Depression and Medication.. The Case for Counseling
When you don’t feel well- you seek care from your primary physician. You may tell them of your symptoms of depression, of anxiety, stress, etc. You are given a medication and you go home. A couple weeks go by, things still aren’t great, and you call a counselor. If you reach my office you hear… I am so glad that you are here. Let me help, I want to hear what’s going on for you, its going to take time, borrow a little bit of my hope- we can help your whole self heal.
Physicians have tremendous expertise, in many things, and so do counselors, they are simply different. Physicians have a medical mindset, where as I, as a counselor, we as counselors, have more of a holistic mind. There is not one answer as to why or how to heal. The thing with mental health is that they are sometimes BOTH needed.
You see I have a unique perspective. I had a career as a pharmaceutical sale representative, selling antidepressants to primary care physicians before becoming a counselor. It was a great lucrative career, I felt like I was helping educate physicians, but I saw another side, my eyes were opened to the gap in care. Having seen both sides I know that physicians want to understand the disease states better, they want to help, but at the same time they have a strict schedule, many demands, and it is hard to fully know how to treat something you don’t have much training in, that there is no scan or blood test for, and measuring progress can be somewhat… abstract. Primary care physician are carrying the weight of treating disease states that might not be in their expertise, and yet they are still expected to treat depression or anxiety with medication, to heal their patient.
As a counselor I have pursued extensive training in suicidology, or the study of suicide. It physically pains me when someone walks in my office or calls letting me know they told their physician of their thoughts of suicide, and were given medication and told to wait… and wait… a couple more weeks, or maybe not told what to expect at all. The fact is, the doctor is a person too. They know that is not their arena, it might even scare them… terrify them… so they do the best they can, what they know … which is medication. Antidepressants generally take 6 weeks or more in order to see some progress, and when you are in the depths of depression or experiencing thoughts of suicide… taking a pill and waiting 6 weeks is just not the only option.. people can begin to lose hope… In the discontinuous mental health system that we have today it leaves little time for collaboration, or education, or training for those that are traditionally the front line- for everything from a sinus infection to depression.
In therapy we can look at the root of the problem. Are you dealing with situational depression, or is there a more chemical component? If a chemical component, if biological… let me help you find a physician well versed in that. Can we deal with your trauma through EMDR, or Cognitive Behavior Therapy to alleviate some of the compounding issues in order to heal, instead of trying to reduce symptoms with medication. Your symptoms can be the physical expression that something is going on emotionally. Can I help you with medication education, to help you understand the medication you are taking to help with your depression, the side effects you might experience and the ways in which you might benefit from medication.
In therapy if you are having thoughts of suicide I want to help you figure out why, to safety plan, to find wrap around services and support. Do you really want to kill yourself, or are you looking to kill the pain you are experiencing? In therapy we allow you the space to explore your thoughts and feelings and understanding of what is going on, and support you the entire time you are experiencing these scary thoughts.
Evidence supports to the benefits of psychotherapy. To counseling. Can you imagine the even better results looking at a medication and psychotherapy collaboration? There is evidence there too… Why is it that sometimes we ignore the evidence, and go for what is the easy “quick” fix. Much to the frustration of our society today- really dealing with mental health issues takes work, it takes expertise and patience and problem solving and vulnerability. It take meeting you where you are and listening to the whole story helping you to understand yourself, your symptoms, where they come from and what they are trying to tell you.
-Mary Ann