People often seem to have their minds made-up in advance about how they need to be treated.  Some want a pill and are very hesitant to seek therapy.  Others don't like to take pills and will resist any suggestion that a medication might be helpful.  In an earlier article I discussed the tendency of providers to use the tools at their disposal, even if that's not what's best for the patient.  This time the subject is the bias that patients bring to treatment.

As a psychologist I generally work with people who don't mind seeing a psychologist.  (Duh.)  Many of these people also take medications - for depression, for bipolar disorder, for a thought disorder such as schizophrenia, or for anxiety.  Others don't need medications, and some could probably benefit, but they resist a referral to a psychiatrist.  Some patients even resist talking with their family doctor about medications.

I was caught off-guard by a conversation with a psychiatrist one day.  She mentioned to me that she had referred a patient to me for therapy, but that the patient was resisting seeing a therapist.  This patient would rather take pills than talk with someone about his problems.  

Medications are essential in the effective treatment of schizophrenia and bipolar disorder.  Psychotherapy, on the other hand, is the primary treatment for post-traumatic stress disorder, borderline personality disorder, and dissociative disorders.  A number of studies suggest that both antidepressants and psychotherapy are effective treatments for depression.  In many cases a combination of the two seems to be more effective than either alone.  Similar results have been found for anxiety, OCD, and other disorders.  It's possible that one treatment is likely to be more effective than the other for a particular person, but the art and science of mental health are not far enough advanced to accurately predict which treatment will be more effective for which person.

Why do people have such strong preferences for either medications or therapy?  I'm not aware of any research on the subject.  If you have such a strong preference I'd love to hear about it.  Keep in mind that a prejudice against one or the other may be limiting your treatment.  I strongly recommend that you keep an open mind when a health care provider recommends medications or therapy.   Both can be effective, and sometimes they are even more effective together.