Psychotropic drugs and psychotherapy have been shown to be a valid help for people with mental and behavioral problems. But what are the criteria for choosing the most appropriate of these two treatments? Different disorders will respond differently to various treatments and therefore you must carefully consider the choice of the right treatment for each individual case.
In today’s world, where there seems to be a pill to treat almost every illness, many people with anxiety or depression assume that a psychiatric drug is the best option for them. So much so that over the past few years, statistics show a sharp increase in the prescription of psychiatric drugs around the world. In the United States, they are in fact the most commonly prescribed class of drugs.
In our society, we all want an easy solution to our problems and psychotropic drugs are considered the easiest method to treat anxiety, depression and other psychiatric illnesses. Ultimately, many people ask: why spend so much time on psychotherapy when you can take a pill and get instant relief?
Our culture has a love-hate relationship with psychiatric drugs. Although doctors prescribe them widely, they are sometimes touted as a kind of “shortcut” to wellness, a quick way to feel better without addressing and trying to solve the real problems that underlie mental suffering.
Beyond this consideration that has characterized the debate for many years between supporters of “mental health therapy” or “medicine therapy”, today we have a large amount of studies that demonstrate the effectiveness of both treatment methods if used appropriately and “tailored” to the individual patient.
Knowing the general pros and cons of both of these treatment options can help you make a more informed decision about which treatment might be best for you.
Pros and cons of the two types of treatment
The speed of action is an advantage of psychotropic drugs, which is very useful especially when the pathology in question is of a very serious nature. Costs are generally higher in psychotherapeutic treatment, in relation to its longer duration and frequency of sessions, but the spread of online psychotherapy platforms also makes this type of treatment very accessible.
The side effects of psychotropic drugs that, at least initially, are added to the various disorders, including physical ones, that already afflict people with anxiety-depressive pathologies (nausea, dizziness, tremors, sedation, sexual deficits, etc.), can constitute an element that discourages the use of this type of treatment, thus orienting the choice towards a psychotherapeutic path.
Those who have difficulty taking psychotropic drugs because of the fear of becoming dependent on them or of suffering personality changes following prolonged use of these therapies also preferably turn to a psychotherapist.
Many studies have shown that various forms of psychotherapy determine more lasting positive results than psychotropic drugs, because they help patients identify the roots of their problems and the factors that trigger or amplify negative, anxious and destructive thoughts. They teach techniques of self-control and greater awareness of one’s psychological functioning, which will be useful, even after the conclusion of the treatment path, for a better quality of life.
What factors you should consider when choosing
When you are trying to decide whether psychotherapy or medication (or perhaps a combination of the two) is right for you, consider the following:
- What kind of disorder do you need to treat;
- How serious is your condition;
- If you have already had to resort to one or the other form of treatment in the past and therefore with which you have already had good results or with which you have not;
- What type of treatment is the most accessible in the area where you live;
- Which is more convenient for you now and which will be more convenient in a long term perspective;
- If your symptoms are related to past (or recent) experiences or traumas that you need to work through with your therapist to try to resolve them;
- If you have any medical problems that would be negatively affected by the side effects of drug therapy.
What about combining psychotherapy and medications?
It has been clearly evident that combined treatment with psychotherapy and drugs has been found to be superior to either treatment used alone. Since then, various other studies have shown that combined treatment has many advantages over single-modality treatment, and the World Health Organization (WHO) clearly indicated that a therapeutic approach that uses both treatments is the most effective in treating many psychiatric conditions.
In fact, if the speed of action of psychotropic drugs can be useful in an initial phase to improve some symptoms, the associated psychotherapeutic work can determine a more stable improvement, providing the tools that will allow them to be faced and managed also in a medium and long-term perspective.
Does this mean that all patients with mental health problems should be offered treatment with a combination of psychotherapy and medication? This cannot be a general rule, it will be up to the specialist to evaluate whether the patient needs:
- Psychotherapy only;
- Only psychotropic drugs;
- Psychotherapy + psychotropic drugs.
Therefore, in the majority of cases, an integrated treatment of psychotherapy and psychotropic drugs is indicated, in other cases only psychotherapeutic treatment, more rarely only pharmacological treatment.
It is also essential that there is constant communication between the psychiatrist and the psychotherapist to share the general goals of treatment and an improvement in outcomes.
How to proceed in individual pathologies
Depression
The combined treatment of psychotherapy and medications is the preferred one for depression disorder, with the possibility of combining them from the beginning or at different times during the course of treatment.
For mild to moderate depression, psychotherapy may be the treatment of choice to manage symptoms. However, for people with more severe depression, a combination of medication and therapy is the most effective approach.
Anxiety and obsessive-compulsive disorders
For anxiety disorders, Cognitive Behavioral Therapy (CBT) and antidepressant / anxiolytic drugs have been shown to be helpful. Pharmacological approaches are indicated for short-term symptom management, but you shouldn’t use these therapies for long-term, because this carries the risk of habituation and dependence.
Which option is best depends on individual preference and the type of disorder the person has. Research generally shows that for several anxiety disorders, such as Social Anxiety Disorder, Generalized Anxiety Disorder, Obsessive Compulsive Disorder, psychotherapy is more effective than medications and that adding medications should be reserved for well-selected cases.
Choose the Best Path for Your Mental Health
Addictions
For alcohol and drug use disorders, Cognitive Behavioral Therapy has been shown to be helpful. People with severe substance use problems may also benefit from the addition of certain medications that reduce cravings or the effects of intoxication.
Eating disorders
For eating disorders, medical management may be essential to control the internal issues that arise in these patients. Cognitive-Behavioral Therapy, Interpersonal Psychotherapy, and psychotropic drugs have all been shown to be helpful.
Even in this area of psychopathology, much evidence suggests that the combination of psychotherapy and medications, when using two separate therapists, may be more effective than either treatment alone.
Personality disorders
In the treatment of personality disorders, one cannot ignore the use of psychotherapy, as it is the only treatment that addresses the fundamental core of these conditions. Also considering the poor response to drugs, which are useful for managing acute phases of behavioral alterations.
Psychotic disorders
For schizophrenia or bipolar disorder, treatment with antipsychotic drugs or mood stabilizers is certainly essential, but research suggests that adding cognitive behavioral therapy or psychoeducation sessions with family members can help monitor and manage patients’ moods and identify early warning signs or triggers of new mood episodes.
Ultimately, the best way to find the right option is to talk to an experienced mental health professional who can assess your situation and make a recommendation based on your specific case.