Medication or Therapy - What's The Right Choice For You?

Both therapy and medication have their place in caring for your mental health. Experts we reached out to say they don't believe therapy is better than medication, or that medication is better than therapy.

Instead, it's about finding the right fit or combination for your personal situation, circumstances and mental health diagnosis.

We spoke to experts - psychologists, psychotherapists, and psychiatrists, to answer some of the questions you might have.

Remember, this guide isn't a substitute for professional medical advice.

Always consult a doctor and mental health professional before you start any treatment.

But with that said, let's clear some of the confusion you might be facing about which option to choose - therapy or medication?

How Can You Decide What's Best For You - Therapy or Medication?

The short answer is, you can't. The only person qualified to tell you whether you need therapy or medication is a mental health professional.

The long answer is that it depends on a number of factors - the nature of your symptoms, the severity of your disorder, how long you've been suffering, and so on.

Every person's condition is unique, and what works for your friend may not work for you. What works for you may not work for your friend.

To decide what care will help you best you need to understand your symptoms - Are you unable to sleep? Have you lost your appetite? Do you have suicidal thoughts?

We spoke with Dr Samir Parikh, director of mental health and behavioural sciences at Fortis Hospitals.

"Look at mental health as health. Look at an illness as an illness. For example, if you have diabetes you'll need a combination of medication and lifestyle changes. But you would speak to an expert about this. You can't decide the treatment for yourself."

Dr. Samir Parikh, Director, Mental Health and Behavioural Sciences, Fortis Hospitals

So while you can't pick and choose what treatment you need, you can choose when to seek help, and how to go about it.

When Should You Start Medication or Therapy?

As soon as possible.

Think of it this way - if you fracture a leg, would you keep putting your weight on it and walking around till it became unbearably painful? No, you would run (metaphorically) to the doctor the moment you fracture your leg and it starts to hurt.

Mental disorders, unfortunately, don't have such obvious markers of pain. The fastest way to know you need to speak to an expert is if your problem starts to become a disorder.

A disorder is anything that disrupts your daily functioning.

Are you unable to sleep? Are you unable to get out of bed and take care of yourself? Have you lost your appetite?

We all have low days, but it's when the lows become constant and start disrupting your daily life that it becomes a disorder.

Needless to say, it's best to approach a mental health professional at or before this point, and even after (as is often the case).

"The medication will help with your symptoms initially and let you function better on a day-to-day basis, and therapy will work on more than just symptom relief. Because the pattern will come back if you don't work on it."

Dr Srividya Rajaram, Psychotherapist

So, What's Right For You - Therapy or Medication?

Every person is different and responds differently, but usually, medication can help in more severe cases by letting you function and perform your day-to-day activities, while therapy can supplement your care by addressing the root cause of the disorder.

Metaphorically speaking, imagine the medication as a plaster cast for a broken leg, and the therapy as physiotherapy, lifestyle changes and other healthy living choices that will heal and bring your leg back to full strength in time.

"Some people need medication and therapy, some need only medication, some need only basic counselling sessions. It has nothing to do with what you think is right for you, it's about what you need."

Dr Srividya Rajaram, Psychotherapist

Caring for your mental health isn't like a pair of free-size socks - there's no one size that fits everyone. And one option isn't better or worse than the other. It's about finding the right fit and in some cases the right combination of treatments for you.

What Should You Expect In Therapy?

Depending on the severity of your symptoms, therapy can be a slow process. It may not offer you immediate relief from your symptoms - whether that's anxiety, PTSD, or depression.

"Go into therapy with questions. Write down any and all of the questions you want to get answers to. Remember that your therapist doesn't know you as well as you know yourself. Help them get to know you better, and talk to them about yourself."

Dr Srividya Rajaram, Psychotherapist

Talk with your therapist as much as you can. Make them understand you as a person - your traumas, your highs, your lows, everything. Lay it all out there for you therapist to see.

"Also expect blockages, and for difficulties to emerge, for things to not work, because this person doesn't know you very well right? But do expect that this person is trying their utmost to help you."

Dr Srividya Rajaram, Psychotherapist

What Should You Expect With Medication?

As for medication - this depends on your situation and specific condition.

Different medications affect your brain chemistry differently. At the initial stage, you might experience a range of feelings depending on your what you are put on. This is usually a part of the process when you begin taking on a new course of medication.

For example, medicines for ADHD can make you feel more wakeful and focused, while medicines for clinical depression can make you feel more sedated and less anxious. The point is each medicine is prescribed to treat a specific condition.

There's no one answer to how you'll feel physically. In some cases you might feel better from the first day of medication, in other cases, it might take weeks for your body to respond to the medicines you're on. The important thing is to stay consistent with your medication and follow your doctor's prescription to a T.

"For example if you have moderate to severe depression, or you're having suicidal thoughts, or your depression is recurrent, then you'd start with medication immediately. If it's a biological correction that's required no matter how much therapy you take, it won't get better without medication."

Dr Samir Parikh, Director, Mental Health and Behavioural Sciences, Fortis Hospitals

Your doctor knows what's best for you. Don't stop taking your medication on your own, and definitely don't stop it abruptly without consulting your doctor first.

This can have bad consequences and in some cases can even be dangerous. Tell your doctor or therapist if you experience any discomfort and do as they say.

Therapy or Medication - Which Costs More?

This is very hard to narrow down and say because there's such a wide ambit for these statistics. The more important question is what do you need?

"There's no way to answer that conclusively. Let's say today I saw you, and I give you medicines. And since it takes a while for them to have an effect, I ask you to come back for a follow-up 3 weeks later. In a year, I might just end up seeing you less than 10 times. There are far too many variables."

Dr Samir Parikh, Director, Mental Health and Behavioural Sciences, Fortis Hospitals

For example, if you're suffering from a severe and continuous episode of clinical depression, you may need strong medication and therapy. If you're just experiencing a temporary mild depressive episode, you might feel fine after a few sessions of therapy.

The point is, cost depends on the treatment your doctor prescribes, and if you need medication no amount of expense on therapy will improve your condition and vice versa.

Therapy or Medication - Which is Faster?

One option isn't necessarily faster than the other. Therapy can sometimes feel like a longer process because it seeks to address the root cause of your mental health woes.

For example, if you suffer from PTSD, you may need a long cycle of therapy to identify and treat your past traumas and patterns, coupled with medication to offer immediate relief while you go about your daily life.

So while medication might provide immediate relief from your symptoms and let you go about your daily life, therapy helps you address the underlying causes of your problems.

Many types of medication can also take time to start showing their benefits. SSRIs, often prescribed for clinical depression, are one such category, where you only feel the full range of benefits weeks or even months after you begin your course.

"Ideally people will go to a psychiatrist and the psychiatrist refers them to a psychologist. Or vice versa, when I feel a client can't proceed any further without medication, I'll refer them to a psychiatrist. So both really work hand-in-hand."

Dr. Srividya Rajaram, Psychotherapist

It's about what you need, really. Not about what's faster.

Debunking Myths About Medication

If you've been going for therapy and you've been advised to start with medication, you might be afraid or hesitant. You wouldn't be the first and you most definitely won't be the last.

Common fears around taking medication include the fear that you'll turn into a "zombie-like" state, or that you'll become dependent or addicted to medication, or even the belief that "taking medication is weak".

"You have to educate clients about medication. Ideally a therapist will spend a good amount of time educating their clients about why this medication, why this combination of drugs, the reason why you're doing this. It should never feel forced. Eventually you have to leave it to their choice."

Dr. Srividya Rajaram, Psychotherapist

Srividya adds, "You don't know what another person's specific situation is if they seem "zombie-like". That might be what's healthy for them. You don't know their specific set of circumstances and conditions."

Therapy or Medication - The Final Word

Before we conclude, remember that the only person who can accurately tell you what you need, is a licensed medical professional. Speak to a psychotherapist or a psychiatrist and follow their advice.

Keep all these points in mind, and get the help you need, not the help you think is right for you. Feel free to write to us with queries at [e-mail].

(If you or someone you know is in distress and needs help, please reach out to them with kindness and call these numbers of local emergency services, helplines, and mental health NGOs)