Therapy vs. Medication: Do You Need Both?

Living with any mental health condition can feel overwhelming at times. Chances are, if you’re reading this article, you’re probably looking for information on how you can feel better — which is an excellent place to start. 

Whether you’ve recently been struggling with anxiety because of a gnarly breakup or have been in the depths of depression for years, different kinds of effective treatments can help you manage your symptoms so you can move forward. Treatment depends on the person and their condition, but it can involve medication, therapy or a combination of both.

You might be wondering, Therapy versus medication — which type of treatment is right for me? Should I do both?

That all depends on your mental health condition and the severity of your symptoms, along with other factors. Ultimately, a healthcare provider — be it a psychiatrist or therapist — is the best person to discuss your symptoms with. And in return, they can come up with a personalized plan for you.

It’s important to remember: There’s no one-size-fits-all solution when it comes to mental disorders and treatment, as everyone is different. What works for you may not work for someone else, and vice versa.

In the meantime, it’s always helpful to have a better understanding of what your treatment options are. In this guide, we’ll take a closer look at how therapy stacks up against medication and provide other resources you can tap into as you take steps toward improving your mental health.

Let’s dig in

Therapy vs. Medication for Depression

Dealing with depression can feel lonely, but you’re definitely not alone if you’re struggling. In fact, about 21 million adults in the United States experienced a major depressive episode in 2020, and like many mental health conditions, it’s very treatable. 

Let’s talk about depression medication first. When it comes to treatment of depression, antidepressant medication can make a significant difference in reducing symptoms.

For some, depression can be more short-term (say, for example, you’re going through a temporary rough patch, like a job loss). And others may have major depression that lasts years.

Symptoms of depression are wide-ranging but can include feeling sad, hopelessness, sleep difficulties like insomnia, changes in weight or a loss of interest in activities you used to enjoy.

If you’re experiencing any of the above symptoms, antidepressant medication can help combat them by targeting specific neurotransmitters in your brain, such as serotonin, dopamine and norepinephrine, to regulate your mood and make you feel better. 

The two types of antidepressant medications most frequently prescribed are:

• Selective serotonin reuptake inhibitors (SSRIs)

• Serotonin–norepinephrine reuptake inhibitors (SNRIs)

SSRIs, or selective serotonin reuptake inhibitors, work to increase your serotonin levels (aka the chemical responsible for making you happy). Some of the more popular SSRIs include:

• Fluoxetine (Prozac®)

• Sertraline (Zoloft®)

• Escitalopram (Lexapro®)

• Paroxetine (Paxil®)

• Fluvoxamine (Luvox®)

• Citalopram (Celexa® or Cipramil®)

SNRIs work very similarly to SSRIs, but they also target norepinephrine. Norepinephrine lends a hand in bodily functions like balancing your sleep-wake cycle, keeping your cardiovascular system in check and triggering your body’s fight-or-flight response. 

Some of the most commonly prescribed SNRIs are: 

• Duloxetine (Cymbalta®)

• Venlafaxine (Effexor®)

Like SSRIs, SNRIs may be considered a first-line treatment by clinicians because they’re so effective and have a low risk of side effects. For more information on how these drugs work, check out our comprehensive guide to depression medication. 

What about therapy? Research tells us that, both therapy — like cognitive behavioral therapy (CBT) — and medication are effective in improving mental health issues.

Specifically with depression, it’s currently unclear whether medication, therapy or a combo of both treatments is the best solution. However, some research indicates that psychotherapy (or talk therapy) and antidepressants combined are more effective than just using antidepressants alone.

Therapy vs. Medication for Anxiety Disorders

It’s totally normal to experience anxiety in everyday life, whether you’re running late for a dentist appointment, had an argument with a friend or your dog just escaped from his leash. Anxiety disorders, on the other hand, are more intense and can be debilitating, interfering with relationships, work and daily activities.

Some of the most common anxiety disorders are: 

• Panic disorder. People with panic disorder are prone to spontaneous panic attacks despite there being no actual danger or threat. Panic attacks can be triggered without warning, causing a sense of doom and/or a loss of control. 

• Social anxiety disorder. Whether it’s school, a job or hanging out with a group of friends, those with social anxiety have a severe fear of being negatively evaluated or rejected — even by people they already know. They might be afraid of being perceived as awkward, boring or dumb.

• Generalized anxiety disorder (GAD). Unlike just regular ol’ anxiety, generalized anxiety order is characterized by excessive worry that lasts for months. Irritability, difficulty sleeping, a lack of concentration and restlessness are just a few symptoms associated with GAD.

Similar to depression, antidepressants are often considered a first-line treatment for anxiety disorders. You’re already familiar with the most commonly prescribed SSRIs and SNRIs, but there are other types of medications that can be used to treat anxiety, such as: 

• Tricyclic antidepressants (TCAs)

• Monoamine oxidase inhibitors (MAOIs)

• Benzodiazepines

• Beta blockers 

• Buspirone

• Bupropion

Some of the above anti-anxiety medications, like TCAs and MAOIs, were developed in the 20th century and have largely been replaced with new medications. However, they’re sometimes recommended when SSRIs or SNRIs don’t work.

Other medications, like benzodiazepines, are different in that they’re designed to provide quick relief for the short term (i.e., you’re about to get on a flight). To learn more about how these medications work and their unique side effects, our guide to medications for anxiety delves into greater detail.

So, how does therapy help with anxiety disorders? Similar to depression, we know therapy has proven benefits, but the best approach isn’t always cut and dried. Whether medication, therapy or a combination of both is the most effective is really based on each individual’s health condition and what works best for them. 

Therapy vs. Medication for Other Mental Health Conditions

Therapy and medication can be highly effective for treating mental health conditions beyond anxiety and depression. Some of these other medications may include:

• Antipsychotics

• Mood stabilizers

• Stimulants

Here’s what to know.

Antipsychotics

Antipsychotics can help treat disorders like schizophrenia, mania, major depressive disorder (MDD) with psychotic features, borderline personality disorder (BPD) and Tourette syndrome. A few of the most common antipsychotics include olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone and clozapine.

When used with other types of medication, some antipsychotics can also help with attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder, obsessive-compulsive disorder and eating disorders. For specific treatment of BPD and schizophrenia, therapy tends to be a necessary companion to medication.

Therapy for trauma, like PTSD, can be especially effect

ive. In fact, the 2017 VA/DoD Clinical Practice Guideline for PTSD suggests trauma-focused psychotherapy as a first-line treatment for PTSD over medication.

However, some research still indicates that atypical antipsychotics can be effective, especially for more severe PTSD symptoms. 

Mood Stabilizers

If you have severe mood swings that range from extreme highs (known as mania) to very lows (aka depression), mood stabilizers may help you feel more balanced.

Bipolar disorder and certain types of depression are commonly treated with this kind of medication. While lithium is the most well-known mood stabilizer (it’s been around for nearly 50 years), valproic acid, carbamazepine and lamotrigine are also prescribed.

Stimulants

Probably best known for treating ADHD in children, teens and adults, stimulants do their job by boosting your energy levels and helping you focus. Though they’re sometimes used to treat depression, certain stimulants like Adderall can make your anxiety symptoms feel worse.

Therapy vs. Medication: How to Find the Best Option for You

We probably sound like a broken record at this point, but it bears repeating: There’s no “best” solution when it comes to mental health treatment. Each person has different needs.

For some people, therapy is the most effective way to reduce anxiety or depression symptoms. Others might need medication or a combination of both. 

While a mental health professional is still the best person to determine a diagnosis and treatment plan, it doesn’t hurt to think about the following questions as you explore your options:

• What kinds of symptoms have I been experiencing? How intense do they feel, and how long have they lasted?

• Am I in crisis? Do I need help ASAP? 

• Have I tried therapy or medication before? What was the outcome? 

• What are my most affordable options? Does my health insurance offer any coverage? What if I’m not insured?

• When considering therapy, what’s most accessible for me? For instance, is online therapy more achievable than in-person?

If you think medication might be a good option for you, here are a few things to keep in mind: 

• You need a prescription for any type of medication. You can’t pick up anti-anxiety meds or antidepressants like you pick up a pizza to-go. But don’t worry — it’s less intimidating than it sounds. A healthcare provider, like a primary care physician or psychiatrist, is the only kind of medical professional who can prescribe medication. That said, the best place to start is by making an appointment, which you can easily do online.

• Medication doesn’t usually work instantly. Unless you’re taking meds meant to provide instant relief, it can take several weeks to feel the full effects of medication. If you don’t feel better right away, it doesn’t necessarily mean the medication isn’t working, and you should never stop your medication cold turkey without talking to your healthcare provider first.

• Different medications cause different side effects. Some effects may be more severe than others. Again, check in with your healthcare provider if you have any concerns.

Considering therapy? Maybe medication and therapy? It’s helpful to remember: 

• Like medication, there are many kinds of therapy. Whether it’s psychotherapy, exposure therapy, supportive counseling, interpersonal therapy (IPT) or CBT, there’s a wide spectrum when it comes to therapy. Some might need therapy for a few months, while others may need it for longer — and both are perfectly normal. Similar to medication, it may take some time before you truly start to feel its positive effects.

• There are also many ways to access therapy. Therapy doesn’t necessarily look like those movies where a patient is lying on a couch, with a doctor (usually an old man) taking concerned notes behind them. Yes, therapy can still be on the “traditional” side (i.e., you’re sitting on an office couch), but sometimes, you don’t have to leave home at all. With online therapy, you can get support from the comfort of your bedroom. You can also join group therapy if you’re looking for more community and connection. There’s no “right” way to do therapy — it’s whatever works best for you.

Therapy vs. Medication for Your Mental Health

Dealing with anxiety, depression or any other mental illness can feel completely overwhelming. The good news is that there are evidenced-based ways to feel better, whether that’s therapy, medication or both.

And you don’t have to figure this out alone: There are many ways to seek help, and once you do, your mental health care provider can guide you toward the best plan of action.

In the meantime, you can explore other strategies to improve your mental health beyond medication and therapy. They include: 

• Being more mindful. Mindfulness is a practice where you’re actively trying to be aware of the present moment. The goal is to accept your feelings instead of trying to push them away. By focusing on your current state, mindfulness can also be an incredibly grounding mental exercise and effective for keeping negative thoughts and anxiety at bay.

• Practicing self-care. Self-care means prioritizing your needs and doing things that make you feel good. It looks different to everyone and can include anything from doing activities that fill your cup (like hanging out with friends) to a skin-care routine to journaling every night before bed.

• Moving your body. Exercise can have a deeply positive impact on a person’s mental health, not to mention the physical benefits. This doesn’t mean you need to sign up for a half-marathon. Instead, start small with things you already enjoy, like simple stretches when you wake up or taking a walk with a furry friend. 

One last thing: You can always turn to our mental health services if you need additional support. You’ve got this.