February 2, 2022

Therapy or Medication? Why combined treatment is best.

Therapy or Medication? Why combined treatment is best.

We don’t want our patients to be on medication for life, but we strongly feel that for most people, starting with medication helps to peel back the layers of symptoms and puts patients in a strong starting position to reap the benefits of talk therapy, coaching and counseling and work towards healthy management of mental health for the long term.

Therapy or Medication?  - Why combined treatment is best.

With happy and healthy brains and bodies as our top priority, why do we recommend a combination of medication (psychiatry) and therapy (psychotherapy) ? Like rehabilitating any part of your body, it’s important to manage the immediate symptoms while also planning for recovery and long term prevention. 

At Cognito we understand that our patients have a wide range of symptoms, severity and experience with mental health and as a result have different preferences and preconceived notions about how to best receive treatment. Because of this wide range, and no two patients' mental health journey being the same, our treatment is always catered to individual needs. 

In less common circumstances, unique patient needs may dictate a diagnosis of only one treatment like a student with milder symptoms wanting a quick turnaround may only be prescribed medication, or a patient with allergies and conflicting drug interactions may only be viable for therapy treatment. Mental health recovery is a collaborative process between patient and physician, with countless unique patient requirements, however, most often the benefits of combined treatment are hard to ignore.

Every day we receive comments from our patients who think they only want medication, have heard horror stories about drug side effects and favour a therapy approach, or patients who are simply trying to choose between the two. Our job is to help sift through the noise and misinformation and educate our patients towards the best path for managing and recovering from mental health symptoms using psychotherapy and psychiatry. Simply put, don’t choose - we believe medication works better when you talk about it.

Why do some prefer a medication only approach? - Talking about our feelings is scary.

Mental health and specifically anxiety and depression has become a polarizing topic. Once long ignored, the public perception is finally shifting in the right direction as people move towards taking care of their brain like they would for any other part of their body. With 1 in 5 Canadians currently experiencing a diagnosed mental health problem, 20% of our population can no longer be ignored. Yet with all of this progress being made, coming forward to talk about our own mental health is still an incredibly vulnerable decision, and for some so scary it can get in the way of receiving the best treatment. Unfortunately an additional 40% of Canadians experience similar problems and seek no help at all. 

To learn more about medication options, specifically SSRI's, click here

What can I do if I don’t want to, or can’t, get a referral to a therapist?- The “path of least resistance”.

Patients who are resistant towards therapy and are seeking medication may experience temporary relief, but won’t get to the bottom of the underlying causes of their symptoms or learn skills for long term prevention, without cognitive therapy. Because of this, when a patient starts to feel better and seeks to stop taking medication their symptoms will likely return as only the pain of the broken ankle was treated, and no therapy to repair the joint and strengthen the leg was administered. This analogy is not meant to make light of mental health symptoms, but rather highlight that it’s finally time to treat our brain with the same serious care that we have for our bodies.

With an overworked medical system, medication is often perceived as the only option for physicians, employers and patients because it is incredibly difficult to coordinate care between physicians, cognitive therapy and resilience skills development. The ineffectiveness of the current approaches are apparent. In any given week, at least 500,000 employed Canadians are unable to work due to mental health symptoms which is why we aim to set our patients up with the tools for success so returning to the workforce or normal life is a sustainable solution.

To learn more about a Cognitive Behavioural Therapy (CBT) session with Cognito, click here

What about the side effects? - Temporary pain for long term gain.

As much as the popularity of openly discussing mental health is rising daily, so is the public concern of taking pharmaceutical medication and the perceived laundry list of associated side effects. Imagine struggling with severe depression, social anxiety disorder or OCD and finally deciding to seek help only to be told that in addition to the symptoms you’re currently struggling with, you can add reduced sex drive, nausea, headaches or worse to your list. Again, it’s our job to educate our patients that their same broken ankle will have a very hard time getting through the therapy to recover and strengthen if the pain medication and anti inflammatories aren’t there to help get to, and get through, rehabilitation. As for side effects, we work with and prescribe a wide range of treatment options and strengths to find a fit that works best for everyone. Ultimately our goal is to get our patients to a place in their mental health journey that they no longer need medication to manage their symptoms. 

Still can’t decide between psychiatry or cognitive therapy? - Let’s talk.

Whether the vulnerability of discussing mental health, the fear of medication side effects or the general inaccessibility of treatment, patients are asking themselves the question: therapy or medication? For our patients that don’t have strong opinions swaying them in one treatment direction or the other, they are stuck in the middle trying to answer a question that doesn’t need to be asked. The current medical system has not yet caught up to the research in terms of combined treatment and when amplified with overrun hospitals, long waits at clinics and increased difficulty finding other local mental health resources, the result is the majority of patients are being prescribed either medication or therapy, but rarely both. Wait times are a major reason for this one-track treatment route as referrals for counselling and therapy can have delays upwards to 6 months. For those walking this line, the analysis paralysis can be stripped away with the right information, which is what we at Cognito aim to provide.

How to give yourself the best chance to recover from negative mental health symptoms?  - Two heads are better than one, trust the pro’s.

So, medication or therapy? At Cognito, we don’t think you need to choose just one. We prefer the hybrid approach because we know it works. Our goal is to set our patients up for success and for most that means working towards a medication free life with stable mental health, and a fit body and mind. 

The research is clear, there are numerous studies advocating for combined treatment. Most notably in 2014, 52 studies with 3623 adult patients with diagnosed depressive and anxiety disorder found significant improvements with combined psychiatry and psychotherapy treatments when compared to only one treatment. This study found particularly profound improvements using combined treatment for patients with major depression, panic disorder and OCD. These improvements in many cases were nearly twice as successful as one treatment alone, and these effects were replicated nearly two years after initial assessments. 

Our objective? - Helping you feel like YOU again.

We don’t want our patients to be on medication for life, but we strongly feel that for most people, starting with medication helps to peel back the layers of symptoms and puts patients in a strong starting position to reap the benefits of talk therapy, coaching and counselling and work towards healthy management of mental health for the long term. Take the aspirin, apply the A535 and go to physio weekly until that ankle can pirouette like a ballerina. 

If you are in emotional distress, please contact the resources below
For emergencies dial 9-1-1 or present to your nearest emergency department.