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Katie Lawliss

The Combination of Therapy and Psychiatric Medication Management



Woman holds a few medications in her hands

Medication and therapy both help people relieve and manage psychological well-being. There are many reasons why a person may choose to only use medication or only participate in therapy. As clinicians, we always hope to foster a sense of autonomy for clients in choosing the best course of treatment for them. However, researchers have demonstrated that the combination of medication and therapy works best together, which is why your therapist may suggest meeting with a psychiatrist for psychiatric medication management, or a psychiatrist may recommend beginning therapy. 


When I work with clients and decide to recommend medication for their mental health symptoms to supplement our work together in therapy, I frame it as this: Medication can help reduce symptoms enough that you are better able to engage in the coping skills you learn in therapy. The idea is that once you can better access the ability to engage in coping skills consistently, the coping mechanisms will be a learned behavior that you will be able to use more effectively going forward. 


At this point, if a client does not wish to continue to be on medication, they can work with their prescriber to try to taper off medication. The idea is that the coping skills are more ingrained at that point, so the client will likely be better able to manage their symptoms without medication.


However, some clients benefit from long-term use of psychiatric medication and for some disorders, long-term use of medication is highly recommended. Psychological disorders have biological bases. A person’s brain is an organ and our psychological wellbeing is largely dependent on neurotransmitters.


People with depression, anxiety, OCD, Bipolar I or II, ADHD, schizophrenia and more, have neurotransmitters that are not working to the degree that they are intended to work. Medication allows for a balance of neurotransmitters. Some medications work to slow down the reuptake of neurotransmitters so that they have the time to do their job effectively, while some medications work to increase the activity of a neurotransmitter at the appropriate receptor or block the receptor so the appropriate amount of a neurotransmitter is accessed.


Whether you are in therapy, taking medication, or both, know that you are engaging in committed actions toward taking care of your well-being. The combination of medication and psychotherapy can be the most beneficial for many clients, so talk to your providers about this if you are interested in how both methods of treatment may suit you. If you are interested in beginning therapy or looking for a referral for medication management, reach out to me. I am happy to help you build your care team.


References:


Cuijpers, P., Noma, H., Karyotaki, E., Vinkers, C. H., Cipriani, A., & Furukawa, T. A. (2020). A network meta‐analysis of the effects of psychotherapies, pharmacotherapies and their combination in the treatment of adult depression. World Psychiatry, 19(1), 92–107. https://doi.org/10.1002/wps.20701 


Kamenov, K., Twomey, C., Cabello, M., Prina, A. M., & Ayuso-Mateos, J. L. (2016). The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: A meta-analysis. Psychological Medicine, 47(3), 414–425. https://doi.org/10.1017/s0033291716002774 

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