The Side Effects of Psychotherapy

The other day I posted a YouTube video by the American Psychological Association (APA) extolling the virtues of psychotherapy. Here’s another video with a similar message: namely that psychotherapy with a licensed psychologist is an effective and safe way to treat depression, anxiety, and other mental health issues.  The bonus is that it doesn’t have the side effects that medications do: no dry mouth, too-much-caffeine feelings, sexual problems, to name some of the most common.  Here’s the clip:

As I noted previously, I am a big fan of APA, but don’t totally agree with the assertion that there are no side effects of participating in psychotherapy other than a better, healthier life.  While I certainly believe that can be true, it is also true that some people notice that their mood goes down a bit before improving when starting psychotherapy.  The thought behind this is that sometimes unhappy, painful memories are discussed in the therapy session.  Sometimes “stirring the pot” of sad experiences, emotions, etc can have the “side effect” of causing a low mood.  Of course the hope is that new, healthier coping strategies will be learned and improved mood will soon follow.

Overall these videos are awesome – I love the message!  Just thought I would point out that while psychotherapy is an under-utilized and highly effective treatment option, it is not entirely without a downside.

Antidepressants, Therapy, Side Effects, and Efficacy


CNN’s The Chart is one of my favorite blogs.  I particularly look forward to Tuesdays when Dr. Charles Raison writes about the world of mental health and

Photo by JasonTromm

psychiatry.  A couple of weeks ago Dr. Raison responded to a question about the safety of long-term antidepressant use. Dr. Raison did a much better job than I can describing the recent findings on antidepressants, including their long-term use, use  in pregnancy, and their effectiveness compared to placebos.  What he didn’t write about (and he usually does) is how psychotherapy is used in treatment of mental illness.

Obviously, given my chosen field, I am a believer in the power of mental health counseling and psychotherapy.  While I am not at all anti-psychiatric medication (far from it) I do believe that no conversation about antidepressants is complete without at least a brief mention of psychotherapy.  The reason is that psychotherapy/counseling (the terms are interchangeable) are a crucial part of the treatment plan for all forms of mental illness that I know of.  Schizophrenia, depression, ADHD, bipolar disorder – they can all be helped by psychotherapy.  In fact, the latest research tells us that therapy is just as effective as medication (if not more so) for many mental health disorders.  Research also suggests that a combination of therapy and medication is the best course of treatment for several diagnoses including many types of anxiety and depression.

Other than being highly effective, perhaps the coolest thing about psychotherapy is its lack of side effects.  We’ve all heard the list of unpleasant side effects that can be experienced on psychiatric medications (sexual problems, stomach upset, headaches, etc).  But therapy’s list is comparatively short.  In fact, some would argue there are no negative side effects at all.  I’m not sure I’d go that far (for example, sometimes talking about painful experiences can be tough and cause thoughts about these experiences to increase in the short term), but I agree that the risks of therapy are dramatically lower than for medication.

With therapy’s efficacy and lack of negative side effects in mind, it makes sense why it should always be included in any discussion of mental health treatment.