What Medication Can and Can't Do

We need to talk about psychiatric medication without the bullshit. No pharma company sales pitches, no anti-med conspiracy theories, just what these things actually do.

First, what medication can do:

Medication can reduce symptoms. If your depression is making it impossible to get out of bed, medication can help lift that enough that you can function. If your anxiety is so overwhelming you can't leave the house, medication can turn down the volume enough that you can start practicing skills.

Medication can stabilize brain chemistry that's genuinely out of whack. Some people's brains don't make enough serotonin or dopamine or whatever else. Medication can help with that. It's not a moral failing. It's just biology.

Medication can give you space to do the actual work. When symptoms are overwhelming, it's hard to practice coping skills or make changes or do therapy effectively. Medication can create enough breathing room to actually engage with treatment.

Medication can be life-saving. For people with severe depression, bipolar disorder, psychosis, or other serious conditions, medication isn't optional. It's necessary.

Now, what medication can't do:

Medication can't fix your life. If your life situation is making you miserable (shitty job, toxic relationship, chronic stress), a pill isn't going to fix that. You've still got to address the actual problems.

Medication can't teach you skills. It can't teach you how to cope with anxiety, communicate better, set boundaries, manage stress, or any of the other skills you need to function well. You've got to learn those.

Medication can't make you a different person. It's not going to transform your personality or magically make you happy. It treats symptoms, not your entire existence.

Medication can't replace the work. You still have to show up to your life. You still have to make different choices. You still have to practice new patterns. Medication can support that work, but it can't do the work for you.

Here's what I tell people: medication is a tool. It's useful for some people and not for others. It can make treatment more effective if you need it. But it's not a solution by itself.

The people who do best on medication are the ones who also do the other work. They take their meds consistently, but they also go to therapy, practice skills, make lifestyle changes, and address the life circumstances that are making them miserable. The medication supports all of that, but it doesn't replace it.

The people who struggle are the ones who take medication and expect it to fix everything without doing anything else differently. They wait for the pill to make them happy while keeping everything in their life exactly the same. That doesn't work.

So should you take medication? Maybe. It depends on what you're dealing with, how severe it is, what else you've tried, and what you need to function. That's a conversation to have with someone who knows your specific situation.

But go in with realistic expectations. Medication can be incredibly helpful. It's not a magic fix, and it's not going to do the work for you.

We prescribe medication when it's appropriate. We also tell people when we think they can address their symptoms without it. We're not trying to medicate everyone, and we're not anti-medication. We're just trying to figure out what actually helps.

If you're on medication and it's not helping, tell your provider. If you're on medication and the side effects are worse than the symptoms, tell your provider. If you're on medication and it's helping but you want to try managing without it eventually, tell your provider.

And if you're not on medication but you're barely functioning and can't engage with treatment because your symptoms are so overwhelming, consider trying it. It might give you the space you need to actually do the work.

Medication is a tool. Use it wisely.