Do anxiety and depression medications preclude therapy?

Medication? Talk Therapy? Or both?

In February 2014, World Psychiatry published the results of a study underscoring the value of combining psychotropic medication with psychotherapy. In this meta-analysis of 3,623 depressed or anxious adults from 52 randomized clinical trials, the effects of treatment with antidepressant medication were compared to the effects of treatment with both pharmacotherapy and talk therapy. The findings demonstrated that the combination of therapy and medication was superior and more effective than treatment with antidepressant medication alone. "Therapy with medication alone may not constitute optimal care for common mental disorders." World Psychiatry, 2014 Feb: 13 (1): 56-56.
Although medications promise rapid relief and provide a "floor," preventing what can feel like a frightening emotional free-fall for distressed individuals, psychotropic drugs can only relieve symptoms. The self is unchanged, and the underlying conditions and psychological processes that led to the emotional distress are still part of the personality structure. If it were simply a matter of correcting chemical imbalances, we would expect the results of the meta-analysis to show no significant difference between those receiving medication only and those receiving both medication and therapy. Instead, the addition of talk therapy produced superior results.
The current stream of scientific research goes further than the results published in World Psychiatry. We now know that the human brain contains mechanisms that allow our neuronal connections to shift and change. This "rewirability," basic to all learning - including learning in therapy - allows us to unlearn maladaptive thought/behavior patterns and develop new associations and connections that lead to emotional well-being, ultimately eliminating the need for medication.
If you are currently on anti-depressant or anti-anxiety medication, you might want to reflect on your characteristic defenses: withdrawal and isolation, persistent irritability, helplessness (feeling victimized by life), hopelessness (resignation), intellectualization (philosophizing to avoid feelings), rationalization, avoidance, denial, procrastination, or projection - to name a few. These defenses, most of which operate out of conscious awareness, become the problem. They create a wall around our ingrained maladaptive patterns and so prevent in-depth examination and resolution.
Without a therapist's challenge to the wall of defense and resistance, one may be left with debilitating anxiety or depression that is only masked - not resolved - by medication.

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