Therapy and medication: Exploring the stigma, impact and benefits

Taking medication? Therapy can still help; here’s why the two work better together. This article will explore why talking is a powerful medicine.

“The good life is a process, not a state of being. It is a direction, not a destination.” - Carl Rogers 

Healing isn’t always a straight line, and it’s not an either/or situation. It’s both/and. You can take medication and go to therapy. You can have experienced trauma and still build resilience. You can be unwell and still be worthy of care. When you combine medication with therapy, you often see more complete and lasting improvements in your mental health. This is especially true because medication alone might not completely solve your symptoms, and it can come with side effects (Ee et al., 2020).

Medication is a foreign body, so any medication you take that impacts your biochemistry is treated as such. And that's why any differences with how you feel after taking the medication will need to be explored and discussed to understand how the effectiveness of the medication affects the usual functioning ability of your body and brain system whilst taking it.

There’s an unspoken myth in both Western and South Asian communities that therapy and medication are mutually exclusive. That if you’re taking medication for anxiety, depression, trauma, or a chronic health condition, then therapy isn’t for you, or worse, that one cancels out the other. This couldn’t be further from the truth.

In reality, therapy and medication often work best together. Like the left and right leg of a healing journey, they support different parts of your mind, body, and nervous system. Especially when you’re managing a medical diagnosis, like an autoimmune condition, fibromyalgia, or even long COVID, therapy becomes a crucial space to process the emotional weight of illness. And unfortunately, for many South Asians, this dual approach is still shrouded in stigma.

Research increasingly shows that combining medication with therapy often leads to better results than using either treatment on its own, especially for more challenging mental health issues (Mucci et al., 2020). 

5 ways therapy works in harmony with your medication plan

1. Therapy helps process the emotional toll of diagnosis

From the moment of diagnosis, shock, grief, confusion, and fear can take hold. Therapy provides a safe container to process the identity loss, uncertainty, and emotional overwhelm that often accompany medical diagnoses, long before any medication is even prescribed.

2. Therapy supports your nervous system through medication changes

Whether it’s steroids, immunosuppressants, antidepressants, or hormone-altering drugs, medication can disrupt your sleep, mood, appetite, and even memory. Therapy helps regulate your nervous system, providing grounding techniques and emotional support to weather these biochemical shifts with more stability.

3. Therapy makes sense of unresolved trauma that illness may unmask

Medication often removes your body's “filters,” making suppressed trauma more accessible, especially at night or during flare-ups. Therapy gently supports you in uncovering and integrating past trauma that may be resurfacing due to the biological vulnerability illness brings (as per van der Kolk and Maté).

4. Therapy reduces chronic stress that impacts recovery

Stress isn't just a feeling; it triggers the release of cortisol, which directly impacts immune function, inflammation, and healing. Therapy helps you retrain your stress response system, giving your body the conditions it needs to recover, rest, and repair more effectively.

5. Therapy encourages you to rebuild life, identity, and meaning

Chronic illness can hijack your plans, your independence, and even your sense of who you are. Therapy can help you redefine your identity beyond your diagnosis, supporting you to set boundaries, reclaim joy, and build a meaningful life with, not despite, your condition.

Our biology is social, and so is our stress

Many clients ask me, "Why do I feel worse even though I’m on the right meds?". The answer often lies in the body–brain–social connection. Chronic stress and trauma, particularly intergenerational trauma, affect multiple systems: the nervous system, endocrine system, and immune system (McEwen, 1998). Elevated cortisol, the primary stress hormone, can suppress immune function, disrupt sleep, raise blood pressure, and even lead to memory and cognitive issues when sustained over time (Sapolsky, 2000).

For those managing conditions like psoriasis, rheumatoid arthritis, lupus, endometriosis, or even PCOS, stress isn’t just emotional; it’s neurobiological. It can trigger flares, worsen symptoms, or disrupt healing.

What’s more, trauma stored in the body, as discussed in Dr Bessel van der Kolk’s ‘The Body Keeps the Score’, doesn’t disappear just because we’ve started a treatment plan. It needs to be seen, heard, and integrated through somatic, cognitive, or relational therapy approaches.

What medication does, and what it doesn’t

Medication, whether it's an SSRI for depression, steroids for an autoimmune flare, or beta blockers for blood pressure, usually targets biological symptoms. These drugs modulate brain chemistry, suppress inflammation, or alter hormone responses (Serretti & Mandelli, 2010). But what medication doesn’t always address is the underlying psychological or relational distress that might be exacerbating those symptoms.

That’s where therapy comes in.

Therapy gives you tools to:

• Explore how you relate to your diagnosis.
• Process grief, fear, shame, and identity changes.
• Rewire trauma responses in the nervous system.
• Build emotional resilience and co-regulation.
• Develop a voice in systems (medical or familial) where you’ve been silenced.

Medication treats the chemistry. Therapy treats the context.

So what can therapy actually do for someone navigating the emotional, physical, and hormonal storms of a medical diagnosis? Therapy will support your journey, especially when medication is part of the picture.

A South Asian context: Silence, shame, and struggle

In many South Asian households, there’s still a deep taboo around medication, mental illness, and therapy, especially when trauma is involved. Emotional pain is often minimised or spiritualised. You’re told to "pray more," "be strong," "keep it private," or just "take your pills and carry on."

But for South Asians, especially those affected by intergenerational trauma, enmeshment, domestic violence, or sexual abuse, emotional pain doesn’t vanish in silence. It stores itself in the limbic brain, in the gut, in the immune system, and in our beliefs about ourselves (Cozolino, 2014).

What I’ve witnessed in therapy, particularly among South Asian clients, is that many are finally connecting the dots:

“My illness isn’t just physical, it’s also emotional.”
“I can take an immunosuppressant drug and still need to cry.”
“I need to talk about what happened, not just treat the symptoms.”

This is a change that’s starting to happen, as it has been known for South Asians to rely on medical doctors and medication for their primary treatment.

What happens when therapy is added to medical treatment?

Therapy helps people make sense of the “why now” of illness. From a psychological lens, illness can be a crisis of meaning. Diagnosis can shake up your worldview, sense of safety, and identity, especially if it comes after years of emotional suppression or caregiver stress. Many South Asian women, for instance, only get therapy after years of sacrificing their needs for others, often while juggling invisible conditions like fatigue, pain, or trauma-related flashbacks.

In therapy, we ask:

• Who were you before the diagnosis?
• What role has your illness played in your family or work life?
• How do cultural beliefs shape your response to treatment?
• Are you carrying unresolved trauma that may be surfacing now?

And yes, therapy doesn’t replace medication, but it may reduce your reliance on it, particularly when trauma is a part of the picture.

Why this needs to be talked about more, especially in diverse communities

I once started a thread in a global Facebook group for people living with autoimmune diseases. When I asked, "Have you ever tried therapy alongside your medication?" the replies shocked me.

Most had never considered it. Not because they didn’t want support, but because no one had ever told them they could. This is what stigma does. It creates blind spots. It stops people from accessing complementary forms of health care that could significantly improve their quality of life, not just physically, but emotionally, relationally, and neurologically.

Real talk from a therapist: What I shared in a global support group

In one of the global Facebook support groups I participate in, a space filled with people navigating autoimmune conditions from all corners of the world, someone recently asked a powerful question:

"Why does this happen? Why am I struggling so much emotionally alongside my physical illness?"

And the truth is, it’s rarely just one thing. Illness is rarely linear. It’s layered. It’s the whole system, your body, your brain, your history, responding to stress it’s been carrying long before the diagnosis ever arrived.

We are born with perfectly designed bodies, sensory vehicles built to help us connect, explore, and make meaning in the world. But when life brings ongoing stress, trauma, or emotional overwhelm, our systems adapt to survive. And over time, that adaptation can cause dysregulation across our nervous system, immune system, and hormonal system, the very systems involved in autoimmune conditions.

In my clinical work, I often describe chronic illness as a “perfect storm” for emotional overload. There’s the daily exhaustion of fighting an invisible internal battle. There’s the emotional impact of medication, which can shift your biochemistry and affect your mood, sleep, and sense of yourself. Then, there’s the identity disruption: routines change, certainties vanish, and independence can be lost.

What’s not talked about enough is this: the stress response doesn’t only show up in our minds, it shows up in our organs, our hormones, our skin, our blood, our sleep. And in today’s fast-paced, high-pressure, comparison-heavy world, many of us are becoming sick in silence.

In that same group, I gently shared my expertise, a common immunosuppressant drug often leads to vivid, dream-heavy sleep. Some nights, those dreams can be deeply unsettling. Did you think taking a medication would mean impacting your sleep? This is why it is so important to discuss and explore your medication journey with a therapist.

What many people don’t realise is that some medications like immunosuppressants don’t just suppress the immune system; they can lower your brain’s usual self-protection “filters.” That means emotional material you’ve long buried, whether from childhood, family trauma, or unresolved stress, can surface more readily, especially at night when your mind is processing.

This doesn’t mean anything is “wrong” with you. In fact, it may be your body trying to heal. As Dr Bessel van der Kolk teaches in The Body Keeps the Score, and Dr Gabor Maté explains in When the Body Says No, unprocessed trauma lives in the body and can resurface in times of vulnerability. Illness and medication can act as catalysts, not causes, of what was already silently stored in your nervous system.

That’s why I advocate so strongly for therapy alongside medical care. Talking therapy can offer a safe, structured space to process not only your current emotional responses, but the deeper roots of stress, shame, or trauma that may have been contributing to your condition long before your symptoms ever appeared.

If you’re experiencing nightmares, emotional turbulence, or confusion during your medical treatment, please know:

• You’re not “broken.”
• You’re not alone.
• And you’re absolutely worthy of support that sees you as a whole person, not just a diagnosis.

Intergenerational trauma, medication, and the dementia connection

There is growing evidence that intergenerational trauma, if unprocessed, contributes to a higher risk of cognitive decline and dementia, particularly among South Asians (Yehuda et al., 2016). Trauma alters gene expression, disrupts the Hypothalamic-Pituitary-Adrenal axis regulation, and damages areas of the brain responsible for memory (like the hippocampus) (Bremner, 1999).

If medication is prescribed without addressing this trauma, the root cause is missed, and long-term healing is compromised. When therapy is integrated, however, we begin to shift the emotional legacy and potentially protect future generations from carrying the same biological cost.

Dr Bessel van der Kolk, valuably quotes:

“The brain-disease model overlooks four fundamental truths: (1) our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being; (2) language gives us the power to change ourselves and others by communicating our experiences, helping us to define what we know, and finding a common sense of meaning; (3) we have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through such basic activities as breathing, moving, and touching; and (4) we can change social conditions to create environments in which children and adults can feel safe and where they can thrive.

When we ignore these quintessential dimensions of humanity, we deprive people of ways to heal from trauma and restore their autonomy. Being a patient, rather than a participant in one’s healing process, separates suffering people from their community and alienates them from an inner sense of self.”

Bessel A. van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

You deserve both pills and presence

Whether you’re managing anxiety, lupus, diabetes, trauma, or menopause, you deserve the full circle of care. You deserve support that honours both the science of your biology and the story of your life.

Medication can keep you functioning. Therapy can help you live.

There is no need to choose one form of health support over another. Let’s stop pretending emotional pain doesn’t need support just because there’s a prescription. We can make it normal and necessary to do both. You don’t have to manage your medication journey alone.

You don’t need to choose between medical care and emotional support. The best health outcomes often come from an integrated approach, one that honours your biology, your story, and your soul.

References

• Bremner, J. D. (1999). Does stress damage the brain? Biological Psychiatry, 45(7), 797–805.
• Cozolino, L. (2014). The Neuroscience of Human Relationships. New York: W.W. Norton.
• Ee, C. et al. (2020) “An integrative collaborative care model for people with mental illness and physical comorbidities,” International Journal of Mental Health Systems, 14(1). doi:10.1186/s13033-020-00410-6.
• McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338(3), 171–179.
• Mucci, A. et al. (2020) “Treating Schizophrenia: Open Conversations and Stronger Relationships Through Psychoeducation and Shared Decision-Making,” Frontiers in Psychiatry, 11. doi:10.3389/fpsyt.2020.00761.
• Sapolsky, R. M. (2000). Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Archives of General Psychiatry, 57(10), 925–935.
• Serretti, A., & Mandelli, L. (2010). Antidepressants and body weight. Journal of Clinical Psychiatry, 71(10), 1259–1272.
• Yehuda, R., Daskalakis, N. P., Lehrner, A., et al. (2016). Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms. World Psychiatry, 15(3), 243–257.