Counseling or Medication?


I’m on my mental breaking point! But what to do: should I get medications or visit a therapist?

Most people opt for the first way at first. Most psychoactive drugs (the class of drugs that can induce changes in mood, sensation, thinking, and behavior) are easy to purchase at most pharmacies, a 5-minute conversation with most psychiatrists can result in a prescription for those drugs not so readily available.

It is convenient to avoid having to tell someone about one’s ‘weak points’, hoping that the unpleasant ‘guest’, in the form of anxiety, depression, obsessive thoughts, etc., might soon leave. This approach follows the idea of man as machine: a (pharmacological) turn on the right cog can reset the machine and have it running smoothly again.

Psychologists and psychotherapists naturally have problems with this concept, because it not only reduces people to ‘thought and digestion machines’ but also ignores the important other two pillars of humanism: mind (our rational skills to tackle problems) and psyche (the idea that mental health problems have specific causes, which we should fix or resolve).

For these two very contrasting views, a modern psychotherapeutic approach has emerged, proving itself well in most all variations of psychological distress. Psychosis, severe mental illnesses, and acute problems, the pharmacological approach is the first choice. Medicines help to stabilize the mental situation so that patients can actually make use of what counseling and other forms of therapy can provide for them.

For conventional mental disorders, psychotherapy and counseling is typically applied. In certain cases pharmacological support can be helpful during the first months of treatment. Purely pharmacological therapy without any form of accompanying counseling or psychotherapy has been abandoned by most Western clinics today. In every individual case, a trained psychiatrist, psychologist or psychotherapist should be involved the diagnosis and assessment of the correct procedure in order to maximize the therapeutic effect.

Self-diagnosis and especially self-treatment with psychotropic drugs is not recommended due to a variety of potential side effects.

Live the happy life you planned! Richard L. Fellner, a psychotherapist trained in Vienna, Austria, is head of the Pattaya Counseling Center in Thepprasit Soi 6 (Khopai) and offers consultations in English and German languages (after making appointments at 0854 370 470).