Choosing the Best Mental Health Treatment Plan

Do I take medication or should I talk it out? Which treatment is right for me? Whether it’s an effort to make a New Year’s commitment to self or because life has been so full of burden, attending to one’s emotional or psychological being is a good idea. But with the mass of information readily available via the internet, choosing the right path for dealing with these issues can be daunting. And face it, scary. Many people do not trust medications and others don’t buy into the idea that “just talking” to someone like a mental health professional would yield positive results. Many potential clients can’t shake the fear that they will be judged by the therapist after disclosing intimate details and vulnerabilities. Some are turned off by the idea of “getting treatment” – it can make us feel vulnerable to believe we need support in navigating our own emotions and decision-making. Some may have strongly-held religious or spiritual beliefs that create a disagreement or discomfort in taking medications. In certain cultures, allowing an “outside” person to know such intimate details of one’s life is seen as highly inappropriate. For many people, coping with life’s stresses can be done without the help of a professional. But for many others, it is a preference or becomes a necessity to involve helping professionals. And when all is said and done, one might question why both options are even available – surely there’s just one best way, right? If only it were that simple.

Simply put – because we are such complex creatures, sometimes both medications AND “talk therapy” are needed. And then again, not always. For certain situations, even more detailed options (other than medications and talking/counseling) are available. When trying to help clients understand their options and needs, I use an analogy of the ocean and a boat. Hopefully, you will find it useful in helping you make the important choice of how to utilize mental health treatment to better your quality of life. Let’s take a look at the 3 most common options for pursuing mental health (or behavioral health as it is sometimes called) treatment. Please know that these options (especially the ones involving medications) should always be discussed with your primary care physician or a psychiatrist (a physician specializing in medications for mental health issues) in order to proceed in the most medically responsible, and safest way, for you. And while these options certainly do not exhaust the choices one may have for addressing a particular need, my hope is that it is a starting point.

This analogy includes the following 2 pieces:

– the ocean which represents the chemistry inside your brain/body that is uniquely yours. It flows like no other.

– the boat you row – this represents your coping skills – those thoughts and behaviors that you use in order to deal with the daily and sometimes unique stresses and situations that you face each day.

First, imagine that you have excellent skills for rowing a boat. Your calm ocean allows you the chance to row across it to all destinations (good or at least tolerable) toward outcomes with which you can live. But, imagine that there is an unexplained storm in your ocean creating an upheaval that would capsize boats navigated by even the most skilled boatsmen. Until that storm is calmed no amount of rowing skill will allow you a desirable outcome. Sometimes for reasons too complex to explain here, we need our sea calmed. This is where taking certain medications may balance the chemistry inside you so that you can carry out the simplest of life functions (sleeping, working, making decisions) with the least amount of challenge. And all the rowing lessons in the world won’t help. Perhaps only medication prescribed by a physician will serve the need to calm your sea. In fact, there are various chemical combinations that nearly always require medication in order to create improvements, for instance, certain thought or mood disorders in severe conditions.

But what if, most of the time, your ocean appears calm (you’re able to carry out most of your major roles in life just fine), but you find yourself needing a few “rowing” lessons to navigate a particular situation (divorce, losing a job, recovering from abuse, making major decisions). This is where traditional “talk therapy” may be the answer. Perhaps you just need to empty the boat of painful thoughts and feelings that are flooding you and threatening to capsize your means of navigating life. “Talk therapy” is not just a comfortable or simple conversation with another person, although a skilled clinician can make it comfortable enough for most clients. It is structured by the licensed clinician (psychotherapist or counselor) in such a way that you can learn more effective ways to think and behave so that you can function in a manner befitting your life’s best interests. If you are fortunate enough to find a skilled therapist with whom you feel a great connection, these structured conversations may actually feel like dialogue with a trusted confidante. But know there is always the goal of teaching you the “rowing” skills you need to cross that body of water called life. With sufficient rowing skills, you may be just fine without medication.

There are some people challenged by the unfortunate combination of a storm in their sea of chemistry while also struggling to develop the thinking skills and actions that may be necessary to navigate the rough waters of stress and change that can come with even the most trauma-free life. For this group, a combination of medication and traditional talk therapy may be the best decision.

There is no blanket answer to the question of which treatment options are the best. Everyone’s chemistry and life situations are the same in some ways and yet different enough to warrant special consideration. If you’re faced with the decision of which way to turn – medication versus “talking” it out – you can visit a physician or licensed mental health therapist to discuss your options. In most all cases, there is a good fit for treatment that can help you gain the quality of life you seek or recover from challenging events in your past and present. Which one is right for you is always a talk worth having.

Note: The information provided in this article is not intended as a substitute for visiting face-to-face with a licensed medical or mental health professional.  Should you feel in need of professional assistance, please call 911 or visit your local emergency room or family primary care physician.

For more information on how to schedule an appointment with me in the Winston-Salem, NC area, you are welcome to visit my website at

About L. Chris Cannida

I am a licensed professional counselor practicing in Oklahoma.
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