have tried to deal with the effects of depression and anxiety in a number of ways I can certainly understand the desire to have something make a difference. Many people feel desperate and find anxiety, in particular, hard to bear. So the thought of taking a pill rather than the effort of doing exercise or working at developing connections in your life, or even going for regular therapy, is very appealing.
When I think of clients who take medication vs those that do not it is not clear who is better off in terms of a reduction in the effects of depression or anxiety. This is just a subjective glance on my part and not a careful study. The difficulty with any of this is it is all subjective. Any research study relies on people’s subjective accounts of any changes they notice and what is actually causing those changes; medication, placebo, change in circumstances, exercise, counselling and so on. From where I sit, one of the most consistent positive effects of taking medications seems to be to help people sleep better.
Side Effects. Clearly the side effects are one of the big disadvantages. Weight gain, loss of sex drive, insomnia, agitation, increase anxiety, to name a few. It can seem that when you look down the list of side effects it can make you wonder what the difference is between the side effects and many of the symptoms that you are experiencing. Some of these side effects do often ease but a number such as weight gain and low sex drive often remain. Any medication is to some degree or other detrimental to our system. Let’s just take chemotherapy or antibiotics – super detrimental to our immune system but we take that risk because our life is threatened. With antidepressants and anti-anxiety medication, there is a lot of question about its effectiveness.
Dependency. The addictiveness of anxiety medication and psychological dependency that can result is a big problem for many people. The anxiety medication is particularly addictive and if your body becomes physically addicted the withdrawal is some of the worst from any drug – even more than heroin. 6 months of sheer hell at least. In addition, regular use of anxiety medication to deal with anxiety prevents you from developing the skills to deal with it by yourself. Anxiety is both a normal human experience and is necessary for giving us signals that we need to pay attention to something.
In my previous blog, I talk about depression as a response to life‘s challenges. The problem with being presented with medication as a ‘treatment’ of depression and anxiety, it is easy to see it as something to live with. That taking medication is the treatment. When the reality is it is for most people a stopgap, something to ‘maybe’ hold back some of the symptoms of depression or dampen down the pain. It doesn’t solve any of the things in your life that are contributing to your depression. In taking medications you are more likely to take on the identity of ‘patient’ and that you do not have the skills within you to move out of it. I often hear ‘I am someone who struggles with depression’ or my mother had depression and I inherited it. This identity that is associated with taking medication, in my view, can at the very least prolong a state of depression and with some people create a resignation to a life that can not get beyond depression.
Treating Depression and Anxiety without medication.
When you see depression in a more holistic way and as a response to life’s challenges then you can begin to identify some of the things that need to change.
Often people have lived with the slow creep of unhappiness and immobilization in their life that by the time they decide to reach out for help they are feeling at their worse. They have often felt that they struggled for some time just ‘hoping’ things will magically get better. So the decision to take medications may come with a sense ‘nothing has worked so far’ when the truth is they haven’t really put anything into place. Because medication is automatically assumed to be needed by most doctors they are often prescribed from the beginning without trying anything else first. It is natural to feel slightly better when we make a decision to do something and so this can be associated with taking medications and when that wears off you are resigned and encouraged to keep taking them.
So if this might be you I urge you to give a few other things a chance before considering medication. Here are some things to think about putting in place and the books at the end of this post are very helpful.
- Are there things in your life that need to change? Lifestyle – unhealthy eating, sleeping, alcohol, and drugs. Relationships that are unsatisfying or abusive, or encourage you into unhealthy living. Job or career changes. Family toxicity. Begin to consider small doable steps to any of the changes you know you need to make. Environment and circumstances are big factors in developing depression.
- Exercise. I put this under its own heading because if there is anything that can begin to change the brain’s chemistry and is consistently associated with improvement in depression and anxiety. This is it!
- Counselling. It can be hard to take action when you are unmotivated and have low energy. Having someone consistently there to provide encouragement and reflection can provide relief from these overwhelming feelings. In addition, they will help you to develop the skills you need to either increase your motivation or calm your fears. These skills alone are enough to replace the role medications have.
- Connection. Many of us know that when you are in a depressed state there is a tendency to isolate. Being around people where you can just feel their company is very important. Of course, this can be complicated if there is a tendency to compare or be hyper-vigilant about how they are not interested in you or not to be trusted. These are other good reasons to seek therapy to process these experiences so you can move towards healthy, supportive and secure connections. If you don’t know many people in your life right now, going to places where you can just be around people like the mall or a coffee shop can help break the isolation.
- Healing Trauma. Trauma is consistent with developing depression and anxiety because our systems often shut down or are in crisis (anxiety) because of painful experiences we have not wanted to face. A therapist specializing in trauma and relational trauma will help you to heal from these experiences and to learn to form safe and secure relationships.
If you would like to work with me drop me a line or call me and we can talk. You can book a free 1/2hr consultation to check it out using the online booking at the top of the page. Or if you want to get going with therapy you can book an appointment.
The first step to making a difference can start now.