Can a Medication Help Me?
My Specialty and Limitations
I specialize in the treatment of depression, anxiety, and their many variations with a focus on therapy over medications. I’m a private practitioner without medical equipment on hand. I do not have a blood pressure cuff, weight scale, temperature reader, or blood draw services. I will ask you to obtain these items yourself at your own cost if you want me to prescribe you certain medications.
I’m limited in the complexity of the cases I receive. If you are already taking three or more psychiatric medications or you are over the age of 60yo and are requesting to take medications, I will kindly offer a referral for you to other psychiatrists in the area. Many psychiatric medications require ongoing monitoring, lab draws, and plentiful availability for urgent calls. In addition, elderly age magnifies the odds of having a negative reaction to medications. It’d be more efficient and safer to work with another provider that already has those services on hand and has experience with older aged patients.
How I view medications
I view medications as a single tool - they’re good at very specific, very limited things and nothing else! I do not believe you can reach recovery with just this one tool. The only things they’re consistently good at in my experience are: preventing and treating manic/psychotic episodes, numbing your feelings, and giving you side effects. They are rather poor at managing or solving the underlying issues leading to your symptoms. Therefore, I’ll almost never recommend taking a medication solely while working with me. I’ll usually recommend some form of therapy with the option of taking medications. The only exception is for conditions like Bipolar and Schizophrenia.
Medications for Bipolar and Schizophrenia
Medications are absolutely necessary in either of these conditions to prevent and treat manic and psychotic episodes. No other tool has the ability to manage those episodes aside from medications. In addition, you’d have to agree to commit to the following if you wanted me to work with you:
Lifetime Abstinence: You’d have to agree to never use drugs/alcohol for the rest of your life. This is to ensure the medications will continue to work for you at the lowest possible dosages.
Medications for Depression, Anxiety, and other symptoms
In my experience, medications are optional in these conditions and are NOT necessary. Therefore, taking a medication for these conditions is a choice for you to make. You can consider the information below on whether you’d want to take a medication for your symptoms.
What can the medications do? What does the evidence show?
The most commonly prescribed medication for almost all psychiatric conditions (aside from Bipolar and Schizophrenia) is the antidepressant medication (list here). You may have the impression that because antidepressants cause a decrease in intensity of negative emotions, positive emotions such as happiness/joy will increase. This has sadly not been the case in my more than 6+ years of practice.
In addition, more studies are coming out showing the effects of antidepressants are barely better than placebo. There’s also new information surfacing that many pharmaceutical companies purposefully obfuscated and buried their own studies to inflate the purported statistical effectiveness of antidepressants. Therefore, when deciding to take a medication, please consider the information below on what the antidepressants can and cannot do:
What this means for your assessment
As mentioned on other pages of my website, it usually takes 2-4 appointments to finalize your assessment, establish a diagnosis, identify your treatment goals, clarify your treatment goals, and negotiate on decisions/commitments you’ll need to make. After the above is done, I can prescribe a medication if I believe it is a necessary tool for your recovery or if you specifically request to take one. In other words, I DO NOT usually prescribe new medications to you within the first 2-4 appointments.
What this means in terms of Treatment Offered
I prescribe Treatments based off of what your Treatment Goal(s) are. You can read more about Treatment Goals at this link here. Some people do want to take medications to assist in attaining their goals, and I will always support you in that direction if it makes sense to both of us. That being said, there are some directions I will NOT support you on when prescribing medications as I ethically believe them to be harmful:
Numbing: Taking the medication solely for its ability to numb your symptoms. This strategy involves avoiding your problems which does not help in my experience.
No End in Sight: Taking the medication in perpetuity with no plan of eventually tapering off of them let alone any plan to solve your problems.
Disagreement on Treatment Plan: Taking the medication without agreeing to recommended therapeutic actions. Recommended actions usually boil down to: confronting your problems now rather than waiting.
No Desired Outcome: Taking the medication without any Treatment Goal(s) in mind. This is like taking antibiotics daily for months to years for unclear, nebulous reasons.
No Willingness to Help Yourself: You may have Treatment Goal(s), but may wish to put off working on them by taking a medication and calling it a day. I won’t feel comfortable supporting you in that direction.
Do you want to take a medication?
Now consider if you’d like to take a medication. There’s a list of GOOD reasons to take and avoid medications below. See which list resonates with you. You can even write down or consider reasons that aren’t on the lists.
