Medication Alone Is Probably Not the Answer to Depression (And Counselors / Doctors Know That)

I just recently watched a TedTalk on YouTube titled, “This could be why you’re depressed and anxious.”

This post is partly a response to that video, and partly a “Now You Know” about counselors, or more specifically, the counselors that I’ve met and studied and spoken with over the years.

First of all I want to acknowledge that this is an awesome video. I don’t necessarily endorse everything he says, as I think he’s kind of conflating the clinical definition of Major Depressive Disorder with the everyday, casual and colloquial use of the term “depression.” This becomes clear in his story about the man who loses his leg in a rice field. However, I think overall Hari does a really good job of explaining in lay language why it’s important not just to stop at medication when you’re treating mental illnesses.

I’ll let you watch the video yourself to see what he says, and I won’t repeat all of it here. What I’d like to do is temper the idea that some people may get from his video – that counselors, psychologists, psychiatrists, and doctors all see medication as this miracle cure to depression, anxiety, and other mental illnesses. This is false – or, at least, the idea that medication is a cure-all is certainly not being taught in any counseling, psychology, or medical program I’ve heard about. It’s definitely not being pushed as a cure-all in my counseling program, and it’s never been pushed by any of the doctors or counselors I’ve seen. But hey, maybe I’m lucky.

Please, please, don’t be afraid to go to your doctor, psychologist, or see a counselor because you’re afraid that they will just throw medicine at you and toss you to the wind. People who have been trained in the last few decades – where holistic health has really been emphasized at both medical and psychological / counseling schools – know that medication is NOT the end-all-be-all. I can speak for me personally. My program teaches us to look at ALL the aspects within and without a person that can influence their mental state – this includes their culture, religion, family, close relationships, school, church, work, community, neighborhood, genetics, biology, thought patterns, early childhood experiences, adult experiences, the parenting styles of their caregivers, trauma history, eating habits, exercise habits, disabilities, cognitive distortions, the messages they’ve gotten about feelings, behaviors, and thoughts, stereotypes about gender, and way, way more. Any of these (and usually several combined) can impact how depressed a person is, or when they become depressed and how they experience that depression.

Is biology and genealogy a part of that? Absolutely. Chemicals in the brain absolutely affect how we think and feel. But it’s just once piece of a huge, huge pie that a good doctor / counselor will examine with you. And if they don’t – dump ’em.

Okay, here comes the second part of my little rant. It’s about being an advocate for yourself as much as you possibly can. This part is being written with the knowledge that not everyone has the ability to choose a different doctor or therapist, or indeed go to therapy or a doctor at all. But please keep in mind I know there are socioeconomic limitations at play here.

Okay. So. Let’s say you have been feeling super sad the last couple months. You sleep way too much, barely can bring yourself to eat, you cry every day. You don’t enjoy your hobbies anymore and these feelings are now getting in the way of your work. Or maybe you’ve isolated yourself from your friends and barely talk to anyone anymore. You recognize these symptoms as a sign that you need to go to the doctor and get checked out – you might have depression.

You go to your normal primary care physician and feel like they’re barely listening to you – then, at the end of the appointment, the doctor says they’re going to write you a prescription for an antidepressant. No referral to therapy, no asking about what’s been going on in your life. She doesn’t ask about your diet, your exercise habits, your early childhood experiences. Just a prescription.

You, being a savvy patient, know that something is deeper. You take the prescription from her but you also want a second opinion. You want someone who is going to go deeper and help you find the cause of this depression. So you speak up for yourself and ask if this person can refer you to a psychologist or counselor, someone who specializes in mental healthcare. Or you go through your phone book (Read: Google) and find a different doctor – one who may take a more person-centered, holistic approach with you, o r refer you to someone who can.

What’s my point here? If you can get yourself to a doctor, or if you have the knowledge to know you may be depressed or suffering from a clinical mental illness, then you probably have the wherewithal to advocate for yourself until you feel like the problem has been sufficiently explored. I know, it’s really hard to speak up. The white coats and the fancy degrees are intimidating. Doctors can have a tendency to talk over patients or patronize us when we speak up. But it’s crucially important to speak up for yourself or find a provider who will listen when you talk.

Yes, medication isn’t the only answer. But if you accept it as the only answer from your doctor, then they won’t even know that you want a more holistic approach. I did this with my doctor – she suggested a start a prescription, but I also asked if she could refer me to a good counselor that took the same insurance as her. She did! She just didn’t think about doing so until I said I wanted more than just medication. And I’m really hoping that your counselor or psychologist is willing to listen to you if you need more intervention than therapy and medication as well.

If nothing else, remember this: If you doctor is willing to stop the buck at medication (and they won’t listen when you say you’d prefer not to, or that you need more than that), then they’re not the doctor for you if that’s not the approach you want. Doctors can be wrong too. They can be assholes, they can be ignorant or arrogant. They can get stuck in their ways. The good news is, doctors are just like other people in another way: If you don’t like one, you can leave them for another. Hopefully that other will treat you and your depression better.

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