Should I consider taking medication for my anxiety and depression?

Medications can be very helpful for people with depression and anxiety. Depression and anxiety are mental health disorders that are caused by a chemical imbalance in the brain. This chemical imbalance can be caused by various factors, including genetics, environmental factors, and life events. Medications that are commonly used to treat depression and anxiety are known as antidepressants and anxiolytics. Antidepressants work by increasing the levels of certain chemicals in the brain, such as serotonin, norepinephrine, and dopamine, which can improve mood and reduce symptoms of depression. Anxiolytics work by reducing the activity in the brain that causes anxiety, which can help to reduce symptoms of anxiety.

According to APA guidelines, for depression with suicidal ideation the combined effect of medicine and psychotherapy was more beneficial, whereas anxiety disorders respond better to psychotherapy than medicine (APA div.12, 2017). This proves why therapy treatment plans must be customized for each patient. This blog post will describe the various factors that need to be considered when choosing between therapy, medicine, or a combination of both for treating anxiety and depression.

  1. Symptomology and Causes

The diagnosis of anxiety and depression is provided if the patient meets the diagnostic criteria specified in the ‘Diagnostic Statistical Manual.’ Still, the reason for having those symptoms varies from person to person. Medications reduce the intensity of the symptoms, but the cause of the problem may remain hidden even after intensive drug therapy. Psychotherapy has a long-term effect as it identifies the cause of the maladaptive behavior and emotions, the triggers, and the risk factors that slow the recovery process while teaching the individual  new coping skills to manage symptoms in future. (Siddiqui, 2018).

  1. Severity and Crisis Management

Patients suffering from severe anxiety and depression may find it challenging to cope with day-to-day activities. It becomes necessary to create strategies to help the patient stay safe, especially patients with depression who are battling suicidal ideations. Severe anxiety may lead to panic attacks that can be managed effectively with medication. In such cases, medications are provided first and then therapy is provided once the patient is safe and able to engage in the emotional labor of healing and change.. (Hairston, 2021)

  1. Socioeconomic factors

People living in underdeveloped areas or areas with poor accessibility to a licensed therapist, improper transportation and transportation, and lack of internet accessibility for online therapy may prefer medications prescribed by the local doctors. (Miranda et al., 2003). 

  1. Childhood trauma

Long-term trauma impacts the areas of the brain that are responsible for fear and stress response. (Shafir & Simbra, 2022). The patient would have a series of learned patterns that influences their perception about self and others even if they don’t directly remember the trauma. In such cases, therapy is more beneficial as patients can then heal from the trauma causing their depression and anxiety. Research has proven that the chance of recovery is higher when a combination of medicine and psychotherapy is given to patients with childhood trauma. (Kuyken, et al 2015). 

  1. Comorbidity

Anxiety and depression may coexist with another psychological disorder, or a person may have symptoms like anxiety and depression due to another psychological problem. Depressive episodes are present in patients with bipolar and borderline; similarly, Obsessive, anxious thoughts exist in OCD. The remission rate for depression and personality disorder is 47% when psychotherapy is given with medicine compared to 19% for only drug treatment. (Kool et al., 2003). Having a more customized treatment plan is crucial. 

Medicine is sometimes viewed as “magical”, especially for treating anxiety and depression as it provides immediate short-term improvement. (Rosen, 2019). However, from a psych-education perspective it is important that patients are aware of potential side-effects  associated with psychiatric medications so that they are able to make informed decisions. Anti-depressants and anti-anxiety medications are categorized according to their effect on the neurotransmitters in the brain. According to Jacquelyn Cafasso’s article in 2019, potential side effects for the various types of medications listed below include: 

  1. Selective serotonin reuptake inhibitors (SSRIs)

Headaches, nausea, trouble sleeping, dizziness, diarrhea, weakness and fatigue, anxiety, stomach upset, dry mouth, sexual problems such as low sex drive, erectile dysfunction, or ejaculation problems. 

  1. Serotonin-norepinephrine reuptake inhibitors

Headaches, nausea, insomnia, drowsiness, dry mouth, dizziness, loss of appetite, constipation, sexual problems such as low sex drive, erectile dysfunction, or ejaculation problem, weakness, fatigue, sweating

  1. Tricyclic antidepressants 

Besides previously mentioned side effects, it also causes blurred vision, trouble urinating and blood pressure issues, and abnormal heart rate or arrhythmia.

  1. Monoamine oxidase inhibitors 

Low blood pressure, nausea, headaches, drowsiness, dizziness, dry mouth, weight gain, stomach pain, confusion, diarrhea, runny nose, sexual problems such as low sex drive, erectile dysfunction, or ejaculation problems

  1. Serotonin antagonists and reuptake inhibitors 

Drowsiness, dry mouth, headaches, dizziness, nausea, fatigue, vomiting, blurred vision, diarrhea, constipation, low blood pressure, confusion

  1. Bupropion 

Trouble sleeping, headaches, irritability or agitation, dry mouth, constipation, loss of appetite, weight loss, nausea, vomiting, sweating, dizziness, and anxiety.

  1. Mirtazapine 

Drowsiness, dry mouth, increased appetite, weight gain, high cholesterol, constipation, weakness and fatigue, dizziness

  1. Vortioxetine

Sexual problems, such as orgasm or ejaculation problems, nausea, diarrhea, dizziness, dry mouth, constipation, vomiting

Some psychiatric medications may lead to allergic reactions, including facial, throat, and tongue swelling, hives, rash, blisters, or, in the worst cases, breathing problems. (Schimelpfening, 2020).

When treating anxiety and depression, a combination of psychotropic drugs and personalized psychotherapy is often recommended. However, while taking medications, you must track the side effects. Tracking side-effects when starting a new medication is very important for several reasons:

  • Safety: Monitoring side-effects can help you identify any potential adverse reactions or drug interactions early on, which can help you avoid more serious complications. Some side-effects can be severe and may require immediate medical attention.
  • Efficacy: Some side-effects can interfere with the effectiveness of the medication. By tracking side-effects, you can work with your healthcare provider to adjust the dosage or switch to a different medication if necessary.
  • Compliance: If you experience unpleasant side-effects, you may be less likely to continue taking the medication. This can reduce the effectiveness of the treatment and may lead to further complications. By tracking side-effects, you can work with your healthcare provider to find a medication that is more tolerable for you.
  • Communication: Tracking side-effects can help you communicate more effectively with your healthcare provider. If you experience any side-effects, it’s important to discuss them with your provider, as they may indicate a need for a change in treatment. By tracking side-effects, you can provide your provider with detailed information that can help guide treatment decisions.

Overall, tracking side-effects when starting a new medication can help ensure that you receive safe, effective, and well-tolerated treatment. The effectiveness of these medications can vary from person to person, and it may take some time to find the right medication and dosage that works for you. It’s important to work closely with a healthcare provider who can monitor your symptoms and adjust your medication as needed.

Medications alone may not be enough to manage depression and anxiety, and it’s often recommended that people also engage in therapy or other forms of treatment to address the underlying causes of their mental health symptoms. If you are thinking about starting therapy or wanting access to trusted psychiatrist referrals for medication management, Serengeti Wellness can help. Feel free to contact us via our website 


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