Medicate or not to medicate…. that is the question?
Boy am I tired. Yes, fed up to the back teeth, of the divisive, useless, arguments around depression and use of medication. Sure, most people know by now that serious psychiatric disorders require medication. When your sister is telling you that she was born with the ability to fly and that God wants her to build a spaceship, you know that it’s time for urgent psychiatric intervention. The break with reality brings special challenges and a visceral imperative to protect our loved ones from themselves.
When it comes to depression however, rather than being seen as on a mental deterioration spectrum and a possible precursor to more serious psychiatric illness if left untreated, depression is often conflated with weakness or a need to “shake it off” and get happy – therein lies a frustrating disconnect with medication necessity as an option and sometimes as an imperative for some individuals.
As a Logan counsellor and mental health practitioner, I often see clients struggle with this question — Should I medicate, or should I try counselling first? There’s no one-size-fits-all answer. What matters is getting professional help early — whether through counsellor Sian Pryce, a Shailer Park counsellor, or another trusted therapist nearby.
Every time I see a discussion about depression and whether to medicate, it seems to degenerate into a us-vs-them mentality thread war of comments; those that are derogating of the whole medication-popping generation and those that see it as a sometimes necessary part of mental health management. Why is it an either/or? There is no definitive answer to date on the effectiveness, or lack thereof, of either, because we still don’t know enough about depression and the body—yet.
Pharmaceutical companies – scum of the earth!
What irks me is the oft-quoted notion that “Big Multinational Pharma-Get-You Company” is gleefully rubbing their hands together as they push the addictive elixir of happiness on any poor soul finding themselves unable to cope with what for many people are just the “ups and downs of living.” Stop being a snowflake! Really, we all get down, people, we all have obstacles to overcome, so suck it up princess! You are being scammed and the bottom line is not health and medicine but profit!
Yet as a mental health counsellor in Logan, I’ve seen both sides — the misuse of medication, yes, but also the life-saving power of antidepressants for those truly struggling. Dismissing medication entirely can be just as dangerous as overprescribing it.
The hero that is medication
If it wasn’t for medication half my family may be dead now, or if 80 years ago, permanently institutionalised with a soul almost certainly permanently hijacked by fear and fantasy. Either that, or become one of those who my Nanna used to say, under her breath, had that nebulous taboo “nervous breakdown” — the lady down the road who spends her time in her pink dressing gown addicted to barbiturates.
We are lucky to live in an age where new-generation, fewer-side-effect drugs are obtainable, despite the fact they still are trial and error and some side effects can be difficult to tolerate. They bring a modicum of relief and quality to many troubled lives and to the families, some semblance of peace.
As a practising Shailer Park counsellor, I often help clients manage the balance between therapy and medication. Medication alone isn’t the solution — but neither is ignoring it when your mind and body are crying for chemical support.
Take it if you need it!
So, back to the anti-medication brigade — are they throwing the baby out with the bathwater? While they may have a point about needless blanket medicating of people because they have just broken up with their partner, lost a job, a pet, or well, quite frankly, are miserable with their lot, sometimes it is just your life situation that needs an overhaul or you need some negative core beliefs readjusted to reality-check status. Cue – a great counsellor.
However, another reality check is this: depression is not just being sad, miserable, angry, annoyed or p#$&d off with life. Major depressive disorder cuts much deeper. When it clinically takes hold, no amount of positive ra-ra can change the way you feel or think. As I read somewhere once, “the apparatus for pulling your socks up just isn’t there.” It’s like telling an alcoholic to not drink and go for a walk with the dog instead.
At Logan Counselling Services, I remind clients that medication can sometimes be the stepping stone that gives them enough clarity to engage meaningfully in therapy — it’s not weakness, it’s wisdom.
Its all your fault !
I remember once being in the throes of a deep depression, yet not really knowing it clinically at the time. I was sleeping 10 hours during the day , had no appetite, and waking up very early each day, thinking about what outside- the house- tasks I had to endure before I could get back to my bed . I remember thinking I am not suicidal but if I get hit by a car tomorrow that’s Ok. I knew I was low, but I believed I “should “ be snapping out of it—like a bad mood. It’s my fault, my lack of resilience. Where did this core belief stem from ?
The people around me saw I was different. But why ? Hell, what can be wrong with you ? You are young, beautiful ,smart, and the gold standard…..skinny. You can easily find, love, a great job, money, more friends right ? Where is your happy face and party hat ?
The irony was I needed company, to be with people, but I had little to offer them. I am generally the one who initiates the work in conversations with people . I was not my usual interactive question -asking self anymore .I was not rude but I was quieter. Happy to chat if someone approached me first, but the energy I usually gave out on them, was limited so I had to be economical , I was in self preservation mode, just holding it together to be present. This was not taken well by friends . I was excommunicated . Told I am not happy enough to be around their friends , that this particular friend would not invite me out anymore to social events with her new friends, she would visit me “privately”. One friend told me, “I created my own pain “.
R U OK?
Not one person saw the obvious painful changes in me and said to me “R U OK?” I could not tell them at the time that I was clinically depressed — I didn’t have the words for it. Would that have changed their response? There was one concern for me at that time, and that was they had now heard on the grapevine that I was taking medication. (Cue – lady in the pink dressing gown).
Back in the 90s the attitude was unless you had something truly tragic happen, like death of a loved one, the onus was on you to “make it in your life, be independent and be resilient.” Nobody likes a weak sad sack. No, it’s not that simple — like the idea of a fabulous skiing holiday to the Swiss Alps when you have acute pneumonia. It’s throwing seed on concrete.
While talking it through with a Counsellor would have helped and maybe long-term psychotherapy would have been even better, I know I needed something more before this — to get me to the counselling couch and back into living with hope.
So when do you know if you need it?
So back to medication and depression. We don’t really understand the connection fully, do we? Depression has many forms and incarnations and it collides with your own life story and neurochemistry to create a different, non-functioning you that you really need to lift yourself out of but just can’t, alone.
The emotional paralysis can only be akin to knowing you want to walk so badly but the legs just can’t do it. The problem is not that we are being pushed into zombie pharmacology syndrome. I think that is unfair and disrespectful to most caring GPs. They get paid whether we pop that pill or not.
The problem is most GPs don’t know how to deal with depression as it relates to our own personal set of circumstances and bio-genetic history. It’s a guessing game and unless you have had a number of counselling sessions with a mental health professional first, then you are unlikely to get a clear diagnosis of whether medication is right for you.
At Counsellor Sian Pryce’s practice in Logan, many clients begin with talk therapy to unpack their emotional state before making any decisions about medication — ensuring the choice is informed and compassionate, not rushed.
Even then medication is no panacea. Antidepressants don’t make you happy, they stop you from being so sad that your mind cannot function at a safe cognitive level to make rational choices—that’s it. Having reached your level playing field psycho-emotionally, then you have the available energy and wherewithal to go out into life and bring in what you need to be at peace with yourself and your choices.
If we are becoming over-medicated as a nation (and I believe we may be too!) it’s a symptom of the gap in knowledge and evidence-based research available to GPs into the nuanced aetiology of depression and its interacting variables. If this becomes more available, people who don’t need medication will not put themselves on it as a first port of call, or be put on it by their doctor prematurely, and then the anti–medication groups will have respect, understanding and true compassion for those who truly do need it.
Then perhaps, the big pharmaceutical companies? We could cut them a little bit of slack… maybe?
Want to talk about depression?
Do you think you might need medication but are not sure?
I can help.
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Reach out today to Counsellor Sian Pryce – Logan Counsellor & Shailer Park Counsellor for compassionate, evidence-based support.