Medication for Anxiety: Why We're Not Talking About It
And why that's probably a good thing in this context.
If you've spent any time in anxiety recovery spaces online, you've probably noticed something: everyone wants to talk about medication. The questions flood in constantly across every platform—Should I take medication for my anxiety? Can I recover without it? What's the best antidepressant for panic disorder? Is medication cheating?
Here’s the audio version of this article
As someone who creates content about anxiety and anxiety disorder recovery, I get these questions daily. Here’s something that might sound odd: I don't answer them. Not because I don't care about your struggles, but because I kinda do care and social / scroll platforms are terrible, borderline unsafe places to have a medication discussion.
From where I sit, I see three fundamental reasons why mental health content creators—including therapists like me—should largely stay out of medication conversations in public forums. Understanding these reasons might help you navigate the overwhelming amount of conflicting information you encounter online.
The Autonomy Problem: Respecting Your Right to Choose
The first issue is deeply rooted in therapeutic ethics: personal autonomy. Every person has the absolute right to make their own healthcare decisions based on their values, beliefs, and circumstances. This principle isn't just a nice idea. It's foundational to ethical treatment.
When I talk about medication in a public forum, I'm not having a conversation with you specifically. I'm speaking to thousands of people simultaneously, each with different backgrounds, beliefs, and needs. No matter what I say, I'm going to contradict someone's deeply held convictions about medication.
If I mention that some people recover from anxiety without medication—which is factually true—people who have found medication helpful might feel attacked or invalidated. They might interpret my words as "med shaming," even though that's not my intention. These individuals may have struggled for years before finding relief through medication, and hearing someone they've come to trust suggest it's unnecessary can feel like a personal attack on their choices.
The principle of psychological flexibility suggests that rather than seeking simple answers to complex questions, we benefit more from learning to sit with uncertainty while taking values-based action. In the context of medication decisions, this might mean accepting that there's no universally "right" answer while working collaboratively with qualified professionals to make informed choices that support your recovery goals.
Conversely, if I discuss the benefits that many people experience with medication, those who have strong philosophical or experiential objections to psychiatric drugs might feel dismissed. Perhaps they've experienced severe side effects or difficult withdrawal periods. Their concerns are valid too.
The problem is that in a one-to-many communication format—whether that's a podcast, YouTube video, or social media post—there's implied authority. People naturally look to content creators they follow for guidance, especially on topics as personal and frightening as mental health. When someone you've come to like and trust makes statements about medication, it can feel like direction rather than general information.
This creates an impossible situation. By discussing medication in detail, I risk inadvertently challenging your autonomy to make your own informed decisions. That's not fair to you, and it's not something I'm comfortable with.
The Complexity Factor: Too Many Variables for Simple Answers
The second reason medication discussions don't belong in public forums is straightforward: it's extraordinarily complicated. The decision to use psychiatric medication involves numerous variables that no content creator could possibly know about you.
Consider just a few of the factors that influence medication decisions:
Medical variables: Your physical health, other medications you're taking, previous reactions to psychiatric drugs, family history of mental health conditions, and any underlying medical conditions that might interact with psychiatric medications.
Social and cultural factors: Your family's attitude toward medication, cultural beliefs about mental health treatment, religious considerations, and community support systems all play roles in how you might experience and perceive medication use.
Financial realities: Not everyone has access to the healthcare system needed for proper medication management. The cost of regular doctor visits, therapy, and the medications themselves can be prohibitive for many people.
Lifestyle considerations: Your work demands, family responsibilities, activity level, and daily routine all matter when considering medications that might have side effects affecting energy, concentration, or sleep patterns.
Personal history: Your previous experiences with mental health treatment, life history, and current life circumstances all influence how you might respond to different treatment approaches.
Individual presentation: While anxiety disorders follow recognizable patterns, how they show up in your specific life—what triggers them, how they interfere with your functioning, what other conditions might be present—varies enormously from person to person.
These variables interact in complex ways that require careful, individualized assessment. It would be absurd for someone speaking to thousands of people through a screen to claim they could account for all these factors in your life. Yet that's essentially what happens when content creators give specific medication advice to their audiences.
Even as a therapist working with individual clients, I approach medication conversations carefully. While I can help clients think through their concerns and make informed decisions, I don't prescribe medication or manage its use. That requires specific medical training and ongoing monitoring that simply can't happen through social media content.
The Time Problem: Everything Changes
The third reason public medication discussions fall short relates to time and change. Human beings are dynamic. You're constantly evolving—physically, mentally, emotionally, and circumstantially. What's right for you today might not be right for you six months from now.
Your body changes continuously. Your brain chemistry, hormone levels, overall health, and response to various treatments all shift over time. Your life circumstances change too. Job stress, relationship changes, financial pressures, family developments, and countless other factors influence your mental health and treatment needs.
Your beliefs and preferences evolve as well. You might start your recovery journey feeling strongly opposed to medication, only to find yourself more open to it later. Or you might begin with enthusiasm for pharmaceutical intervention but develop concerns over time. Both trajectories are normal and valid.
The decision to use psychiatric medication—or to continue, adjust, or discontinue it—isn't a one-time choice. It's an ongoing process that requires regular reassessment as you and your circumstances change. This process needs to happen in relationship with qualified healthcare providers who can monitor your progress, adjust treatments, and respond to changes in your condition or life situation.
A content creator posting about medication can only offer a snapshot perspective from one moment in time. Even if I knew everything about your current situation (which I don't), that information would quickly become outdated as your life evolves. This makes public medication advice not just inadequate, but potentially dangerous.
What This Means for You
Understanding these limitations doesn't mean you're left without resources. It means recognizing where to look for appropriate help with medication decisions.
If you're considering medication for anxiety, the right conversation happens with qualified healthcare providers—typically your primary care doctor, a psychiatrist, or both. These professionals can assess your individual situation, monitor your response to treatment, and adjust your care as needed over time.
If you're working with a therapist, they can help you process your thoughts and feelings about medication decisions. In a good collaborative environment they might coordinate care with a prescribing physician so you have a team of qualified individuals helping you navigate through the issues from multiple perspectives.
Become an informed healthcare consumer. Learn about your options and understand the potential benefits and risks. But before you even work directly on the medications and side effects and outcomes themselves think hard about the sources you’re looking to for actionable, safe, ethical advice.
In The End …
My refusal to answer medication questions isn't about dismissing your concerns or avoiding difficult topics. It's about recognizing the limits of what I can responsibly offer through public content and respecting your right to make informed, autonomous decisions about your healthcare.
Medication decisions are deeply personal, highly complex, and continuously evolving. They deserve more than can be provided through social media posts or podcast episodes. They deserve careful, individualized attention from qualified professionals who can get to know you, monitor your progress, and adjust their recommendations as you change over time.
Your recovery journey—whether it includes medication or not—is valid. There's no right or wrong choice, only what works best for you in your specific circumstances at any given time. And that's a decision that belongs entirely to you and your healthcare team.
If you are finding the work I do helpful or useful in some way, you can support it by checking out my books, my workshops, or even buying me a coffee ☕️ . None of that is ever required here, but always appreciated.
Drew Linsalata is a therapist practicing in New York State, specializing in anxiety disorders. He is the host of The Anxious Truth podcast, co-host of the Disordered podcast, and author of three books on anxiety recovery. Having personally recovered from panic disorder and agoraphobia, he combines professional expertise with lived experience in his approach to anxiety recovery.