If you are a client who is depressed or anxious you will usually be faced with two competing opinions on how to deal with the problem. If you talk to a physician, she/he will often prescribe medication. If you talk to me, I will usually dissuade you from that course (unless you are severely non-functional or suicidal). This conflict is confounding because you are likely to believe that medicine and psychology approach the human organism in the same way. In fact, psychology and medicine tend to see the human organism in diametrically different ways. The medical model sees the body as a machine, like a clockwork mechanism, that can be objectively examined, taken apart, put back together, and functionally understood by looking at its parts. Psychology, however, focuses on subjective experience as a means of understanding the individual. The Self cannot be reduced nor understood by looking objectively at its body parts; nor can complex behaviors be reduced to lesions in the brain or chemical reactions.
Thus, the difference in treatment options: In the medical model, depression is believed to be caused by a chemical imbalance and pills are prescribed to resolve the imbalance. This same medical model believes that rapists have a hormone excess and that a chemical castration will solve the behavioral problem. Psychology is not reductionist: It does not reduce a behavior to one or more static entities, like chemicals or lesions in the brain (neurological insults and degenerative disease are not being considered here). Psychology takes the position that the organism is actively and continually in the act of self-definition. Moreover, psychology believes that, in general, the human is capable of changing beliefs and altering emotional response patterns by doing inner work.
A person who is depressed and is told that a chemical imbalance is the problem has no understanding that he or she has something to do with the depression being present. ( I am referring to the typical depression, not a psychotic level depression.) The person is not responsible. It is as if the person were walking down the street and a rock fell from the sky and "made" her/him depressed. Solution: take the prescribed pill and the depression goes away. In fact, it often does, but those who take pills do not learn, as they do in talk therapy, what they are doing to create or maintain the depression and thus have a high likelihood of becoming depressed again. Those individuals who learn how to understand and manage their emotions and challenge and direct their thoughts, learn life long tools about how to deal with what life throws at them.
I believe that if you are depressed or anxious, you have some mental ideas about yourself that are not accurate--for example:" this is happening to me and I am an innocent victim." Moreover, you do not know that your emotions and your thoughts are at the basis of the problems and well within your ability...and responsibility... to change. We tend to think that emotions have some truth factor: 'If I am anxious there must be a good, reliable, true reason for it.' ; 'If I am depressed, it is because there is some emotional truth to these emotions'; 'I have a good reason to be depressed'; or, 'It is something that just happened to my brain chemicals and I have nothing to do with it.'
Now you can appreciate why I do not usually encourage medication (exceptions noted above). If you ascribe the improvement of your emotional life to the pill, you do not learn anything about how to avoid the same mental habit "hole" next time. Clients who tolerate the intense discomfort and anguish of depression or anxiety-- because,face it-- depression and anxiety are quite unpleasant, realize that when their moods and their thoughts begin to change, their depression or anxiety begins to lift and they are the ones making that happen. It is empowering to know that we are able to direct and manage our emotions... and thus ourselves.
