Quick Summary
Medication is one of two main treatments for depression; psychotherapy is the other. For mild to moderate depression, therapy alone is often enough. For moderate to severe depression, treatment guidelines generally support combining medication and therapy, and medication can make it possible to engage in therapy when depression is at its heaviest. Therapists do not prescribe; physicians, psychiatric nurse practitioners and psychiatrists do. At Creative Healing in Chippewa Falls, we help you think it through, coordinate with your prescriber when you give permission, and provide the therapy side. Decisions about starting, changing or stopping medication always belong with you and your prescriber. Call or text 715-797-2770.
Table of Contents
People ask us about medication almost as often as they ask about therapy, usually with some worry attached: will I need it, will it change me, does taking it mean I have failed. This guide answers the questions we can answer as therapists, and is clear about the ones that belong with a prescriber.
When medication is considered
Medication is more likely to be part of the plan when depression is moderate to severe; when it has lasted a long time or recurred; when it is affecting the basics (eating, sleeping, getting out of bed); when there is a family history that responded to medication; or when someone is too depressed to engage in therapy yet. It is less often the first step for mild depression or depression clearly tied to a specific situation, where therapy alone is usually recommended first. None of this is a rule. A prescriber weighs your history, symptoms and preferences.
Why therapy and medication work together
They do different jobs. Medication acts on the biology of mood, which can lift the floor enough that a person can think, sleep and act again. Therapy changes the patterns (thinking, behavior, relationships, unresolved experiences) that drive depression and, importantly, that predict whether it comes back. For moderate to severe depression, the combination generally outperforms either alone. Many of our clients start therapy while waiting for a medication to take effect, which typically takes weeks, and find the skills carry them through that stretch.
What a therapist can and cannot do
- Can: assess how severe your depression is and whether a prescriber conversation makes sense; help you understand the options in general terms; help you prepare questions; coordinate with your prescriber when you give written permission; track how you are doing between medical visits.
- Cannot: prescribe, recommend a specific medication or dose, or advise you to stop or change what you take. If your therapist ever notices something that needs medical attention, we will say so and point you to the right person.
Preparing for the conversation with a prescriber
If you are considering medication, a short list makes the appointment more useful:
- What your symptoms are, how long they have lasted, and what they are affecting
- Anything you have tried, including past medications and how they went
- Other medications, supplements and substances you use
- Family history of depression or of medication response
- Your own priorities and concerns (side effects, cost, how long you might take it)
- Questions: how long until it works, what side effects to watch, how you will know whether it is helping, and what the plan is if it is not
Your therapist can help you build this list. Your primary care physician is often the first stop; a psychiatric provider is appropriate for more complex situations.
What the therapy side looks like
Whether or not medication is part of your plan, the therapy work is the same: understanding what is driving the depression and changing it. At Creative Healing that includes CBT and behavioral activation, EMDR when depression is rooted in loss, trauma or long-held beliefs, parts work, mindfulness and expressive approaches. Our guide to types of depression therapy explains each, and what to expect from depression therapy walks through the first weeks.
Getting help in Chippewa Falls or Eau Claire
If you are having thoughts of ending your life, call or text 988 now or go to your nearest emergency room. Otherwise, call or text 715-797-2770 for a free 20-minute consultation with our therapists; we will help you figure out the right next step, including whether a prescriber conversation makes sense. We accept most major Wisconsin plans; see rates and insurance.
Ready to talk to someone?
Creative Healing Mental Health Center offers a free 20-minute phone consultation. Call or text 715-797-2770 or send us a message. We serve Chippewa Falls, Eau Claire and the Chippewa Valley from our office at 1791 County Highway OO, Chippewa Falls, WI 54729.
Frequently asked questions
Do I need medication for depression?
Not everyone does. Many people with mild to moderate depression improve with therapy alone. For moderate to severe depression, guidelines generally support combining medication and therapy. The decision is made with a prescriber, based on your history, severity and preferences.
Can a therapist prescribe antidepressants?
No. In Wisconsin, medication is prescribed by physicians, psychiatric nurse practitioners, physician assistants and psychiatrists. Therapists provide psychotherapy and coordinate with prescribers when you give permission.
How long do antidepressants take to work?
Most take several weeks to show their full effect, which is one reason therapy is valuable during that period. Your prescriber will tell you what to expect for the specific medication.
Will I have to take medication forever?
Not necessarily. Duration depends on your history and how you respond. Any decision to reduce or stop belongs with your prescriber; stopping abruptly can cause problems.
Can I do EMDR or therapy while on medication?
Yes. Therapy and medication are commonly combined, and medication often makes it easier to engage in therapy when depression is severe. Tell your therapist what you take so care can be coordinated.
This article is for general educational purposes and is not a substitute for individualized care or medical advice; decisions about medication belong with you and your prescriber. If you are in crisis, call or text 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room.