Therapy & Meds - Bad Combination?

[Notsowild]

I was told by my psychologist that I wouldn't respond well to CBT as long as I was on Ativan. I take a small dose .5 mg. Has anyone heard of this?

 

[Deleted member 1860]

No that's not true. If you were OVER drugged then it is possible for therapy to not work as well, however a combination of medication and therapy is a common way to go.

If you need medication, please don't let this psychologist persuade you otherwise. A lot of people take medication in order for therapy to work better. That is, medication is a stabilizing device and allows therapy to work better. Sometimes people are so symptomatic that no amount of therapy would make a dent in your issues in the absence of medication.

Bottom line, if you need it, then take it.

 

[Notsowild]

Thanks @Solara for your reply
Yes it sounded strange to me too . I'll have to ask her again why she thinks its not compatible. She did say in our last session but my mind being so jumbled right now I did not retain the information.

 

[Barconian]

But your psychologist is not a psychiatrist and doesn't have the ability to make such a judgement

 

[Deleted member 1860]

@Barconian,
But they do it anyway! I had one say something similar to me. She didn't believe in medication at all but I was to the point of being pushed over the edge. I knew I needed medication to pull me up and that was the end of my therapy with her.

 

[Justmehere]

That really makes no sense. If someone is really struggling, sometimes medication can make therapy more effective! That is strange what this psychologist said. Maybe there are other reasons why they would want you to stop the medication or not do CBT. I did and intensive TF-CBT based trauma treatment program and I did it while on klonopin, not too different from Ativan. It was really helpful. In fact, most the people in the program were on one kind of medication or another. The program psychiatrist very much believed that the less medication, the better, BUT he also believed that for some people, some medication is needed to help the person engage the therapy process at all - which can be triggering. Ativan is rarely a good idea to use long term for years, but I am sure your prescribing doctor knows that.

 

[Notsowild]

Okay@Solara,@Justmehere, @Barconian
My T said Ativan reacts with the acetylcholine as a inhibitor to therapy

Acetylcholine is one of many neurotransmitters in the autonomic nervous system (ANS). It acts on both the peripheral nervous system (PNS) and central nervous system (CNS) and is the only neurotransmitter used in the motor division of the somatic nervous system. Acetylcholine is also the principal neurotransmitter in all autonomic ganglia

Drugs acting on the cholinergic system
Blocking, hindering or mimicking the action of acetylcholine has many uses in medicine. Drugs acting on the acetylcholine system are either agonists to the receptors, stimulating the system, or antagonists, inhibiting it.

I also mentioned I was seeing a psychiatrist to help with my meds. She wasn't too happy about it. @Solara - you're so right- she doesn't believe in medication at all

 

[Barconian]

Wouldn't the dose size of any drug, measure the affect it has on your nervous system. For example, too much Axanax would cause you to be too doe-sol to have any therapy. I don't know what Ativan is, but a small does surely wouldn't affect your cognitive abilities that much would it?

 

[Deleted member 1860]

To be honest, I haven't had that experience with Ativan (a benzodiazepine in the same family as Xanax).

I understand the anti-med camp, but at the same time it can actually prevent a sufferer from utilizing a powerful healing tool. I have times when my anxiety is purely physical. That is, it's not mental, rather I can literally feel it pulsing through my veins. I have yet to find a coping skill that is very effective against this symptom. It's more a matter of letting time elapse so that these darn "fight or flight" chemicals get out of my body. If I listened to my last therapist, I would feel weak for taking medication to help me through the rough times. I know I'm not weak, I just need a little extra help.

Sorry, I mean to say more but my minds a bit scrambled. I'm dealing with the dreaded physical anxiety but didn't take my Ativan today because I had to go out and about. This anxiety really takes it out of me and I'm exhausted, both mentally & physically.

If the meds help, then I wouldn't necessarily dismiss them. I aim to be as medication free as possible, but I know they do have a place in my healing.

 

[Notsowild]

@Barconian

but a small does surely wouldn't affect your cognitive abilities that much would it?

I am on the lowest dose .5 mg and she still thought it would hinder our therapy

 

[The Albatross]

Yeah I've heard of it, though my T did not subscribe (and neither did I) to prescription medications. I was only on an SSRI low dose for a year then toughed it out.

 

[Justmehere]

That's what anxiety meds do - they calm down the ANS, thus calming down PTSD related anxiety. That's also what therapy does. Meds can more directly block the effectiveness of somatic work, but even with that kind of therapy sometimes there is a place for medications until the sufferer is in a better place. With CBT, it just doesn't make sense to say CBT won't work at all with it. She does sound very anti-medication. Ativan is not a long term solution, but it can be really helpful in the short term while more and more work is done in therapy until someone just doesn't need it anymore. There is always risk of biological dependency, but as long as you are working closely with your doc who is prescribing it and only taking what they prescribe, then you should be ok.

Are you feeling inclined to go with her opinion and stop the Ativan? Do you prefer to stay on it for a little longer? If so, I think it would be very reasonable to get another opinion with someone who prescribes meds for PTSD and keep plugging away at therapy too.