Medication Skepticism

Q: My therapist told me to stay away from psychiatrists. All they do is fill you up with mind altering meds. What do you think? A: Well….your therapist may have a point. But maybe not! I actually spend about 50% of my work getting patients off unnecessary meds. But most psychiatrists today are trained with the ‘medical model’ and so they will jump all too quickly to prescribing. However, therapists also need to be careful. Some of them may be so “anti-medication” that they could be depriving patients of good care. I’ve seen all too many patients over the years who have been locked in therapy with no resolution of debilitating panic, or compulsive behaviors, or deep penetrating depressions. What we think we know in 2022 is that there are certain psychiatric conditions that seem to be strongly based in biology. In other words, it’s in one’s DNA. These include panic disorder, obsessive compulsive disorder, severe depression, bipolar disorder. Therefore, logic says that a ‘biological agent’ (a medication) can be an extremely effective part of the treatment. When I started my psychiatric residency, I too was skeptical about medication treatment. But over the years I’ve seen the dramatic positive power of medications that have literally saved lives. Bottom line: it is crucially important for psychiatrists to know when NOT to prescribe meds and when to refer patients to therapists. Conversely, therapists need to know when therapy alone is not enough and then to refer their patients to psychiatrists for a medication evaluation. And certainly, all mental health professionals, no matter their approach, should not neglect the importance of spirituality in their course of treatment.