NATALIJA HAYTERPSYCHOTHERAPY & COUNSELLINGWhen you are struggling with low mood or anxiety, one of the first crossroads is this: do I try therapy, or medication? It is a genuinely important question, and the honest answer is that it is rarely a simple either/or.
What medication does
Antidepressants, prescribed by a GP or psychiatrist, work on the brain's chemistry and can be very effective at lifting the floor — reducing the intensity of symptoms enough that daily life becomes manageable again. For moderate to severe depression, and for some anxiety conditions, they can be important and sometimes essential. They tend to address how you feel rather than why.
What therapy does
Talking therapy works differently. It helps you understand the patterns, experiences and ways of thinking that contribute to how you feel, and it builds skills and insight that remain yours after the work ends. Where medication can lift the floor, therapy tends to change the room. For mild to moderate difficulties it is often as effective as medication, and its benefits are more likely to last.
Why it is often both
For many people the most effective approach combines the two: medication to create enough stability to engage, and therapy to do the deeper work of change. There is good evidence that the combination outperforms either alone for moderate-to-severe depression. Choosing medication is not giving up on therapy, and choosing therapy is not a rejection of medication.
How to decide
A useful starting point is a conversation — with your GP about the medical picture, and with a therapist about the psychological one. Severity matters (the more severe, the stronger the case for medication or both), as does your own preference, which is a legitimate and important factor. There is no single right answer, only the right answer for you, now.
This article is for information and is not a substitute for professional advice or diagnosis. If you are struggling, you don't have to manage alone — in an emergency call 999, NHS 111 (option 2) for urgent mental-health support, or the Samaritans free on 116 123, any time.
Natalija Hayter is a BABCP-registered psychotherapist with over a decade of clinical experience across the NHS, the voluntary sector and private practice, trained at the Tavistock and AGIP. She offers CBT, psychoanalytic and relational therapy in Pimlico, London and online, in English, Latvian and Russian. More about Natalija
Last reviewed: June 2026 by Natalija Hayter, BABCP-registered psychotherapist.