Mental health problems plague the lives of many, many people. In the search for improved mental wellbeing, the most common treatment types are talking therapy and medication.

Many people are reluctant to take medication, and may therefore favour talking therapy. Others may feel that medication gives them additional support. Some do both, some do neither, it is down to personal feelings.

This article takes a look at talking therapy and medication. While it isn’t possible to consider one to be “better” or “superior” to the other, there are things about both that appeal to certain people.

Talking therapy and medication are the main options for treating mental health conditions

What is talking therapy and medication?

Talking therapy is the name given to a range of treatments that focus on talking through problems relating to mental health. Common forms of talking therapy include Cognitive Behavioural Therapy, Psychoanalytical Psychotherapy and Schema Therapy.

Medication refers to the broad range of medicines that are used to treat mental health conditions. Antidepressants are the most widely-used medicine class. Mood stabilisers, antipsychotics and benzodiazepines are other classes of medicine that can be used.

When are talking therapy and medication used?

Talking therapy is used for the vast majority of mental health conditions. It has been shown to be very useful for conditions like Depression, Anxiety, trauma-related conditions, Somatic disorders, eating disorders and substance abuse problems.

As there are so many different types of talking therapy, there is usually a form of therapy that works for everyone. Certain forms of therapy are most frequently used for certain conditions. For example, trauma-related conditions often use Psychoanalytical Psychotherapy due to its focus on past events.

Medication can be used for virtually all mental health conditions. Antidepressants are often used for conditions like Depression, Anxiety, Post-traumatic stress disorder (PTSD), Eating Disorders and Somatic Disorders among others.

For more debilitating conditions like Schizophrenia and Bipolar Disorder, antipsychotics and mood stabilisers can be used. But every case is different, so this is not guaranteed.

For most conditions, talking therapy is seen as the first line of treatment. If a person’s symptoms continue after therapy, then medication may be looked into. For conditions like Bipolar Disorder and Schizophrenia, medication is usually the first line of treatment, although therapy can still be used.

What are the benefits of talking therapy for mental health problems?

There are a range of benefits of talking therapy. Talking therapy offers a safe environment for a person to discuss their troubles with a trained therapist. Together, the therapist and patient will set targets and try and find answers to problems.

The therapist will listen to the patient in a non-judgemental and confidential way – what is said will not be repeated to others. Therapy is also a chance for someone to realise that their problems are serious, and merit help.

Therapy also has a good record of being successful in treating mental health conditions. The fact that there are so many different types of therapy is another benefit, and means that most people will be able to find a type of therapy that helps.

In terms of cost, talking therapy is free if the patient uses the NHS. If they do choose to go private however, they will need to pay rather hefty sums. This is a choice some people have to make.

What are the benefits of medication for mental health problems?

Studies do tend to show that medication does have a positive impact. All mental health conditions have the potential to benefit from medicine, and in some cases – it can literally be life-saving.

A positive of medication is how it is incredibly easy to take it. Medicine will usually come in tablet or capsule form, so by swallowing these once or twice a day, this is all a person needs to do. It is then a case of waiting for changes.

For those with conditions like Bipolar Disorder or Schizophrenia, they may find that medication is the only assistance they need. Medicine does have the ability in some cases to stabilise a person.

What are the negatives of talking therapy for mental health problems?

Arguably the biggest disadvantage of therapy is the length of time it takes for it to take effect. It can take several weeks or sessions for a person to start to see an improvement in their symptoms and general wellbeing.

Also, when their sessions come to an end, a person may find that without help, a relapse will happen. Therapy won’t always provide long-term solutions, which therefore does increase the risk of problems coming back.

If a person uses the NHS for their treatment, they will typically have a very limited choice of therapy types, and will typically be on a long waiting list to begin with.

For those who can afford to use the private sector, they will have an enormous choice of therapy types. However, the price of private therapy is very high, and is something that not many people can commit to.

What are the negatives of medication for mental health problems?

One of the biggest issues with medication is the time it takes for its effect to be felt. Antidepressants can take a few weeks to fulfil their potential, with antipsychotics and mood stabilisers slightly shorter in length. Even so, it can be a frustrating wait.

Further to the above, it is a common misunderstanding that antidepressants are “wonder drugs” that solve problems instantly. This is not the case, which can lead to some patients getting impatient.

Surely the main issue with medication is the side effects involved. Whilst antidepressants generally have rather mild side effects, antipsychotics can cause a range of problems. Mood stabilisers and benzodiazepines also have a risk of side effects too.

It is also not guaranteed either that medicine will work. For example, many people who use antidepressants will end up having to try 2 or 3 different antidepressants before finding one that suits them. Going through the process of adjusting to a new medicine is a challenging experience.

How to decide

It is important to remember that the patient has the final say. Whilst mental health professionals and doctors can give their input, it is up to the patient to decide for themselves. Making an informed decision is important.

It could be worth trying at first to try therapy alone. Hopefully, therapy will have a positive effect on the patient, resulting in them seeing an improvement in symptoms. But if this doesn’t work, a person may choose to add a form of medication.

Statistically speaking, there is very little to separate talking therapy and medication. Both are similarly popular with patients, with medication slightly more popular [1]. It appears that therapy is at least of equivalent efficacy, if not slightly superior, especially in cases involving antidepressants [2].

It is important to see a mental health professional or a doctor. They will be highly experienced, and will be able to provide the patient with a comprehensive guide and picture of their situation and options.

Summary

Medication and therapy are two forms of treatment that both have the potential to be effective. It can be difficult to decide which to go for. It is different for every person, especially as taking medication for the first time can be difficult.

It must be remembered too that it is possible neither therapy or medicine will work. There is unfortunately no guarantee. While it is rare, sometimes neither will provide relief from symptoms. If this does happen, other avenues could be explored.

Most people see medication as something to boost mood and try to get themselves out of a hole, while therapy helps them in the longer-term. But both forms of treatment aim for total remission of symptoms, which is what truly counts.

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References

[1] McHugh, R. K., Whitton, S. W., Peckham, A. D., Welge, J. A., & Otto, M. W. (2013). Patient Preference for Psychological vs. Pharmacological Treatment of Psychiatric Disorders: A Meta-Analytic Review, Journal of Clinical Psychiatry. 74(6): p595–602.

[2] DeRubeis, R. J., Siegle, G. J., & Hollon, S. D. (2008). Cognitive therapy vs. medications for depression: Treatment outcomes and neural mechanisms. Nature Reviews Neuroscience. 9 (10): p788-796.