Some patients with depression or sleep disorders will often ask me whether it is better for me to be medicated or unmedicated for this condition. Others will openly say that they do not want to use medication and only want to receive psychotherapy. Or they think that psychotherapy is useless and that it is impossible to cure without medication. And such misconceptions actually exist to a greater or lesser extent even among psychiatrists themselves. In the past, a significant proportion of psychiatrists were divided into “two schools of thought” – the biological school (the mainstream in mainland China) preferred medication and did not recognize the role of psychotherapy, while the kinetic school was more inclined to explore the psychological dynamics of the patient, to the extent that hallucinations would be treated as psychological. The kineticists, on the other hand, are more inclined to explore the psychological dynamics of the patient, so much so that they will analyze hallucinations and delusions as internal projections and refuse to give medication. Of course, more and more psychiatrists are learning to “walk on two legs,” training in both psychopharmacology and psychology and using a combination of techniques in their work, which can provide patients with more avenues for recovery and better outcomes. What is the role of each of these two types of treatment? 1, medication: Psychotropic drugs are a class of drugs that act on chemical transmitters in the central nervous system to alter the thinking activity of the human brain. Sounds pretty scary ha! As if the drug can control the human mind as well. Actually not, because the current medical development is not so precise to find which nerve represents what you are thinking. Pharmacologists have only discovered that the background state of mind like depression in depression, insecurity in schizophrenia, etc. is related to chemical transmitters like pentothal and dopamine, and when drugs are used to increase or decrease the concentration of the corresponding transmitters in the synaptic gap of central nerve fibers, this background state of mind will be changed and the corresponding hallucinations and delusions of depression and schizophrenia can be relieved. The same principle is used in the development of various other drugs. Therefore, various antidepressants, antipsychotics, emotion stabilizers, anxiolytics, etc. were created. So, the drugs are skipping the external causes that produce the emotions and altering brain function directly by chemical means. Some patients can tell me very clearly how they feel after taking the medication – the things that upset them are still there, but their low mood has been lifted up by the medication. In the eyes of traditional doctors, such treatment is considered to be in place. “In the past, you were deep in the mire of depression and couldn’t get out, and now that I’ve pulled you out, it’s up to you to fix the rest of the mess in your life.” However, there is also a significant portion (in fact, the majority in the contemporary urban population) of patients who, even with improved mood, are still unable to resolve many of the distractions in their lives. I would make this analogy: many of life’s problems, including some patients’ own personality base is itself will produce depression, just as a fertile ground will grow weeds, antidepressants are like herbicides, although the weeds are removed, but as long as the character is still there, then the drug once the weeds will continue to grow. This makes it seem that many patients simply can not leave the drug. Some patients may mistakenly believe that this is their dependence on the medicine, and as a result, they are caught in a dilemma: they are afraid to take the medicine for fear of addiction, and they are afraid of being haunted by depression if they do not take the medicine. So well, psychotherapy comes in handy at this point. 2, psychotherapy: psychotherapy is actually more ancient than drug therapy. Classical psychoanalysis has a history of more than 100 years, but the world’s first anti-psychotic drugs – Thorazine was introduced in the 1970s in the past without anti-psychotic drugs, psychiatric patients either to accept the complex to understand the psychoanalysis, or be confined in a mental hospital They were either subjected to unintelligible psychoanalysis or confined to psychiatric institutions to “carry” their symptoms. This also gave the older generation of psychiatrists the impression that “psychotherapy is useless. In fact, this is really a mistake to psychotherapy. The key reason is that psychotherapy must be based on the patient’s “self-awareness” and “desire for self-change” in order for it to work. Unlike medication, I can forcibly change the chemical environment in your brain, regardless of what you think. But psychotherapy is more humanistic than medication. Once medication is started, both the doctor and the patient begin to focus on the improvement of symptoms and the side effects of the medication, ignoring the fact that “in the field of psychiatry, there is a deep psychological meaning behind every symptom”. Psychotherapy is a personalized service that brings the doctor and the patient closer together. Through intensive one-on-one communication, we understand, empathize and clarify the actual causes of the patient’s psychological problems. Compared to medication, in which the patient has no say, psychotherapy is more like the patient’s active participation and the doctor is more like a close friend guiding, analyzing, and sometimes even studying the patient’s problems together. The results achieved by such treatment are the result of the patient’s personal adjustments, which are far more important for the patient’s gains than the medication. In a word, medication is a way to let someone else solve the problem for you, but if there are too many problems and too much stress, medication does have the effect of quickly reducing the symptoms. But there are also times when we just alleviate the symptoms without solving the problem, or even expect too much from medication when we have many problems of our own but absolutely no motivation to change ourselves. Psychotherapy is solving the problem yourself with the support of others, and if the symptoms are largely under control, you may need to receive psychotherapy along with medication if you want to get rid of the problem completely in your life. So in this way I would say: if you want to shorten the treatment cycle and not rely on medication for so long, then psychotherapy might be a shortcut if you want. Some studies have found that natural recovery from depression progresses much more slowly without psychotherapy than with psychotherapy (perhaps this time is 5:1). Of course, psychotherapy is not as clear-cut as the medication cycle, for example, when a patient starts psychotherapy and asks me, “How long do we need to do this? I always think at first that the process may take a year, but in reality it doesn’t seem to take that long (maybe six months or even three months) for the patient’s mindset to change so significantly that he can cope with his life independently in a short time without the support of a psychiatrist. I often say to my patients, “Don’t expect drugs to solve all your problems, otherwise, the problems of modern society are too easy to solve, no matter if you are corrupt or a criminal, you can just take two pills to solve them.” Yes, what drugs can really improve is the symptoms, but not all of you. We also need to be brave enough to face our actual troubling problems and solve them, which is the way to self-growth and self-healing.