Do I need Therapy, Medication, or both?

Therapy and medication management are two courses of treatment for mental health challenges. With so many types of therapy options and treatments, it can feel overwhelming and uncertain about where to start. This blog post will review the differences between therapy and medication management.

What’s the difference in training/education between a therapist and a psychiatrist?

A therapist is an individual who has received education in counseling and mental health (typically in the following areas: assessment, diagnosis, and treatment. Therapist is a broad term, and encompasses clinicians from many different fields of study. These include marriage and family therapists, social workers, professional counselors, addiction specialists etc... A therapist typically attends undergraduate, followed by a master’s program. Master’s degrees take about two years to complete an involve both classroom work and an internship/practicum in the field for one year.

A psychiatrist is a medical doctor who prescribes medication and monitors the clients progress as it relates to the medication. These individuals completed undergraduate education, followed by medical school and residency.

 What’s the difference in treatment if I see a therapist vs. a psychiatrist?

Therapy involves processing stressors, issues or concerns. Therapists can aid in providing education around symptoms and diagnoses, in addition to teaching helpful coping strategies. Therapists typically meet with their clients on a weekly basis to build upon success and work towards reaching treatment goals. Once clients feel they have done so, it can be common to transition to a lesser frequency (bi-weekly, monthly) for maintenance work.

For clients who feel they are plateauing in therapy or are having significant symptoms that are interfering in functioning, consultation with a psychiatrist regarding medication options can be beneficial. A psychiatrist, or other prescriber, will complete an evaluation and make recommendation about what medication options might be helpful. They will review the risks and benefits of medication, answer any questions you might have, and continue to meet with you at identified intervals (ex: every two months), to monitor.

Do I need to see a psychiatrist, therapist, or both? 

 Our practice commonly sees individuals with anxiety, depression, trauma etc…all of which have several evidence-based treatment options. This means, there are treatment protocols evaluated by research/science to be effective in reducing symptom severity. One of these therapies is cognitive behavioral therapy, and casually referred to as the gold standard. This is a structured therapy that is collaborative in nature and focuses on the impact of thoughts on behaviors and emotions. This approach also emphasizes skills and behavioral interventions in addition to cognitive work. Many people find relief from therapy as a standalone treatment. However, if symptoms continue to persist, including medication management can be a helpful addition to further boost treatment efforts. Research has shown that engaging in both therapy and medication yields the most positive treatment outcomes. *However, this is not to say that clients can't find relief or achieve their goals by only engaging in one service.

When “should” I see a psychiatrist?

 Deciding to pursue medication is your choice, and one that you do not need to make right away! There are several factors to consider when thinking about medication. One reason might be that your symptoms are interfering with functioning. This can be seen in multiple areas such as school, work, relationships etc... Another reason may be that you feel you have engaged in multiple types of therapy, and it appears to be "treatment resistant". This is when treatments have been successfully delivered and found to be ineffective or only modestly effective. This can feel particularly frustrating for any client. Positively, several emerging treatments are available to discuss with a prescriber.

Medication myths

There are still many myths around taking medication, which can sometimes be a barrier to individuals reaching out, and can perpetuate the stigma around mental health and mental health treatment. Let’s debunk some of the common myths below:

“Medications are for those with serious mental illness”

-There are medication options for many mental health challenges, such as stress, anxiety, sleep difficulties, poor attention/focus etc… Medication is not just for those in hospitals or presenting with complex needs

“If I take medication, I’ll be trading in one problem for another set of problems” (referring to side effects).

-It is valid that medication can lead to unwanted side effects. These are indicated on labels and typically discussed prior to starting any regiment. However, most of these are mild in nature and people find they dissipate after initial doses.

“I’ll become addicted if I start taking medication”

-While warnings exist for nearly all medications, the class of medication most commonly used to treat mental health conditions, SSRI’s, have been found to be generally safe for most.

“Taking medication is a sign of weakness, that I can’t do this on my own”

-It can be helpful to reframe your use of medication as just another tool you are using, like therapy or utilizing friends/family for support. It can be helpful to remember that not everyone remains on medication for the duration of their life (Especially when an individual can implement skills and strategies from therapy).

As always, consultation with a trusted provider (therapist, primary care physician etc…) regarding your ongoing symptoms and concerns is important. Devising a treatment plan that addresses your specific needs, goals, and is within your comfort level, is key.