Do I Need Medication?

Dear Ellen:

Do I need medication for depression? My doctor is ready to give me a prescription, but I'm afraid of getting addicted to it.Can I get better without it?

Sad Me

Dear S.M.:

While I am a psychologist and not a psychiatrist who can prescribe pharmaceuticals, when it comes to issues about recommending medication, I use science as my guide. I believe that medication for symptoms of depression is a second line of treatment if you don't respond positively to cognitive-behavioral intervention. Research shows that CBT can be just as effective as medication alone, but the two in conjunction can speed up recovery and help prevent relapse.

There are some individuals whose mood disorder is biochemically based, and who may need to stay on antidepressant medication indefinitely. I wouldn't categorize this person as "addicted" to medication. An analogy would be an insulin-dependant diabetic. If the pancreas doesn't produce insulin, it has to come from an external source. It is reasonable to assume that neurotransmitters function similarly to hormones, and there are some people whose brains need an external chemical boost to function optimally.

The science of psychopharmacology is still relatively new and the medications that are currently available don't work for everyone. Often people have to try a few different kinds or combinations before they find a formula that works. It's also important to remember that it may take about a month before the medications really start to show their effects. Most importantly, medication is not a substitute for the support and skill development you get through psychotherapy; consider both your therapist and physician as part of "Team You."

Ellen