A close friend of mine recently decided to explore medication to help with some difficult things he was going through. He asked me to help him research the options, and I told him the first step was simple. You need a psychiatrist. Not a general practitioner. Not the internet. A psychiatrist. They live inside this field. They follow the research. They know what is being prescribed and why. They see what actually works.
So he found one, and we prepared a thoughtful list of questions. We wanted to understand the full picture, not just get a pill.
The first question was one I thought was especially sharp. Does a medication reduce anxiety, or does it lift depression. The psychiatrist answered that many modern medications are designed to do both at once. That was encouraging. It reflected how far the science has come.
We also asked how the medication actually works, what the mechanism is in the brain, and what the most common side effects are. Those are not optional questions. They are the foundation of informed consent.
In general, the safest medications tend to be the ones that have been on the market the longest and prescribed the most. Time exposes problems. Time reveals patterns. But safety is not the only concern. Sustainability matters. So does having an exit strategy. A drug that stabilizes someone today should not quietly create another dependency tomorrow. Otherwise, you are just intoxicating the body while trying to climb out of a psychological hole.
No amount of research replaces personal chemistry. At some point, a person has to try the medication and see how their own nervous system responds. Occasionally someone finds the right drug at the right dose and feels like themselves for the first time in years. More often, the dose is wrong, or the drug is wrong, and they feel worse. That is why psychiatric medication has to be monitored carefully by someone who is paying attention to the whole person, not just the prescription.
This is not a magic pill situation. It never is.
At one point, my friend asked the psychiatrist if this particular medication would help with panic attacks, especially the kind he gets on airplanes. He described being close to panic when flying. The doctor’s response shocked me. He said something like, in that situation, just have a drink, maybe a martini or two.
That is not just bad advice. It is dangerous.
Telling someone to use alcohol as an anxiety treatment is like prescribing gasoline for a fire. Alcohol might dull the feeling temporarily, but it amplifies anxiety in the long run and creates an entirely new addiction risk on top of the original problem. You are not treating panic. You are teaching the nervous system to rely on intoxication.
That kind of advice opens a terrible door. A person walks away thinking, my doctor told me to drink when I am anxious. That bypasses all the real work of learning how to regulate the nervous system, process fear, and build resilience. It also sets the stage for alcohol becoming the next disorder layered on top of anxiety.
I do not believe every psychiatrist would say something like that. I am not trying to paint the whole profession with one brush. But the fact that this came from the one psychiatrist I personally encountered in this context was alarming. Someone with that much power over other people’s mental health should understand addiction, chemistry, and long term consequences far better than that.
When a doctor takes the Hippocratic oath, they are committing to protect patients from harm, including harm that comes from ignorance and careless advice. Suggesting alcohol as a mental health tool fails that standard.
This is why people need to do real due diligence when choosing a psychiatrist. A good one is not just someone who can write a prescription. They need experience, wisdom, and a broad understanding of psychology, addiction, trauma, and human behavior.
One simple question I always recommend asking is this. Would you take this drug yourself if you were prescribed it. Start there. Then ask about mechanisms, risks, alternatives, and exit strategies.
At the same time, do not fall into the other trap of listening to internet quacks. There are many safe, effective medications. There are many excellent psychiatrists who use them with care and integrity. When used properly, these tools can help people regain stability and get their lives back.
The goal is not to avoid medicine. The goal is to use it intelligently, with respect for both chemistry and consciousness.