We've all heard of the undesirable side effects of certain medications that are used therapeutically. But according to psychiatrist Peter Kramer, author of the renowned Listening to Prozac, many of today's antidepressants not only have fewer side effects, but give psychotherapists more flexibility in their treatment options.

Given the stigma still attached to psychiatric drugs, it’s no surprise that today’s kids might have reservations about taking them. But as a specialist in working with kids and teens, therapist and author Ron Taffel knows that for burdened young clients, medication is often necessary to get therapy moving. Therapists, he says, can’t always go it alone.

Psychotherapists are usually on the front lines of mental health treatment, trained to spot and assess everything from changes in mood to unusual physical reactions. But given all their expertise, why don’t more of us make judgment calls when it comes to medication? And why do so many therapists show only a perfunctory interest in the ups and downs of their clients’ reactions to psychiatric medications?

By Andrew Weil - Depression and anxiety should be as fully conquered as smallpox and polio. But more of us than ever aren't experiencing optimum emotional well-being. Why is the vast enterprise of professional mental health unable to help us feel better? I want you to consider the possibility that the basic assumptions of mainstream psychiatric medicine are obsolete and no longer serve us well. Those assumptions constitute the biomedical model of mental health and dominate the whole field.

I want you to consider the possibility that the basic assumptions of mainstream psychiatric medicine are obsolete and no longer serve us well. Those assumptions constitute the biomedical model of mental health and dominate the whole field. This leaves no room within its framework for the social, psychological, and behavioral dimensions of illness. Our health or lack of it is the result of biochemical interactions and genetics, dietary choices, exercise patterns, sleep habits, hopes, fears, families, friends, jobs, hobbies, cultures, ecosystems, and more.

As both a prescriber and a therapist, I believe that the chemical effect of pills is only part of their impact. The other part may seem a little weird, I warn clients, but it has to do with their thoughts, feelings, and expectations around the medications they take—in other words, their relationship with their drugs. I emphasize that for some people, more may be riding on this relationship, the source of so much hope and potential disappointment, than on any other in their life.

Doctors, especially psychiatrists, have been changing their view of children's problems since the 1970s. Before then, based on the Freudian model, Johnny's problems were considered the result of inner conflicts generated primarily by his relationship with his mother. But in 1980, with the publication of DSM-III, a new concept---for most psychiatric conditions, including ADHD---was announced. The diagnosis of ADHD and the use of drugs like Ritalin rose at rates never before seen in this country---or anywhere else, for that matter. The year 1991 marked a veritable sea change---a social movement began that changed the way our society views children's misbehavior and underperformance.

In the last decade, a vast intellectual and emotional sea change has taken place. We now inhabit a culture where many people hold the view that their emotional pain is "biochemical" and can be cured by simply taking a pill. In this prevailing cultural script, therapy is sometimes ignored altogether. These views have taken on the luster of scientific truths. But they are not truths. They are myths. Our culture's exaggerated faith in these psychiatric medications rests not on science, but on brilliant marketing by a profit-driven industry. Outcome research has not found these drugs to be any better than therapy, and only marginally better than placebos.

Americans have a history of valuing quick-fix solutions to difficult problems. But the simplistic psychopharmacological approach to depressive disorders underestimates the remarkable human capacity for self-transformation. We have the ability to use imagination and intelligence to change our life circumstances, our attitudes and emotions, even, to some extent, our personalities. It is the privilege of our profession to be able to help troubled people along this path, and though medications may make this journey less arduous, in the long run, therapists are indispensable for getting their clients to this destination.

Many people with OCD aren’t easy to diagnose or treat. Clients with OCD can present as panicky, depressed, and agoraphobic, as well as with a wide range of personality problems and relationship issues. But by locating the obsessive thought that initially raises anxiety distress and the compulsive thought that provides the temporary relief, therapists can help these clients break their self-reinforcing cycles of anxious arousal and counterproductive stress-reducing behavior.