Before I share my thoughts on the use of psychiatric medications for mood disorders, let me first clarify my lack of credentials.
Some people think the terms psychiatrist, psychologist and counselor are basically interchangeable, but there are some distinct differences. A psychiatrist is a medical doctor who is an expert in mental health and prescribes psychiatric medications. A psychologist is an expert in mental health with a Doctorate degree. A counselor is an expert in mental health with at least a Master’s Degree. All can provide talk therapy, but only a psychiatrist can prescribe medication and has extensive training in brain physiology, chemistry and the like.
I am a counselor.
So, when I share my opinion on psychiatric medications, it is from the perspective of someone who believes in the power of insight oriented solutions, a belief that changing circumstances and thinking is a means to make changes in a person’s mood and life. My opinions come from observations, rather than education and detailed understanding.
Many of my clients also make use of psychiatric medications, either prescribed specifically by a psychiatrist, or often by a primary care doctor. I have learned a lot from their experiences and insight, as well as by seeing the effects in their lives.
Some people are eager to find the relief they need in medication. Others are very resistant to using medication. I would say my initial attitude on medication was similar to those people who want to solve their problems on their own, by their own will power. Other people are afraid of becoming addicted, dependent or having side effects. It is an unfortunate fact that I have met some people who have ongoing suicidal thinking, depression or other lasting side effects from bad medication reactions.
But the research I have seen suggests that counseling and medication are more effective together than either one separately. I tend to simplify the matter by thinking of medication as something that can make the emotions less raw, and counseling helps people make real changes to their thinking and behavior. If you just take medication, you may feel better, but may not make any real changes. However, for some people, counseling alone is unlikely to be productive if the emotions are just too overpowering. For some people, medications may be like a scaffolding that is put in place while a structure is being built, but then can be removed when the building is complete.
However, for others, there is a legitimate ongoing chemical imbalance that needs ongoing treatment. I witnessed the reality of chemical imbalances when I saw my wife go through post-partum depression. Here was a woman just blessed with a beautiful new baby and she knew she was supposed to be happy, but every night she found herself weeping when it got dark. The doctors predicted it might happen because she had been producing chemicals for two and now suddenly she was getting all those chemicals just for one. And as the doctors also predicted, the depression went away after a few weeks. I saw the very real mood effects of a chemical imbalance. It was not due to external circumstances, my wife’s thinking or anything she had done wrong. She was aware of what was happening, but the feelings were still just as real and just as painful.
If someone had asthma, would you expect them to run a race without an inhaler? Thyroid conditions, blood pressure issues and many other medical conditions require ongoing medical treatment to manage symptoms, so should there be any shame in needing medication when there is a legitimate chemical imbalance? Do we expect people to just will power themselves through slipped discs or vertigo?
So, sometimes medications are in order for long term chemical imbalances and sometimes they are just temporary aids while people make the necessary underlying changes via counseling. Sometimes people are unsure which is the case. I usually just trust each person’s judgment. I have seen cases where people weaned off of medications as they made progress, but I always suggest this be done under advisement of a medical doctor. I have also seen some people start without medications and when they have thoroughly addressed their thinking, behavior, beliefs and circumstances and they still feel depressed or suicidal despite no discernible reason, then they usually feel satisfied that they have done their due diligence and a medical approach is in order.
At the end of the day, I just generally encourage people to stop worrying about the stigma and pressure about what others think they should do, and instead trust their own judgment about what they need.