The Meds-Therapy Chat: A Psychiatrist’s Perspective

by | Jul 10, 2018

Is there a cure for depression

The meds-therapy chat has gone on seemingly forever. And with so much at stake, why not? I mean, mood and anxiety disorders hurt – deeply. So who wouldn’t want to know which of the two work better, faster? Hmmm, if you ask me it’s time to consider a psychiatrist’s perspective. Let’s go…

As physicians, we must guide our patients in the knowledge that medication alone is not a treatment, it’s simply a mask…

Psychiatrist Laura Dabney, MD dropped me a line a couple of weeks back asking if she could contribute to Chipur. I gladly took her up on the offer and we quickly agreed upon a topic: the meds-therapy chat.

To best address the issue, I’m bringing you the bulk of two articles written by Dr. Dabney. And, of course, I’ll be sticking my two-cents in here and there.

Now, we’re going looong here, so get comfy. I think you’ll find Dr. Dabney’s perspective relevant and interesting. Heck, you may even find it controversial.

Oh, almost forgot. Dr. Dabney practices in Virginia Beach, VA and has been at it for some twenty years. She’s board certified in psychiatry and has been featured on radio and in print media, and she consults for a number of institutions, including the Virginia VA Medical Center. Dr. Dabney’s practice includes meds evaluations, therapy, and coaching. Live & Online Skype sessions are available.

Alrighty, then. Your dime your dance floor, doc…

“The Problem with Medicating Our Problems”

Meds or Therapy

Dr. Laura Dabney

Psychiatric drugs have, for decades, benefited the seriously mentally ill and eased the suffering of millions. And psychopharmacology, the study of these drugs’ effects on the brain, has enabled numerous life-changing treatment options.

Yet, despite these advances for the field of psychiatry as a whole, the idea of throwing pills at our problems has been proven ineffective, and its time is coming to an end.

Psychiatric medications are so regularly prescribed that one of the questions most often asked of me by new patients is how long I need to talk to them before writing a prescription.

They expect the same experience in my office that so many have had with other doctors in the past – they feel unsettled, they seek help, they get pills. And while prescriptions may offer temporary relief of symptoms, patients are not always aware that they also come with very serious risks.

The Psychotropic Downside

Patients need to know that psychiatric medications may cause alarming side effects. As a medical doctor and therapist, I have seen first-hand the harmful effects of our dependence on medication for resolving emotional issues. Counter to current treatment trends, the use of medication alone increases the duration, and sometimes the intensity, of common emotional problems.

Often, medication simply mask the symptoms, a course of treatment that would be deemed unacceptable in any other field of medicine. For example, few people would be satisfied to treat the headaches caused by a brain tumor with ibuprofen alone. Rather, we would seek to eradicate the problem at its source.

The same should be no less true for our emotional health issues because, unlike acute mental health conditions such as schizophrenia and some bipolar disorders, common complaints such as anxiety and depression are often not based on biology. And yet, most patients seeking help for these conditions are being treated with biology-altering pharmaceuticals. The condition clearly does not warrant the intervention.

The Most Effective Treatment

The most effective course of treatment, by far, is what I have used with patients in my practice for nearly twenty years: psychodynamic therapy.

To treat the real source of emotional problems, we must discover its source, a process to which therapy is expertly suited. With the right guide, a patient can be led to discoveries about their history, their beliefs and their feelings, all of which, in turn, affect the success of their daily lives and relationships.

When we discover how we got to today’s state, we can change the path towards tomorrow.

Despite being an MD, I avoid prescribing medications as often as I can, and when they are necessary, I use them very cautiously. As physicians, we must guide our patients in the knowledge that medication alone is not a treatment, it’s simply a mask.

Okay, people, Bill here. This is the perfect time to once again bring you the words of M. Scott Peck, MD from his must-read book, The Road Less Traveled. So special are these words to me that I wrote them on an index card many moons ago and keep it in my wallet…

The symptoms and the illness are not the same thing. The illness exists long before the symptoms. Rather than being the illness, the symptoms are the beginning of its cures. The fact that they are unwanted makes them all the more a phenomenon of grace – a gift of God, a message from the unconscious, if you will, to initiate self-examination and repair.

Let’s move-on to Dr. Dabney’s second article. In my mind, it’s the perfect example of her treatment philosophy…

“A Runner Who’s No Longer Running Away” (Tricia’s Story)

Is there a cure for depressionTricia was in her fifties by the time she sought my care, though not because she’d been procrastinating. She’d been trying to get help for decades, having started and stopped treatment with practitioners up and down the east coast for nearly thirty years.

“I’d seen a number of people…from psychiatrists to psychologists to religious people,” she says. “And you know, I never got through to where I did with Dr. Dabney. She just helped me, like, work it through to the end.”

Led By a Suicide Attempt

It took a suicide attempt with a handful of pills to get her into my office, but once there, Tricia unraveled the story of a childhood filled with physical and sexual abuse and parental neglect. Her childhood experiences were so extreme, they warped everything she saw, everything she did, and her relationships with everyone she met.

“What Dr. Dabney helped me see was that I was not letting go of my past.”

She recalls a session when, wracked with emotion, she asked me if it was ever going to be possible to feel better. “She just looked at me like, ‘Would I be doing this if it wasn’t?'”

Today, Tricia says everything is different. “My personal life, my relationship with my husband, with my children, with people at work…I feel like I’m much more open with myself and with others, as a result.”

Nor is the past able to control her any longer. While running away was, for decades, the only way she says she knew how to deal with emotion, she now has control over her life.

A devoted runner who hits the trail every morning, she says, “I’ll be running down the path and my thoughts will drift to my parents or to something in my past and, literally, I stop my thoughts. I say, ‘Go away, I don’t want you.’ And that’s it.”

That’ll Do It

Absolutely, the meds-therapy chat will go on and on, as, yeah, there’s so much personally at stake for those of us enduring a mood or anxiety disorder. And, of course, our opinion, and how we’ll behave in kind, will be grounded in our collections of informed perspective.

I appreciate yours, Dr. Dabney…

Hey, be sure to head over to Dr. Dabney’s site and check-out her work and services.

And speaking of perspective, find all sorts of it in hundreds of Chipur articles. Isn’t it time to review the titles?


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