Medication Isn’t the Only Answer — But Sometimes It’s the Right One
When people think of psychiatric treatment, they often assume medications are the only option. Given that many psychiatrists focus solely on medication management, whether by preference or insurance constraints, this belief is understandable.
Medications are a vital tool in psychiatry, often providing life-saving results in conditions such as depression, bipolar disorder, and ADHD. Yet, medications alone rarely address every dimension of mental health. The landmark STAR*D trial, for example, found that only about 30% of patients with depression achieve remission after their first antidepressant trial.
Because behavioral health challenges often arise from a mix of biological, psychological, social, and environmental factors, holistic care recognizes that a pill alone is often not enough.
When Medications Might Not Be the Answer
Mental health conditions exist on a spectrum. On one end, symptoms are severe enough to meet criteria for a formal DSM diagnosis. On the other, a person’s distress may stem primarily from life circumstances rather than a biological disorder.
When someone’s symptoms don’t fully meet diagnostic criteria, the issue may be best understood as an adjustment disorder, and in these cases, medication may not be necessary.
For instance, I once worked with a patient experiencing low mood during a difficult time. He was unemployed, isolated during the COVID lockdown, and coping with the loss of close friendships. Rather than immediately prescribing medication, we focused on talk therapy to help him build coping skills, process emotions, and reestablish purpose.
Over the next few months, he found a new job, moved into his own apartment, and gradually began feeling like himself again. By addressing the root causes rather than medicating symptoms, he achieved lasting growth and resilience.
When Medications Are the Right Answer
There are situations where medications are absolutely necessary. For example:
Individuals with recurrent major depression and suicidal thoughts
Those with bipolar disorder experiencing frequent manic episodes
People with severe ADHD who face accidents or job loss due to impaired focus
In such cases, medication can be the difference between stability and crisis — even between life and death.
Pharmaceuticals can also help those with less severe but persistent symptoms. Returning to the previous example, if therapy alone hadn’t led to improvement, adding medication would have been a reasonable next step. Integrative care often means knowing when to combine both approaches.
Common Fears About Medication
It’s understandable that people have concerns about starting psychiatric medication. Common worries include:
“It’s going to change me.”
“I don’t want to be dependent.”
“I should be strong enough to handle this on my own.”
But mental health deserves the same compassion and seriousness as physical health. You wouldn’t call a person with diabetes weak for needing insulin, nor someone with a broken bone weak for wearing a cast.
Similarly, psychiatric medication can be temporary, a support that helps the brain heal, build resilience, and regain balance. Once someone feels better and their coping systems are strong, medications can often be tapered safely under guidance.
My Approach
Deciding whether to start medication or to focus on other modalities requires a deep understanding of each person’s context, values, and goals.
In my practice, I schedule ample time during the initial evaluations to understand the full picture. We discuss medication options in depth, address concerns, and decide together whether it’s the right path.
When medications aren’t indicated, I draw on my training in integrative psychiatry to offer alternatives such as therapy, lifestyle optimization, mindfulness practices, and nutraceuticals.
To medicate or not to medicate is never a simple decision. It’s a collaborative process grounded in trust, understanding, and respect for each individual’s healing journey. Ultimately, my goal is to help patients find balance, whether through medication, therapy, or a combination of approaches, and support them on their path to lasting wellness.
If you’re interested in exploring whether medication or other modalities are right for you, contact me to schedule an initial consultation.