When Does Medication Make Sense

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Depression, Anxiety, Medication & You

Depression and anxiety are two of the most common psychiatric concerns among adults, adolescents and children in the USA. The impact of depression and anxiety can be devastating.

Just looking at depression, research from the World Health Organization shows that it is the fourth leading cause of disability. In younger individuals the impact of depression has far reaching consequences. For example, depressed teens are much more likely to become pregnant than their non-depressed peers. Their peer relations are also negatively impacted, as is their ability to prepare for adulthood.

Depressed college students are 60% more likely to drop out of school than their non-depressed peers, and marriages where one spouse is depressed are more likely to end up in divorce.   

Not surprisingly, depression frequently has a profound economic impact. Annual household incomes where one spouse is depressed are significantly less than households that are free of depression.   

The list of problems associated with depression could fill the pages of a book, but I think the picture is clear, depression is a serious problem.

The case is the same when looking at the impact of anxiety (and severe emotional distress in general).  

These statistics paint an alarming picture – having anxiety or depression is not a matter of simply dealing with distressing emotions. Instead it is a matter of dealing with something that can turn your life inside out in a dozen different ways.

When you, or someone you love, has anxiety or depression, some serious decisions need to be made regarding treatment. Living with depression or anxiety for years, or worse, for a lifetime, is a horrible option. The cost is too high.

When faced with anxiety or depression, one needs to decide how to overcome the challenge it presents. Many people turn to psychotherapy as a proven means for bringing about positive change (as an aside, research shows that medication and psychotherapy in general are equally effective, but therapy produces longer lasting results, and medication provides faster results). 

At some point during therapy you are likely to discuss with your therapist the idea that medication could be a help. How can you wisely decide whether this is a road worth travelling down?

The Down Side of Antidepressants and Anxiolytics

When the topic comes up in conversations with those that I work with I find it helpful to focus on the risks versus benefits of medication. For most healthy individuals the risk attached to taking an antidepressant or anxiolytic (medication for anxiety) are minimal.

Even so, some people do experience one or more side effects. These may include nausea, blurred vision, drowsiness, diminished libido, dry mouth, upset stomach, insomnia, fatigue, and a several other symptoms. With anxiolytics there may be the risk of developing a dependency on the drug, and eventual abuse needs to be guarded against.

Of course, the specific side effects and probability of developing these symptoms, varies according to the specific medication. As a psychologist I don’t prescribe medication, which means that my clients need to see their personal physician, or a psychiatrist, to obtain medication and have follow up visits to monitor for side effects.

To summarize, the main cost of taking medication for anxiety or depression includes the possibility of developing one or more of the side effects just mentioned; the time/money required to see a physician, and; the need to follow up periodically with medical checkups.

The Benefits of Antidepressants and Anxiolytics

But what of the benefits?

On this side of the ledger there is one major benefit… and it can be a game changer. Medication can quickly allow someone with anxiety or depression to feel better, and in doing so unleash their potential to benefit even more from therapy.

Keep in mind, severe anxiety and depression robs a person of the ability to fully utilize his or her strengths. The depressed or anxious person is operating under the incredible weight of these disorders, and this means that they have a difficult time tapping into skills that would otherwise allow them to make greater progress.

An analogy may be helpful (stay with me, this will make sense in just a moment). Imagine you just bought a new car and are driving it home on a country road, enjoying the terrific deal you made (and trying to ignore how much the car depreciated once you drove it off the lot). A dog runs out in front of you, and with Dale Earnhardt like reflexes you swerve, artfully missing the little canine but sending your brand-new set of wheels off the road and into a ditch.

The dust settles. You slowly exit the car and carefully examine it from fender to fender. With a dramatic flair you fall to your knees in gratitude and shout out "Not a scratch! Not a single ding!”  But then, looking around, you realize that you, and your car, are not going anywhere.

It may have all the horsepower and all the other wonderful customized features that first attracted you to it, but you are still in a ditch. That car isn’t going anywhere as long as it is in the ditch.

What do you do?

You call a tow truck, which comes and pulls the car out of the ditch, back onto the road. Now all of those features that could not be made use of while the car was in the ditch are available to you again. You say goodbye to the tow truck, and serenely ride down the road.

Medication can function like that tow truck. When anxiety or depression has put you in a ditch so deep that your abilities and skills are not able to be employed, the right medication can help. It can relieve the symptoms enough to unlock your potential to face challenges, think more clearly, develop creative solutions, to persist toward your goals, and to make the most of therapy.

CONCLUSION

When you are faced with the decision of whether to take medication to help with symptoms of depression or anxiety, consider the costs and benefits. One of the best reasons to take medication is that it has the potential to “turbo charge” your psychotherapy by unleashing the skills and abilities that anxiety and depression have kept suppressed. If your depression, or anxiety, is so severe that it has blocked you from tapping into your strengths, cut you off from those abilities that would help you to effectively fight back and overcome these problems, then medication should be 'on the table.' Don't let your fears, or pride, keep you from taking medication.

By the way, I’m not a physician, so none of the above should be considered medical advice. It is, however, the sort of practical advice I’ve seen work well for many many people.

Let me know if you have any questions. Would love to hear from you.