If you’ve had much in the way of experience in the fight with anxiety and depression then you have at least thought about the subject of medication in dealing with that anxiety. This topic has come up a number of times in the last two months in discussions I have had with coaching clients. I have written on this in a much earlier blog post, but I wanted to revisit and expand my writing on this subject.

It is hard (and very troubling) to hear people (coaching clients, subscribers to this blog, friends, co-workers) say something like the following:

“Yeah, I’ve fought anxiety for a long time, but you know Erik, I tried medication and I tried therapy. They helped a little, but nothing really seemed to fix the problem. So I just don’t think that it does any good to take meds or go to a therapist. It may help other people, but it didn’t do anything for me.”

I will address the role of therapy in my next blog post. In the meantime, let’s talk a little about what meds can do for us, and how we can make them effective allies in the war on anxiety –

Yikes…

When I hear people tell me things like the above quote I have several thoughts and more than a little concern:

1) Too often that means (when I talk to people a little more after hearing a statement like what I just wrote) that this person has given up – that they believe that they will have to endure anxiety for the rest of their lives.

Ugh and double ugh – nothing could be further from the truth. I believed that for a long time, and it was both scary as hell and it shut me down from finding out whether or not that was actually the case.

2) What went wrong with their experience with therapy and medication? If you’ve read this blog you already know that I don’t believe that medication or therapy can usually by themselves fix the issues that create anxiety. By the same token they can be highly useful tools in that direction. Why didn’t they help this person?

3) That they are missing out on potentially powerful tools in their fight with anxiety/fear/depression. And there isn’t any reason they need to do that. Just because meds and/or therapy haven’t worked for them in the past doesn’t necessarily mean they can’t use those tools effectively, with a little knowledge and correct application.

First Things First

If you’ve been paying attention at all here in the last 2 years on this blog you can probably recite from memory what I’m about to say: fear and anxiety start in our thinking, and that is where we will deal with it as well.

If that’s the case, then what IS the role of medication and therapy in dealing with anxiety?

Well, first we have to get clear that our primary mission is to get our thinking clear/straightened out. If we are afraid then we have converted one or more problems into what we believe is a crisis. We have started down the rabbit-hole of the Chronic Anxiety Cycle, and our thinking, in a very real sense, is spiraling out of control in the direction of our fears.

So the mission of medication and therapy HAS to be something around helping us cut that spiral, as well as assist in getting our thinking clear/useful/effective.

What CAN Medication Do For Us?

It is my strong belief (after dealing with anxiety most of my life and clarifying for myself what generates anxiety in the first place) that medication can serve a very powerful and useful role in anxiety work. It can, quite simply, temporarily disrupt the Chronic Anxiety Cycle. It can do that in this way: It can slow or interrupt the anxious thinking that we’re doing in our skulls.

It can do that in two directions. It can 1) help interrupt the frightened thinking that is scaring us in the first place, and it can 2) help the anxiety we feel around our Flight or Fight responses – which of course then can help temporarily stop the Flight or Fight responding that we’re doing as a result.

That’s pretty great when you’ve been living like a prisoner in a steel cage with an electrified floor, and you have been getting shocked again and again by both your thinking and your Flight or Fight Reflex.

The effectiveness of this help will vary from person to person based on several factors. One is how severely anxious and/or depressed they are. Another is how they respond to a particular medication, both in how effective that medication proves for them, and what side effects that medication may generate for them.

In addition many people begin to develop a tolerance for a particular medication, diminishing how effective that medication continues to work for them.

What this means is that people can have widely varied responses to the same medication. A person can try one med and have excellent to moderate success with that one med, or he/she can run through a number of medications before finding one that does much to make a difference.

This Isn’t A Miracle Cure!

This is a good place to clarify the definition of what we mean by “work”. Can medication help us get some breathing room from our thinking and Flight or Fight responses? Very often the answer is yes. Can it end anxiety all by itself? No.

In other words medication isn’t going to work the same for every person, and the degree to which it is going to work is going from person to person. One person might start on meds prescribed by his/her psychiatrist or doctor and see significant relief for months or years. Another person might have to cycle through two or more meds before they find any help. Still another might not find much help at all with medication.

It also helps to be clearer on what relief we’re seeing. For some of us it simply means we’re able to get a decent night’s sleep – no small thing in the fight against anxiety.

For some of us it means the easing of the pulse of anxious thinking – not usually the cessation, but some relief. For still others it might mean the lights coming back on, to some extent, in the darkness of our depression and/or chronic anxiety.

But whatever they experience with those meds they in all likelihood WON’T shake free of anxiety until they sort out the thinking that makes them anxious in the first place. That’s to be expected, and it DOESN’T mean we’re doomed to keep feeling anxious/having anxiety run our lives.

The central thought to keep in mind is that meds can help mitigate the impact of anxiety on our thinking an physical/emotional responses to anxious thinking. What they can’t do, ultimately, is unpack and unplug the anxious thinking and responses to that thinking – they can’t by themselves bring an end to anxiety.

Next up – some discussion about the role of therapy in the fight against anxiety.