If I See a Psychiatrist, Do I Have to Take Medication?

This is Dr. David Baldes, a board-certified psychiatrist practicing in the state of Minnesota, accepting patients in person and on telehealth. You can find me at davidbaldesmd.com. Today I want to talk about the question that comes up: If I see a psychiatrist, do I have to take medication? I don't want to be on those psych drugs.

And it's important to understand that the current divide in care where psychologists and therapists provide the assessment and therapy and psychiatrist provides med management is an artifact of the managed care era of insurance and it doesn't reflect the origin of the psychiatric specialty nor does it reflect the training the psychiatrists actually receive.

And so psychiatrists are trained in the comprehensive assessment, diagnosis, and management of mental illnesses. And so that will and can include medication treatment, but almost always involves psychotherapy. And in the context of a medication management relationship, a psychiatrist might provide brief psychoeducational psychotherapy, but psychiatrists are trained specifically and authorized to provide longer-form psychotherapy like hour-long sessions using a variety of different approaches including supportive therapy, cognitive behavioral therapy, psychodynamic therapy, and oftentimes they use an eclectic approach that is a hybrid of a variety of therapeutic modalities tailored to the specific needs of the patient.

So when you're going to see a psychiatrist, it's important to understand that you absolutely will not be forced onto medication, at least not with me. Medication is one tool among several tools and whether or not it makes sense to add a medication to your life is a decision that we make together with you as the expert on your experience, on how you feel, on your priorities, and on your values. And so, you know, as we've discussed previously, there are two experts in the room, and all the action happens with the patient.

So if you decide that you don't want to make the step of taking medication, that's absolutely fine. And you may find that a psychiatrist is useful even for careful monitoring of symptom presentation or refining diagnosis or perhaps providing the primary psychotherapy with the option to revisit medication later down the line.

If medication is on the table, the next important questions that really need to be addressed is why specifically this medication, what to watch out for, and how will we know that the medication is helping. We'll talk more about how psychiatrists identify appropriate medication treatment and tailor that to particular patients' needs in a later video.

Now this is general education. It's not a recommendation for or against medication for any given person. If you already have a clinician, you work with them because they know your history and can guide you appropriately. In my practice most patients take medications but no patients are obligated to take medications and many have the goal of working their way off of medications over time.

So you can learn more about how I work at davidbaldesmd.com. If you're interested in scheduling with me, there are resources there. Again, I'm based out of Duluth, Minnesota and also provides telehealth services across the state of Minnesota. Thank you.