Counseling in Tokyo

Do I have to take psychiatric medication?

The simple but seemingly vague answer is "preferably no and preferably yes".

Some persons have some feelings of anxiety and depression as transient responses to some clear stress. These are not “illnesses", however, because they only last a short time, usually they get much better in a few weeks. These persons will usually recover quickly with some support and counseling, and time put between themselves and the stressor. These persons usually do not need antidepressant medication, although on occasion they can’t sleep and thus do not function well at work-they may benefit from a short course of a sleep medication.

Some persons have certain mental schema about themselves that you can call a "core issue", that constantly nags the person and causes anxiety or some low feeling. For example, feeling inadequate, feeling unloved or unwanted, etc. These phenomena usually do not require medication but can be helped with psychotherapy. Persons also often use psychological defenses to protect themselves from the bad feelings of these core issues, like bragging, being too competitive, avoiding people, or becoming too desperate in relationships, etc. If the defense is too maladaptive, then this can lead to troubles like few friends, stressful relationships at work or in one’s private life etc., leading secondarily to feeling anxious and/or depressed. These phenomena usually do not require medication but can be helped with psychotherapy.

If, however, ones depression becomes severe, either as a continuation of the situations described above, or with no clear precipitant or cause, and if the depression is effecting ones life for many months in such a way that they can not function at work or in relationships, and/or they can not eat or sleep well, they can not concentrate, they may feel life is not worth living anymore, etc.-for these persons it is preferable, and sometimes life-saving, that they take antidepressant medication to get out of the depression. No one should ever take medication, however, that does not work or that has any side effects, and if these occur one should confer with their physician about stopping or changing their psychiatric medication.

For mild or moderate depression, psychotherapy and other non-medical interventions may be of benefit. These interventions may include using certain supplements, special exercises, and biorhythm therapies. The Counseling Tokyo staff is familiar with these interventions and uses them in appropriate cases.

A challenge to the therapist's recommending medication evaluation is that as these illnesses effect identity itself. Accepting medication means the person also needs to accept some personal weakness, and that is not an easy task for someone who is already feeling low because of the illness itself.

Counseling Tokyo makes all efforts not to recommend medications, but if absolutely necessary, the Counseling Tokyo staff can provide you with information and make recommendations to you about medications for depression of anxiety. If you decide to go to a licensed physician to receive medications, either in Japan or elsewhere, the physician who writes the prescription (or dispenses the medication) is naturally responsible for that aspect of your care. Counseling Tokyo can refer you to a number of Japanese and foreign medical doctors for medication if required.

Counseling Tokyo strongly advises that one only use medications while under the care of a licensed prescribing physician, and to consult with that physician in all instances regarding side effects, missed doses, dose changes, stopping medications, and any other aspect of medication treatment or medical care.

Counseling Tokyo provides counseling, support, and advice, for both the international community in English, as well as the local Japanese community in Japanese.