Psychopharmacology: Drugs & Psychotherapy - A Word of Advice


First, a word of warning. I am neither trained nor qualified to speak about psychoactive drugs. You need a Doctor and probably a specialist for that. I am though privy to a certain amount of privileged information about the climate of opinion about psychopharmacology.  

My own position on drugs for emotional problems is: if it works for you, great, go for it. Either until you no longer need the medication. Or, decide to continue, with reviews, on a schedule that allows for developments in what is known about the drug you are taking and of new drugs. 

That said I want to now address the shifting climate of public opinion about psychoactive drugs; because I think what's going on is of concern to anyone considering entering psychotherapy. 

In the good old, bad old days, when Doctors were Lords of all they surveyed, few dared question when told to take two pills daily. Not any more. The availability of information once the preserve of health-care professionals has allowed everyone a far greater role in the decision-making process regarding medicines. 

This is good, but more information has also come with misinformation. This breeds both confusion and the polarization of opinion; with some who would seemingly rather die than swallow a prescription drug; and others fearful they might die if they ever went without. Both these extreme positions can exert sway on the majority in-between. 

Reaching a decision about what is the best medicine is difficult. Even ‘balanced reporting’ in the media (while good in principle) can spawn such a stream of conflicting information that confusion rampages like a super-virus. The real tragedy of the easier availability of information is that some may be missing out on medication that could manifestly improve their lives.  

A healthy skepticism about taking medication is a good thing. Pharmacology is big business - very Big Business indeed. A great many people’s self interest is served by the profitability of the drug industry. So, as in all such cases, proceed with caution. However, an almost reflex-like aversion to even considering psychoactive medication seems to be gaining momentum and influence. This makes for an unhealthy climate for making informed choices.  

Ironically, it is self interest, your own, which is the antidote. A healthy skepticism harnessed to a vigorous and dedicated self-interest is the best way to investigate the options available when you are seeking emotional help, including whether or not to take drugs:  

Skepticism + self-interest + persistence = informed choice  

Ideally, you would adopt this approach and join forces with an open-minded, similarly skeptical and dedicated Doctor. But it is not an ideal world. This is most regrettable, but what is important HERE, if you are suffering NOW, is to understand the options so that you can make the greatest headway in the shortest time to make your life better.    

So, what is it useful for me, a non-expert in the field of psychopharmacology, to convey right HERE and NOW about drugs and psychotherapy? This depends foremost on the nature of your suffering. To oversimplify grossly:  

For Those with a Serious Psychiatric Illness: This includes any affliction involving psychosis. Also, serious eating disorders and anyone with frequent and/or acted upon suicidal thoughts. People with these problems need virtually constant care and a reliable and intensive support network. Drugs are of invaluable help in many of these cases to get the person into a state in which they can benefit from other help.  Psychotherapy with an independent psychotherapist is almost certainly not the best way forward. Psychotherapy may form part of an overall program of rehabilitation, also involving, perhaps, residential care and other all-round life-skills support.

For Those With a “DSM Diagnosis” from a Physician or in Acute/Chronic Emotional Distress: Drugs may or may not help. Be pro-active. Be your own advocate. Seek out the options. Find someone qualified to prescribe who really knows about the drug options as a guide. A GP might know enough. But you might need a Psychiatrist; or a specialist in psychopharmacology. Aim to build a team around you that can provide the particular support you need. This may or may not include psychotherapy. Which kind and which therapist? You have to explore the options and decide for yourself. Employ your skepticism here too. 

Everyone Else: Psychotherapy alone can probably suffice to help you change. Re-framing the question you consider can be a good way to begin:


Do I NEED therapy? Or do I WANT therapy? 

In other words, for you it less a question of illness and cure, and more one of well-being, personal growth, of existential quandary, or getting what you really want from life…