Cliff Straehley III MD


Contact Us
Medical Legal Services
Self-Help Options
Twelve Step Groups
Reference Books
Spiritual Emergence



I hope this article will help you will learn some of the basics, so that you can make more informed choices about the use of psychiatric medications. Of course none of the following can take the place of finding a mental-health provider whom you trust, who is knowledgeable, and from whom you can get all your questions answered.

The vast majority of psychiatric medications used in the United States today are not prescribed by psychiatrists. The majority of these medications are prescribed by primary care physicians, and many times these medications are used correctly and with good results. If you are now taking psychiatric medications, and your various symptoms have resolved completely in response to the use of medications, and you also do not have troublesome side effects, then you probably don't need to try a different approach.

One common mistake is that general practitioners may prescribe the right medication, but at too low dose. As a result, the patient only gets a partial response. Patients may not know that the appropriate goal is total resolution of symptoms and not just improvement. Not knowing any better, many patients are settling for improvement only.

Some patients with potentially avoidable side effects may discontinue these medications, and therefore not obtain relief. Many side effects can be completely eliminated, without losing any of the benefit of the drug, so discuss any side effects with your doctor. If a psychiatrist is not prescribing your medications and you have been having ongoing problems, you could ask for a consultation with a psychiatrist. Seeing a psychiatrist doesn't mean you are crazy!

Why should anyone consider taking psychiatric medications? In order to answer this question, you could take a look at your ability to function in your daily life. Ask yourself if your psychological symptoms are stopping you from fulfilling the role of mother, father, worker, or spouse. If you cannot perform your roles satisfactorily, psychiatric medications may decrease your symptoms enough, so that you can. Most psychological disorders involve too much anxiety or too much depression or both. Just struggling with these unpleasant emotions on an everyday basis, "costs a great deal of psychic energy". It's possible for these psychological problems to drain away so much of your energy, that you do not have any left over to be a good mother, a good spouse, or an effective worker at your job. Many people's psychological problems have increased so slowly over the course of time that they don't even realize how dysfunctional they have become.

Many people have a negative attitude about relying on psychiatric medications. They may be ashamed, embarrassed, or frightened of medications. Hopefully you will discuss this with your doctor. Antidepressants are not addicting. It is uncommon for them to have any permanent side effects. It is almost always safe to do a therapeutic trial of a medication to see if it causes positive changes. Each person's biochemistry is totally unique. Understandably, it may take a trial and error process to find the best medication for you. For example there are around 40 different antidepressant medications to choose from. Because of that, it's much more likely that your doctor can find one that is helpful for you, without unacceptable side effects.

Sometimes after being on a medication a patient may not remember how bad they felt in the past before taking their medication. I've worked with some patients who have later tried stopping their medications on their own, only to be surprised that they become depressed again. Only then do they realize how much the medication had been helping them.

Your doctor can help you distinguish between normal sadness and worry versus severe depression or anxiety. They can help you decide whether you are functioning well enough without medications. When a person is severely depressed or anxious, it can be very difficult to make necessary changes in a person's life. The medications can help you improve enough, so you can take risks and establish new relationships or find a new job. After those changes are made, you have a much better chance of getting off the medications.

Many people worry about psychiatric medications becoming addictive. Some psychiatric medications are potentially addicting. Examples are Valium and the other benzodiazepines (Xanax, klonopin, to name a few). However, many people can carefully take even these drugs appropriately, usually on a short term basis.

It's also important to be honest with yourself about whether or not you may be using "over the counter drugs" to self-medicate. For example, be honest with yourself about your use of alcohol, caffeine, sugar, sex, or ice cream.

We all choose to ingest a variety of chemicals every day. Make no mistake that caffeine, sugar, salt, and herbs are all chemicals. Herbs are really just complicated chemicals. Because they are grown in different climates and soils, with different amounts of sun, it may be difficult to control their concentration and purity. I'm not against herbs at all. But they can also have negative side effects. My main point is that you should be honest with yourself about the choices you are making about what chemicals you are putting in your body.

There is abundant recent research which suggests that when psychotherapy is added to medications, the results are better. It is also true that many psychiatric disorders can be resolved by psychotherapy alone, without medications. An experienced mental health professional you trust can help you find the best pathway for you.