Do I need medication or therapy?

Answered by Dr. Nitnem Singh Sodhi · Consultant Psychologist & Psychotherapist · Updated 2026-05-05

Short answer

Mild-to-moderate cases respond well to therapy alone. Moderate-to-severe cases — especially with significant sleep disruption, suicidal ideation or psychotic features — usually need medication alongside therapy. Decision belongs with a qualified clinician, not a search bar.

This is one of the most common questions I get and the honest answer is: it depends on severity and on you. Both work; the question is which combination works fastest for your specific presentation.

Therapy alone is usually appropriate when

Symptoms are mild to moderate, you can still function, sleep is broadly intact, there is no suicidal ideation, and you have the bandwidth to engage in weekly work for 6–12 weeks.

Medication is usually appropriate alongside therapy when

Symptoms are moderate to severe, function is significantly impaired, sleep is collapsed, there is active suicidal ideation, or there are psychotic features. Medication does not 'fix' you; it lowers the symptom volume enough that the therapy work can actually land.

What to do now

Take the relevant screener (PHQ-9 for mood, GAD-7 for anxiety). Bring the score to a qualified clinician — myself or another psychologist/psychiatrist you trust — and let the decision be made together with someone who can examine you. Please do not start, stop or change medication based on the internet.

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