According to ADAA (2016), Anxiety and Depression Association of America, anxiety disorders

are the most common mental illness in the United States (2016). They affect 40 million adults

age 18 and older, equal to 18% of the population (Anxiety and Depression Association of

America, 2016). Although anxiety and depression are treatable, only about 1/3 of those suffering

receive treatment or it. Of those with an anxiety disorder, are three to five times more likely to go

to the doctor and six times more likely to be hospitalized for a mental disorder (Anxiety and

Depression Association of America, 2016). There are many reasons why an individual may not

seek therapy for their anxiety. With all of the easy options of various prescriptions offered on the

television it almost takes psychotherapy out of the picture completely. With the added social

stigma, or cultural stigma, add the fear and shame, this is a perfect mix to keep an individual

clear from therapeutic treatment (Anxieties, 2016). With possible lack of insight and/or having

limited awareness of their illness, can also lead a client into the belief that there is no need for

therapeutic treatment, that all they need is the magic pill on television which says it will get rid

of all of their symptoms, and a promise to do so quickly. There is a time for medication

treatment, and for therapy. And often times the medication is not necessary or would actually be

a hindrance to the client’s treatment, as will be shown in the following. Only after a careful

interview and assessment of the client, their goals and severity of symptoms can any

psychotherapy and pharmacotherapy be determined (DeRuebls & Hollen, 2002).

When a client decides on treatment they are faced with many challenges. They are often

confused, scared, and uncertain of their future. Battling the symptoms of their mental illness and

the impact it has had on their life can be intimidating. When coming in for treatment many

clients just seek the “quick fix” of a prescription medication to alleviate the symptoms. This may

help with some of the symptoms but it does not help the client with understanding their disorder,
and with other treatment options. It is difficult for some client’s to for see a future with therapy

sessions, short term or long term. Taking medication is easier to hide and to cope with. With

therapy there is much more a client has to face. The have to face the reality of family and friends

learning about their disorder, and possibly their employer. The client also has to be willing to

invest in him or herself, and commit to doing the work necessary for successful treatment.

Whether this includes medication along with the therapy or not.

Psychotherapy is known to be an effective treatment for many psychological disorders.

Cognitive Behavioral Therapy (CBT) and pharmacology treatment combined has shown

significant improvements in adults, according to Massachusetts General Hospital (Norqvist,

2010). A team, at Massachusetts General Hospital tested adults (86) with medication combined

with 1-on-1 sessions of CBT. The study showed there is greater improvement of symptoms than

compare to a client who has only the medication (Nordqvist, 2010). But the average person seeks

out medication before therapy to alleviate their symptoms. Consumer Reports states that in a

1994 survey of their readers only 40% of those who sought care for any type of mental health

problem received medication compared with 68% in the current survey and 80% of those with

depression or anxiety (Consumer Reports, 2016). This number reflects the fast growing sales of

antidepressant drugs over the past decade (Consumer Reports, 2016). This can be for various

reasons. For example, psychotherapy works at a different pace then medication. Of the same

study done by Consumer Reports, those who responded and took prescription medications alone

did improve substantially in just a few visits (Consumer Reports, 2016). Yet, those who received

only psychotherapy had gradual improvement, but their improvements were not as successful in

the short term as those with prescription treatment alone. But the longer they stayed with therapy

the outcome was better than those who only received medication. Consumer Reports also found
that the most successful were those who received both psychotherapy and medication treatment

(Consumer Reports, 2016). This future counselor believes that the increase in the use of

medications over psychotherapy can be attributed to the media and the many prescription

advertisements, which are shown on a regular basis. Any amount of time watching television and

you will be witness to ads for heartburn, for bi-polar, depression, or anxiety, and the supposedly

best prescription available on the market. Unfortunately, with no mention of the benefits of

psychotherapy in conjunction with the medication. The vast majority of people seeking treatment

for depression and anxiety prefer medication to therapy by a ration of 3 to 1 (McHugh, Whitton,

Peckham & Wedge, Utto, 2013).

For the treatment of anxiety, the use of medications can help to ease symptoms caused by

mental health issues. Yet, medication does not cure mental illness, it can assist in managing the

symptoms and their severity (Wilson PhD & Guerra, PhD, 2016). It may also be necessary at

times, for the client’s stability and safety. When a client is struggling with anxiety and/or

depression, the use of medication can help to stabilize a client. It can allow the client to focus on

the therapy, without symptoms interfering. Clients may be prescribed one or any of these

medications, which have been found to be successful in the treatment for anxiety:

Benzodiazepines, Beta Blockers, Tricyclic Antidepressants, Monoamine Oxidase Inhibitors

(MAOI’S), Selective Serotonin Reuptake Inhibitors (SSRI’s) (Wilson PhD & Guerra, PhD,

2016). Benzodiazepines are a class of widely prescribed medication, which have rapid, anti-

anxiety and sedative-hypnotic effects. The four most commonly prescribed for the treatment of

anxiety disorders are, diazepam (Valium), clonazepam (Klonopin), and alprazolam (Xanax).

Studies have shown that they are effective in reducing anxiety symptoms in 70%-80% of patients

(Anxieties, 2016). Benzodiazepines are preferred since they are fast acting, and there is not a
tolerance in the anti-panic or other therapeutic effects (Anxieties, 2016).

Of the 26 randomized research studies conducted involving CBT and medication

treatment, there have been limitations (Talbot MD PhD, & McMurray, MD, 2016). It has been

suggested CBT and medication may have differing effects across anxiety disorders. Preliminary

data has shown that CBT and medication has shown to better than medication alone for the

treatment for OCD. Also, for the treatment of patients with PTSD, CBT with sertraline greatly

improved their symptoms (Talbot MD PhD, & McMurray, MD, 2016). Yet, when a follow up

was conducted one year later of patients with SAD who were treated with therapy and placebo,

therapy and sertraline or sertraline alone discovered that those treated with therapy alone or

placebo alone did not deteriorate after the treatment was completed. This suggests that the

combining of medication and CBT for the treatment of anxiety may have a negative effect. The

explanation being that clients with anxiety are hyper sensitive to any anxiety related

physiological responses. Medication reduces the anxiety response and may interfere with CBT

treatment, which is meant for clients to understand their maladaptive beliefs about these

responses (Talbot MD PhD, & McMurray, MD, 2016).