Counselling vs Medication - Which is better?
By Ho Shee Wai
Clinical Director / Psychologist
Counselling vs Medication - Which is better?
Understanding the role of medication in mental health. Explore when and why to consider psychopharmacological medicine alongside counselling for holistic support.
Oftentimes when we or our loved ones are struggling with mental health or life challenges, a thought that frequently pop up in our head is “I wish there is a pill I can take to make it all go away!” Well, there are pills you can take, and the question then is does it make it all go away? Also, when do we do counselling and when do we take medication? What do we take medication for?
Purpose of Psychopharmacological Medicine
To answer that, let’s look at what is the purpose of psychopharmacological medicine. There are 2 main reasons to consider taking medication. Firstly, there are some mental health diagnosis, e.g., ADHD, OCD, Depression, that have biological underpinning or genetic component. While counselling can resolve the environmental, behavioural, and personality causes, and provide some coping skills, it doesn’t obviously change your body’s chemical make-up. Taking medication to manage the chemical imbalances is no different from someone taking medication to manage their blood sugar level when they have Diabetes. Is taking medication the only way to change the body’s chemistry? No, your body chemistry can change with your diet or exercise (which research has shown to be as effective as taking medication).
How Medication Can Help
Secondly, sometimes life crisis can be too overwhelming for us. In such time, medication can help provide a boost in the baseline to give us the time and energy to use counselling to sort out the issues. An example that I like to use is: if you have something to reach on the ceiling, you can keep jumping to reach it with the uncertain outcome of sometimes reaching it and other times not. This resulted in you being exhausted and if you usually can’t reach it, you can get discouraged or disheartened and can stop trying. This is worse if you have a broken leg (which can be some trauma from the past) and cannot jump. The other alternative is you can use a stool to help you reach the ceiling easier. Using the stool doesn’t mean you don’t do any work - you still need to reach out your arm to touch the ceiling. However, with the stool you have more consistent outcome and higher probability of reaching the ceiling. After you sort out the issues in counselling, you can take away the stool and keep jumping as per normal. Medication is the stool.
Some Of The Frequently Asked Questions (FAQ) That I Get From My Clients Regarding Medication:
Q: Should I get medication from my GP or a Psychiatrist?
A: While a GP (or any doctor) is able to prescribe Psychiatrist medication, a Psychiatrist is a specialist trained in the field of Psychiatry and is better able to monitor to ensure you are giving the right medication at the right dosage. Speak to your Counsellor or Psychologist who can recommend a Psychiatrist that they work with.
Q: Is there any side effect if I take medication?
A: All medication has side effects. What we want to do when taking medication is to balance the benefits and side effect so that the benefits outweigh the side effects. Some common side effects of psychiatric medication can be dry mouth, headache, weight gains etc. For a comprehensive list of the side effects of a particular medication, for Singapore you can search on the MIMS.
Q: I heard medication is addictive, is that true?
A: Most psychopharmacological medication are not “cure”. While some like antidepressant can cue the body to produce the right amount of chemical after some time, others are required long term to manage the diagnosis, e.g., ADHD. If we go back to the example of Diabetes, if you must take medication daily to manage your blood sugar level would that be considered as addictive or corrective? When our body doesn’t produce the right amount of chemical, we may need to use medication to correct it.
Q: My friend took antidepressant and felt more suicidal.
A: When you first ingest medication, your body will have a reaction to it. This just means the medication is working. Usually it takes time for the body to adjust to the medication. Therefore, often time people will notice the negative side effects first before the positive comes in. As I often prepared my clients, the first day and the first week of taking medication is the worst. So be prepared and braced yourself for that. Once you get through that first day and first week, you can see the positive effect kicking in. Sometimes our body reacts different to different medication which is also why for you to consult with a Psychiatrist rather than a GP, they will be able to change to another medication that is better suited for your body.
Q: If I take medication does that mean I don’t need to do counselling?
A: Medication only address 1 facet of your diagnosis, the biological and genetic part. You still need to do counselling to explore the underlying root environmental, relational, and personality causes. You may need to learn new skills or ways of thinking to counter unhealthy and unproductive behaviours. You may need counselling on order to heal from past hurts and traumas. You’d also need counselling to learn to set new goals and cultivate new healthy habits to get you to your new goals. A good approach is usually to do counselling in tandem with medication. In Singapore a Psychiatrist only prescribes medication and does not do therapy. Therefore, it is important for you to have both a Psychiatrist and a Counsellor or Psychologist in your support team to help you achieve optimal mental health.
Q: Can my Counsellor or Psychologist prescribe medication?
A: No, Counsellors and Psychologists are not doctors, therefore they are not able to prescribe medication. If you are still uncertain about medication, it is best for you to consult with your counsellor or psychologist who can make a good recommendation base on your individual situation. At The Counselling Place, our therapists, counsellors, and psychologists have experience helping clients who may need additional medical support.