Psychotherapy vs. Medication for Depression & Anxiety

What Is Depression?

Depression displays differently for each person, but common depression symptoms include prolonged feelings of sadness, worthlessness, irritability, loss of interest, withdrawal, and suicidal ideation.⁵

What Is Anxiety?

While there are many different anxiety disorders, common symptoms include feeling tense or on-edge; racing or worried thoughts; restlessness; avoiding situations that cause fear; and physical symptoms of sweating, shaking, and racing heart.⁵

The Benefits of Psychotherapy For Anxiety & Depression

There are many benefits of psychotherapy that make it a powerful healing and coping tool, especially for those with anxiety and depression. The most important element of psychotherapy that medication alone cannot provide is the presence of a healthy therapeutic relationship.² In fact, it has been shown that the relationship between the client and therapist is the largest contributing factor to client improvement.³

The second key factor is that psychotherapy also provides a high level of flexibility. A therapist is able to take context and new information into account during every session in order to tailor next steps for the individual client. They will also adhere to the structure of different treatment models to ensure progress is made.⁴

Specific Benefits of Psychotherapy For Those With Depression

Psychotherapy specifically helps with depression because it addresses the underlying contributing factors by pinpointing life events that contribute to symptoms. It works to help the individual reframe their distorted beliefs, develop coping skills to manage symptoms, and look forward to the future.⁶

While there are many different types of therapy that have been shown to treat depression, the modalities with the most studies and evidence to support effectiveness include CBT for depression, interpersonal therapy, acceptance and commitment therapy (ACT), and mindfulness-based cognitive therapy (MBCT).^7,8

Specific Benefits of Psychotherapy For Those With Anxiety

Options for anxiety therapy specifically help with targeting and reframing anxious thoughts, providing coping tools, and building up a tolerance to one’s avoided situations.

The most commonly used approach is (CBT) for anxiety, because it has been extensively researched.¹⁰ Exposure therapy is a form of CBT that is specifically designed to help people face and overcome their fears. Other types of therapy that have been shown effective include acceptance and commitment therapy (ACT), and interpersonal therapy.^11,12

Limitations of Psychotherapy In Treating Anxiety & Depression

While there are many benefits to engaging in psychotherapy to manage anxiety and depression, there are limitations to its efficacy.

Limitations to consider when using psychotherapy without medication include:

• Psychotherapy may not be helpful if one’s anxiety and depression are not solely based on previous life events and are attributable to a chemical imbalance
• Psychotherapy generally takes longer for clients to begin seeing results, compared to medication
• While psychotherapy provides tools to manage symptoms, an individual must continue to use these tools after completion of therapy to see lasting results

The Benefits of Psychotropic Medications For Anxiety & Depression

Sometimes a person can manage anxiety and depression with the help of medication prescribed by a psychiatrist or other prescriber. The goal of medication is to help a person’s brain use chemicals more effectively in order to reduce symptoms.

Some commonly used medications include SNRIs vs. SSRIs, tricyclic depressants, monoamine oxidase inhibitors, or new medications that target NMDA receptors such as Auvelity (dextromethorphan-bupropion).¹³

Specific Benefits of Medication For Those With Depression

Medication for depression is prescribed to relieve and reduce symptoms, help regulate sleep problems, reduce restlessness, and prevent suicidal thoughts. This way, one feels stable to follow normal daily functioning.¹⁴

Specific Benefits of Medication For Those With Anxiety

As with antidepressants, the main aim of medication for anxiety is to relieve and reduce symptoms. They work by reducing one’s worries and baseline levels of stress/tension. They also decrease intense desires to avoid certain situations or stimuli. While most antidepressants take time to fully take effect, some anti-anxiety medications may provide relief within a few days.

Limitations of Medication In Treating Anxiety & Depression

While there are many benefits to using medication as part of your treatment plan, there are also limitations.

Limitations to consider when using medication include:

• It may take several trials of various medications until you and your prescriber find a medication that works for you
• Medications increase the probability of experiencing new or worsening symptoms
• It can take weeks to begin noticing symptom changes with medication
• Once you decide to stop medication, the effects of the medication end as well. This can cause relapse if there are not other methods to manage your symptoms (such as coping skills learned in psychotherapy).

Combination of Psychotherapy & Medication

While there are limitations to both psychotherapy and medication, there is evidence to show that combining these two approaches lead to higher efficacy rates, compared to the use of one approach alone.^15,16 When combining psychotherapy and medication, one treatment approach has the potential to make up for the other’s limitations.

Medication can reduce symptoms and severity enough that skills learned in psychotherapy are more readily practiced and maintained. The skills and strategies learned in psychotherapy help reduce the risk and severity of relapse once medication is stopped.

How to Choose Between Medication & Therapy

There are benefits to psychotherapy and medication on their own or combined. However, there are many factors to consider before starting a treatment plan, and there is no one-size-fits all approach.

Things to consider when deciding which treatment or combination of treatment is best for you:

• What your insurance and financial situation allows for treatment options: therapy can be expensive and is not always included in insurance plans. Medications require appointments and follow-ups that can be time-consuming.
• Your level of comfort and past experiences with medications: if you are uncomfortable with medications, finding the right therapist can help you achieve results and relief from symptoms. Medication is not required for recovery.
• Personal readiness and ability to be open and committed to psychotherapy: while therapy can be beneficial and healing, it does require a high level of honesty, reflection, and discomfort at times. Without bringing a readiness to therapy, the experience can be frustrating and seeing results can be difficult.
• Intensity and severity of the symptoms you are currently experiencing: if you’re experiencing severe and debilitating symptoms, medications may be required to improve functionality enough for psychotherapy to be effective. If your symptoms are manageable, psychotherapy may be sufficient to feel relief.

How to Find Professional Help For Anxiety & Depression

If you’re considering seeking treatment for your anxiety or depression, there are many professionals available for therapy or medication management. To begin your search for a therapist, utilize an online therapist directory to filter for in-network providers, location, etc. You may also reach out to loved ones or other professionals for referrals. If in-person visits are not possible for you, online therapy is an option.

Final Thoughts on Psychotherapy Vs. Medication

Acknowledging and seeking out treatment for your anxiety or depression can be a huge and overwhelming step. Remember that there is no one-size-fits-all approach to treatment, so start with what you feel the most comfortable with. While it can be challenging to work on managing symptoms, there are many options and professionals available to help you on the road to relief.