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When talk therapy may not be enough

January 2, 2024 By Dr. Katrina Wood

depressed woman

Research shows that a combination of medication and “talk” therapy provides the best outcome in treatment of depression, anxiety and some other mental health issues.

While this may not be the case for everybody, there is enough evidence to support this combination as being optimal for wellness.

There is a case for alternative forms of therapy that may not require medication, particularly for people who are “pill resistant” and fear side effects or simply hate the idea of taking strong medicines every day.

Talk therapy alone may be very helpful. There are also other forms of therapy that include EMDR, hypnotherapy, somatic, EFT tapping as well as adjunct therapies.

Good old-fashioned talk therapy has proven very helpful, particularly as more and more insight and understanding into the causes of depression and anxiety have come into play.

Treatment that includes medication is generally not a long-term solution, but for some that may become necessary. There is no one-size-fits-all when it comes to medication management; there is no right or wrong as to what each person may require. Discussing with an MD, psychiatrist or nurse practitioner — all of whom are qualified to prescribe meds — are good options when considering your symptoms and the types of medication available. (Consider the psychiatrist or nurse practitioner first choices.)

It would not be unusual to have a psychiatrist prescribe and manage your medications, while a psychotherapist handles the talk therapy.

It may take a while for the medication to take effect. Being patient is important. Everyone is different and no two medicines affect individuals the same way. One medication may not work as effectively as another. Another may be a bad match due to unpleasant side effects such as sexual dysfunction. If one type does not work well for you, there are quite a few options to explore (with a trained professional) until you find the best one for your symptoms.

Sometimes medication use can be short-term or time-limited, especially when dealing with episodes of life stressors such as the death of a loved one or a divorce. Weaning off medication with a step-down approach is not uncommon, as symptoms become reduced, and life becomes more stable and manageable.

It is vitally important not to come off medications cold turkey. Medicines used to treat mental health issues are powerful. A careful professionally monitored weaning is essential.

The most common type of antidepressant medicines increase the availability of serotonin, which is an existing chemical in your body that regulates your mood. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) help retain this chemical. Common SSRIs include Paxil and Zoloft. The effects of depression often deplete serotonin in the brain chemistry; a once-a-day antidepressant helps stabilize this. There are also medications for anxiety, and other severe conditions, all of which can be controlled. Yet medication alone is often not enough.

Talk therapy — sharing pain and the stressors of life with a trained professional, no longer suffering in isolation — also contributes to an overall sense of well-being. Sometimes talk therapy may be enough. A place where suffering is understood, normalized and shared can have a huge positive impact on how we feel about our problems. When another person makes sense of pain and suffering and assists in reducing our negative inner dialogue, we start to feel better. Over time, new ways of being in the world start to make good sense.

Opportunities for positive choices emerge as wellness improves. Medication and/or talk therapy provides an understandable, effective path back to restoring wellness.

Filed Under: depression, healing Tagged With: panic & fear

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Southern California psychotherapistKatrina Wood is an author, lecturer and certified life coach focusing on psychotherapy and emotional healing. She lives in Los Angeles, where she runs the Wilshire/Valley psychotherapy center. ( More )

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This blog discusses psychotherapy issues in a general way. Readers should address pressing concerns via their personal-growth support system. Some problems covered here are best handled directly by mental health providers.

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