Combining Medications with Psychotherapy is The Best Option but Still Just the Beginning. By Michael Barness, M.D.

Multiple studies have shown that individuals who combine Psychotropic medications with Psychotherapy have better outcomes in comparison to those who only use one of the two options. I prefer not to debate which treatment is better but rather focus on the synergy that is created by combining the two modalities. In many ways optimizing treatment by offering multiple solutions seems intuitive. Still, let’s take a closer look.

In terms of data the evidence is overwhelming. Combining the two treatments creates faster responses (Bowers, 1990), Improved long-term recovery rates (Fava et al, 1998), Decreased rate of relapse (Paykel et al, 1999); (Teasdale et al, 2000), Improved long-term social functioning (Klerman et al, 1974), Improved medication compliance (Basco and Rush, 1995);

(de Jonghe et al, 2001); (Vergouwen et al, 2003), Greater patient satisfaction (Seligman, 1995); (de Jonghe et al, 2001) and Lower long-term health and social service costs (Browne et al, 2002); (Goldman et al, 1998). These are just some of the studies that show a benefit.

I can personally say that I have successfully treated multiple individuals by combining medications and therapy. Still this is just the beginning. Much more is needed to successfully treat mental illness.  My colleagues can refer to me as the “Anti-Psychiatrist” as I tend to minimize the role of medications when treating my patients. This may seem like a slight against medications but it is actually quite the opposite. I have noticed a paradoxical effect when taking the focus away from medications. I have noticed that by doing this the medications actually work better!  How can this be? I believe most patients have preconceived notions and expectations that are simply not reasonable or even feasible. Allow me to explain.

Think about your experience with doctors in general. Since a young age we are taught that when we feel ill we go to the doctor for treatment and cure.  Have a fever? Multiple medications can lower your temperature. Have an infection? Antibiotics and other medications will cure that right up. Have pain? There is certainly no shortage of effective pain medications. High Blood pressure? Changes in blood sugar? Cholesterol? Thyroidism? You guessed it; your doctor is just one visit away from prescribing a medication that will change all of that. Unfortunately many people erroneously take this same mind frame with them when visiting their psychiatrist. In my opinion by doing this they are trying to fit a square peg in a circular hole. It sets up the patient for failure and disappointment.  Treating mental health is often very different than treating concrete physical ailments.  Using the same approach will often result in partial resolution of symptoms and a frustrated patient.

With all of this in mind it is only logical to begin with the most proven combined treatment of mental health disorders. When possible individuals taking medications should supplement with psychotherapy and vice versa. I challenge and encourage readers who seek mental health treatment to think outside the box and take an eclectic approach to their treatment. At Mindful Medicine patients can take advantage of both medication management and individual psychotherapy at one location by the same clinician. But it does not end there. We emphasize and integrate exercise, diet, healthy life style changes and much more to fully round out ones treatment.

Thank you for taking the time to read this article. Please check back soon for even more articles related to mental health care.