Therapy, Medication or Both: How the Options Compare

Compare Facts checked November 8, 2026 · Clinically reviewed by Emily Biggs-Heisler, Ph.D., Licensed Clinical Psychologist, Clinical Director and Co-Owner (Colorado psychologist license PSY 6010) on November 8, 2026

Short answer

For depression and anxiety, the National Institute of Mental Health says treatment typically involves psychotherapy, medication, or both. For milder depression, therapy is often tried first. For moderate or severe depression, medication is usually part of the first plan. The right mix depends on your needs, preferences and health, and is worked out with a clinician. Talk to a health care provider before starting or stopping any medication.

In crisis or thinking about suicide? Call or text 988 now (in Colorado it reaches the 988 Colorado Mental Health Line). If you are in immediate danger, call 911.

This guide is not enough if

You are thinking about suicide or might act on it. Call or text 988 now, or call 911 if you are in danger.
You have questions about a specific medication, dose or side effect. Your prescriber or pharmacist is the right person to ask.
You want to start, stop or change a medication. Do not do this without your prescriber.
You are looking for a prescriber. Mountainside provides therapy and does not prescribe medication.

Weighing therapy, medication or both

Maybe a doctor mentioned an antidepressant and you are not sure you want one. Maybe you already take medication and wonder whether therapy would add anything. Or a friend swears by one approach and you are wondering if it fits you.

These are common questions, and there is no one right answer for everyone. This guide explains what the National Institute of Mental Health (NIMH) says about each option for depression and anxiety, who can prescribe in Colorado, and how a therapist and a prescriber can work together. It is general information, not advice about your own medication.

What NIMH says about depression and anxiety treatment

NIMH says depression treatment typically involves psychotherapy (in person or virtual), medication, or both. The plan is based on a person's needs, preferences and medical situation, and finding what works may take trial and error.

According to NIMH, psychotherapy is often tried first for milder depression, with medication added later if therapy alone does not produce a good response. People with moderate or severe depression usually are prescribed medication as part of the initial treatment plan. NIMH names cognitive behavioral therapy (CBT) and interpersonal therapy among the evidence-based therapies for depression. The site's article on how CBT helps with depression describes what CBT sessions involve.

When these treatments do not reduce symptoms enough, NIMH says brain stimulation therapy may be another option. It is generally used after a person has tried psychotherapy and medication.

For generalized anxiety disorder, NIMH says treatment also typically involves psychotherapy, medication, or both. It calls CBT a research-supported therapy that is commonly used to treat generalized anxiety disorder, and describes it as the "gold standard" choice for psychotherapy for this condition. NIMH also mentions acceptance and commitment therapy (ACT).

NIMH's fact sheet on stress and anxiety says psychotherapy and medication are the two main treatments for anxiety, and that many people benefit from a combination of the two. For how the practice approaches anxiety, see anxiety treatment in Denver.

NIMH also notes that even when medication relieves symptoms, psychotherapy can help with specific issues, such as self-defeating ways of thinking, fears, or trouble coping at home, school or work.

Who prescribes, and who provides therapy

SAMHSA says medicines for mental health conditions have to be prescribed by a doctor, nurse practitioner or physician assistant. That can include a psychiatrist or a primary care doctor. In Colorado, a 2023 law (HB23-1071) also lets a licensed psychologist who holds a prescription certificate from the state board prescribe psychotropic medications, while keeping a collaborative relationship with the provider who oversees the client's general medical care.

Many kinds of professionals provide psychotherapy. NIMH lists psychiatrists, psychologists, social workers, counselors and psychiatric nurses. The guide comparing psychologists, psychiatrists and therapists explains the differences in training.

Therapy, medication or both: what each involves (based on NIMH and SAMHSA)

Option	Who provides it	What NIMH notes
Psychotherapy	A licensed mental health professional, such as a psychologist, social worker or counselor	Often tried first for milder depression; CBT is commonly used for generalized anxiety disorder; works in person or by telehealth
Medication	A doctor, nurse practitioner or physician assistant; in Colorado, also a psychologist with a prescription certificate	Antidepressants usually take 4 to 8 weeks to work; finding the right one may take several tries
Both together	A therapist and a prescriber, ideally in touch with your permission	Usually part of the first plan for moderate or severe depression; many people with anxiety benefit from the combination
Brain stimulation therapy	A medical team	An option for depression when other treatments have not worked, usually after therapy and medication

How therapists and prescribers work together

If you choose both, you may see two people: a therapist every week or two, and a prescriber less often. Care tends to go more smoothly when they are not working in the dark. Careful therapists usually do the following:

Ask for your current medication list at the start, so they understand the whole picture.
Ask for your written permission before they talk with your prescriber, and explain what they would share.
Encourage you to bring up side effects, mood changes and questions with your prescriber, rather than adjusting anything on your own.
Never tell you to start, stop or change a dose. That decision belongs to you and your prescriber.
Pay attention to how you are doing in sessions and, with your permission, let your prescriber know about big changes.

Questions worth bringing to each appointment

You do not need to have it all figured out before you talk to someone. NIMH suggests questions to ask a therapist, and lists steps to take if you are prescribed a medication. A few of them, in plain words:

For a therapist: What are the goals of therapy? Do you suggest a time frame or number of sessions? How will we check progress? What happens if I am not starting to improve? Are medications an option, and can you prescribe them?
For a prescriber: What should I expect, and what side effects should I watch for? How do I take this medication? Let them know about every other medication, vitamin and supplement you take, and any allergies or past problems with medications.
For both: Can you two be in touch, and what would you share? Who should I call if something feels wrong between appointments?

Medication safety basics from NIMH

If you or someone you know is having thoughts of suicide, call or text 988 now. If there is immediate danger, call 911.

NIMH says antidepressants usually take 4 to 8 weeks to work, and that sleep, appetite and concentration often improve before mood lifts. It notes that people should not stop a prescribed medication, even if they feel better, without the help of a health care provider, who can lower the dose slowly and safely.

NIMH also notes that in some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks or after a dose change. It says people of all ages taking antidepressants should be watched closely during the first weeks. If you notice changes like this, contact the prescriber right away.

Where Mountainside fits

Mountainside provides therapy, including CBT, DBT and trauma-informed treatment, for teens and adults. It does not prescribe medication. If you think medication may help, a primary care doctor or psychiatrist is the place to start, and you can do therapy alongside that care. The Denver mental health resources page lists other local options.

If you are unsure whether you need more than weekly sessions, the guide to choosing a level of care can help. The site's mental health FAQ also answers common questions about medication and therapy. When you are ready, you can start with a free 15-minute consultation. The depression treatment page explains how the practice works with depression.

Frequently asked questions

How long do antidepressants take to work?

NIMH says antidepressants usually take 4 to 8 weeks to work, and that problems with sleep, appetite and concentration often improve before mood lifts. It says giving a medication a chance to work is important before deciding whether it is right for you. Questions about your own medication and timeline belong with your prescriber.

Is it safe to stop an antidepressant once I feel better?

Talk to your prescriber first. NIMH says people should not stop taking a prescribed medication, even if they are feeling better, without the help of a health care provider. A provider can lower the dose slowly and safely if stopping makes sense. Stopping too soon may cause unpleasant or harmful side effects.

Can my primary care doctor prescribe medication for depression or anxiety?

A primary care doctor is a physician, and SAMHSA says doctors, nurse practitioners and physician assistants can prescribe these medicines. NIMH lists a primary care doctor among the providers to talk to if you think you may have depression. Some people later see a psychiatrist for more specialized medication care.

Do supplements like St. John's wort help depression?

NIMH says the FDA has not approved any natural products for treating depression, and research findings are inconsistent. It notes that products like St. John's wort can carry risks, including interactions with prescription medications. NIMH advises not using supplements or natural products for depression without first talking to a health care provider.

Should I tell my therapist what medications I take?

It usually helps. Therapists often ask for a medication list so they understand what you are already doing and can notice changes in how you feel. Your therapist will not adjust your medication, but they can encourage you to raise questions or side effects with your prescriber and, with your permission, keep in touch with them.

Next: get ready to decide

Weekly therapy, intensive programs, inpatient and crisis care: what each involves and how to tell which fits now.

Choosing a level of care Depression Treatment in Denver

Sources

Clinically reviewed by Emily Biggs-Heisler, Ph.D., Licensed Clinical Psychologist, Clinical Director and Co-Owner (Colorado psychologist license PSY 6010) on November 8, 2026. Facts checked against the sources above on November 8, 2026. This guide is general education, not medical advice, a diagnosis or a treatment plan. It does not create a therapist-client relationship. For advice about your situation, talk with a licensed clinician.