How Do You Know If It’s the Therapy or the Drugs That is Working?
For many years, the psychiatric community has known that therapy plus medication is more effective than either mental illness treatment alone. It all depends on the specific therapy, medication and person, but that’s, generally, the rule.
But the question is, if you’re being a good patient and you’re working your therapy and taking your psychiatric medications as you should, how do you know which one is causing positive results?
How Do You Know if Therapy is Working?
There are essentially two main types of therapy: talk therapy and skills-based therapy.
Talk therapy is freeform therapy and is designed to be in-depth, longer-term and can delve into more serious long-standing issues. This is the hardest type of therapy to determine its effectiveness. A gain produced by long-term therapy tends to be a slow, long-term gain. Moreover, it’s generally obvious when you have a beneficial breakthrough in therapy that you will find helpful. Goals are often set within the therapy so you know when you reach those goals as well.
Skills-based therapy is like cognitive behavioural therapy (CBT) or dialectic behavioural therapy (DBT). These therapies focus on giving you skills to deal with your emotions and life. When you put these skills into practice, you can see an improvement in dealing with everyday situations and stress tolerance. But these therapies only work when you work them. In other words, you have to actively use the tools for them to work so it’s fairly obvious when they’re working as you’re the one using the tools.
How Do You Know if the Drugs are Working ?
This one can be more complicated because sometimes drugs work quickly and sometimes they work slowly over the course of weeks. However, it’s faster than talk therapy (typically) and works regardless as to the tools used from skills-based therapy.
Which are Working, the Drugs or the Therapy?
The easiest way to determine this is when you actually started the therapy. If the last thing you added to you regimen was CBT, while your medications remained the same, then it’s likely the CBT that is making the difference. Similarly, if you’ve been doing talk therapy for six months and then you suddenly feel better after adding a new medication, then it’s likely the medication that’s caused the change.
But it’s important to remember that it isn’t an either / or scenario. While either therapy or medication can cause an acute improvement, it might only be able to do so in combination with the other therapy. So it’s important not to contribute all improvement to any one thing. In the end, if you find an improvement using a combination of therapies, what does it matter, as long as it’s improvement?
Tracy, N. (2012, November 5). How Do You Know If It’s the Therapy or the Drugs That is Working?, HealthyPlace. Retrieved on 2022, August 11 from https://www.healthyplace.com/blogs/breakingbipolar/2012/11/how-know-therapy-or-drugs-working
Author: Natasha Tracy
I think of my therapy, medications, learning, family support, social involvement, yoga and meditation etc as a circle of support for myself - when there is a link in the chain broken the entire thing will start to fall apart.
I think that it is hard to tell in the early years when you're constantly tweaking your meds, and going through new tapering-up periods (not always at the same time) and trying new ones every few weeks or months.
The significance is that talk therapy and CBT type therapy is dearer than the drugs, so budget cuts target the non-drug treatments.
Just as there are ineffective meds, there are ineffective therapists. Make sure to get the right fit.
If I have a therapist that knows nothing about how taking care of an alcoholic parent from a young age has affected me then I'm in the wrong place. I have to revisit that trauma and neglect sometimes because the survival skills I learned so long ago now work against me. ACOA meetings are extremely helpful, too.
Stay with it.
Excellent final point, who's to say that one treatment worked independent of others already in place. The talk therapy or CBT may have made you ready to gain an advantage from changes that medication can offer. Conversely, meds may make you more receptive or capable of gaining from therapy.
We're all chemical stews with emotional seasonings, multi-modal treatment is the norm for many mental health issues. But still, it would be nice to know where the best improvement came from ...