The true cost of using medication as the default treatment for anxiety and depression

Years ago I had a client, Liz, who came to me with an anxiety disorder triggered by fear about moving in with a new love. Liz was considering medication but knew I often helped people manage such things without meds. While evaluating her I learned she was so “in love” she’d lost her appetite. She’d been subsisting on a little fruit, yogurt and lot of diet soda! Liz also mentioned she’d let her exercise regimen lapse so she could spend more time with her beloved. I said, well, meds won’t kick in for weeks and you may feel worse before you feel better. Why not stop drinking caffeine, add more protein and good fats to your diet, exercise aerobically daily for 30 minutes, and come back and let’s see if, together, we can heal whatever issues are underlying your anxiety. She did all of the above and in six weeks the anxiety was gone. A decade later, I hear via holiday cards, Liz is
happily married with children to that ‘love’ and remains careful about exercise, nutrition and emotional healing.

Now, I realize healing anxiety and depression without meds is not usually so seamless. However, given the overwhelming evidence that exercise, nutrition and psychotherapy are more effective in many cases for treating anxiety and depression than meds, why isn’t everyone encouraged to at least try them first! Of course, if someone has been down so long there’s no motivation for improved self care, let alone self exploration, it can be humane to take medication temporarily along with ongoing psychotherapeutic support. Research also shows that meds with psychotherapy are more effective than meds without.

I had another client, Ed, who depended on a strong daily dose of meds to survive a sexless marriage in which he didn’t feel strong or secure enough to ask for what he needed. It took two years of therapy before Ed felt resourced and ready to speak up for himself. Ed had feared all along that bringing up sexual needs would end the marriage – and he was right, though not for lack of his efforts in an additional year of couple’s counseling.

It wasn’t until Ed was back in the dating game and finally having opportunities for emotionally and sexually fulfilling relationships that he realized his meds were interfering with his satisfaction. He tapered off slowly with a doctor’s support. Now, Ed is med free and currently enjoying the most fulfilling relationship of his life.

I don’t know if, without meds, Ed’s marital distress would have led him to find resources within himself sooner or whether those meds enabled him to feel stable enough to do the deeper healing required to honor his needs and to change his life. I don’t propose depriving Ed or others of medications which may enable deep healing or provide a certain comfort in a ‘good enough’ life.

I do know, though, that once started on meds many lose faith in the possibility of not only surviving but thriving without them. Meds change brain chemistry so profoundly that people often lose track of the deep (scary, inconvenient, life altering) needs meds may mask. Sometimes meds themselves create whole new levels of problems with motivation, confidence, lethargy, digestive distress, sexual disinterest (and in rare and tragic cases suicidal and homicidal behavior). In any case, no one considering meds should proceed without psychotherapeutic help. And no one should ever try weaning off of meds without a doctor’s support.

Unfortunately the pharmaceutical industry has done a good job convincing people (psychiatrists, family doctors, licensed psychotherapists and lay people alike,) that taking psychtropic medication for depression or anxiety or other mood disorders is the treatment of choice…that it’s the ‘responsible’ choice. There is not enough clarity in the medical and/or psychiatric community that depression and/or anxiety are strong signals something about the person’s inner and outer life is seriously amiss. They seem to believe in the unproven hypothesis that so many of the population suffer from hereditary medication deficiencies!

The true cost for individuals turning reflexively to pills for relief during mental crises is the missed opportunity for deeper awareness of what is needed to insure well being in body, emotions, mind, spirit, and relationships. The true cost of meds for society is that we are consigning increasing  numbers of people to lives that are less fulfilling, satisfying and creative.

It’s frustrating to see pills become a panacea when what is needed is loving support from skilled professionals and lifestyle changes. Mental distress is a clarion call from your soul that something needs to change. What would our world be like if, when you come to one of these moments of deep despair or anxiety that appear in almost everyone’s life from time to time, you were invited safely and gently, again and again to feel, heal and grow? I imagine individuals’ lives brimming with creativity and a vibrant populace resourced and ready to take on the challenges of our time.

I am writing this newsletter today to add my voice to the growing numbers of professionals who are committed to helping people use mental distress as a vehicle for life altering transformation rather than as a justification for prescribing long term use of body, mind and spirit numbing medications. For more information about the science of side effects of psychotropic medications and to find practitioners who support non-drug treatments for mental illness, check out Dr. Peter Breggin’s website,

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