Adjunctive Treatment Strategies: Add-On Options When Standard Care Isn’t Enough
If you’ve tried different treatments for your mental health and still don’t feel like yourself, that doesn’t mean you’re out of options. When one strategy isn’t enough, adding another can make a big difference in how you feel and function from day to day.
While treatment for mental illness has come a long way, traditional care still doesn’t work for everyone. If this is the case for you, you may benefit from adjunctive treatments. This article will explore:
- Why adjunctive therapy is now a standard part of mental health care.
- Therapy plus medication treatment plans.
- Add-on treatments for depression.
- Secondary treatments for anxiety disorders.
- Advanced psychiatric treatment options.
- Lifestyle-based and non-traditional mental health therapies.
What Is Adjunctive Therapy in Mental Health Care?
Adjunctive therapy for mental health care comes in many forms. Mental health combination treatment plans, for example, include two types of treatment at the same time, such as psychotherapy and medication.[1][2] Augmentation treatments, as another example, are add-on strategies meant to boost the effects when the first treatment has only partially helped.[3]
Integrated or adjunctive care is a broader term for adding supportive interventions to a primary plan. These additions may include psychotherapy, medication, or lifestyle-based strategies.[1] Whichever terminology your mental health provider uses, the goal is the same: better care and improved outcomes for your mood, well-being, and daily functioning.
Therapy Plus Medication Treatment Plans
There is a strong case for treating depression with a combination of therapy and medication. We now understand that the two approaches work better together than alone, especially if you have a more severe form of depression. Studies show that therapy plus medication treatment plans achieve remission rates of 48 percent, compared to 29 percent for medication alone and 33 percent for psychotherapy alone.[2]
Because of this, guidelines for depression now recommend adjunctive treatments as necessary, not optional. This is especially true if traditional antidepressant treatments either fail to work or result in a partial improvement of your symptoms.[3]
Given that two approaches are better than one, cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are most commonly paired with antidepressants. Both CBT and IPT are structured and skills-based, and each has been tested extensively as a companion treatment with antidepressant medication.[2]
More specifically, therapy and medication can be very effective when you first start on an antidepressant and add psychotherapy after a partial response to the medication. This sequential combination improves remission rates and reduces the risk of long-term relapse into major depression as well.[2]
Combining therapy and medication doesn’t just reduce symptoms, though. Therapy alone helps you build coping skills, protects against relapse, and addresses residual symptoms. Alongside that, medication helps reduce depressive symptoms.[2] This is why psychotherapy plus medication benefits extend beyond what either approach can achieve on its own.
Mental Health Add-On Treatments
While combination therapy is beneficial for depression and many other mental health disorders, the specific mix of treatments that works best depends on many factors. For example, your specific diagnosis and the severity of your illness are important for determining the best course of action.[1]
Some mental health conditions, including complex mental health conditions, respond better to certain adjunctive treatments than others. Psychotherapy is a good example, as its effect as an adjunctive method is best for depression and bipolar disorder.[4][5]
The same principle, that combination therapy psychiatry methods improve outcomes, applies to anxiety disorders and other conditions where standard care often falls short.[5]
Add-On Treatments for Depression
Therapy and medication aren’t the only combined approaches for treating depression. Suppose you have been taking an antidepressant, but you still experience significant depressive symptoms. Your mental health provider might start by adding a second medication to support the first-line medication you’re already taking. Common options include the following:[3]
- Atypical antipsychotics might be added to your existing medication, especially if you have treatment-resistant depression.
- Lithium helps support the effects of antidepressants and provides you with better outcomes than antidepressants alone.
- Thyroid hormones, such as T3, could be prescribed if you’ve tried multiple antidepressants without improvement.
Mindfulness-based cognitive therapy (MBCT) is another option that can help if you have residual depressive symptoms or recurrent depressive episodes. Not only does MBCT reduce relapse rates, but in some cases, you may also be able to reduce the dosage of your antidepressant or stop taking it altogether.[2] These augmentation strategies for depression treatment give you and your provider more options when standard approaches fall short.
Treatment Augmentation for Bipolar Disorder
If you live with bipolar disorder, you might have found that prescription medication is not enough to treat the varying symptoms.[4] Mood stabilizers and atypical antipsychotics (the same medications used in depression augmentation) are a good start, but they don’t address the interpersonal and emotional complexity of the disorder.[1][4]
As such, adding structured psychotherapy to medication is a common pathway to treat bipolar disorder. Four approaches are particularly effective:[4]
- Psychoeducation helps you recognize symptom patterns, learn your triggers and warning signs, and be more engaged with your medication regimen. Group psychoeducation can be especially helpful for reducing the number of manic and depressive episodes.
- Cognitive behavioral therapy (CBT), which targets the thought patterns and behaviors that can trigger episodes or make them worse, works best if you’re currently stable or have mild symptoms.
- Interpersonal and social rhythm therapy (IPSRT) helps stabilize your daily routines (such as social outings, sleep patterns, and interpersonal relationships). This is important because disruptions to these aspects of your daily life can be triggers for bipolar episodes. This approach is typically used during or after an acute depressive or manic period.
- Family-focused therapy (FFT) brings your family into treatment with you and helps improve communication, teach coping strategies, and reduce interpersonal stress. Research shows FFT can make depressive episodes less likely to occur.
The availability of so many add-on treatments for bipolar disorder is encouraging because no single approach is right for everyone. The best choices depend on your current mood, your family situation, the severity of your symptoms, and your personal preference for the type of therapy. Treatment augmentation for bipolar disorder is now a well-established part of comprehensive care.
Secondary Treatments for Anxiety Disorders
Anxiety disorders present a similar challenge to bipolar disorders and a similar opportunity. Take generalized anxiety disorder (GAD); you’re about as likely to need additional treatment for GAD as you are to respond well to the first treatment you try.[6]
The first add-on treatment for anxiety disorders is usually psychotherapy, like CBT. The benefit of CBT in this case is that it helps you identify worry patterns and learn how to cope better with anxiety triggers, two features of the disorder that medication doesn’t fully resolve.[6][7]
Other therapies might be used, too. Mindfulness-based approaches, like biofeedback, meditation, and progressive muscle relaxation, help reduce symptoms of many anxiety disorders. Relaxation therapy, which uses many of the same mindfulness approaches, is also effective for making anxiety symptoms more manageable.[7]
Sometimes, such as with treatment-resistant GAD, adding medication to your treatment plan is necessary. If, for example, you’re taking an antidepressant for your anxiety, you might also be prescribed a GABA-related agent like pregabalin, which often works fast (sometimes within days) to help reduce symptoms. Atypical antipsychotics are also useful if your anxiety doesn’t respond well to usual treatments.[7]
If you have anxiety that doesn’t respond well to your initial medication, it isn’t a sign of failure on your part. Instead, it’s a signal that additional interventions are needed, nothing more. It can be discouraging, yes, but think of it as getting more information about your unique situation that your mental health provider can use to modify your treatment and make it more effective.
Mission Connection is here to help you or your loved one take the next steps towards an improved mental well-being.
Advanced Psychiatric Treatment Options
If you’ve tried multiple combinations of therapy and medication and they haven’t worked, it’s understandable to be dismayed. But advanced treatments like neuromodulation therapies are available and offer many benefits by directly influencing how your brain works. These treatments are generally used as adjunctive interventions in addition to your current psychological and medical care.[1][8]
One of the most common neuromodulation therapies is transcranial magnetic stimulation (TMS). It uses electromagnetic pulses to stimulate different areas of your brain involved in mood regulation. It’s a noninvasive procedure that involves no surgery, no anesthesia, and no electrical impulses, so you get the benefits of treatment with little to no discomfort.[8][9]
Usually, TMS consists of 15 sessions over several weeks. You remain awake and alert throughout and have no ill effects afterward. The result is that it changes how neurons in your brain communicate, which is why its effects last well after you finish treatment.[8][9]
A new version of TMS, one that’s pharmacologically enhanced, is also gaining popularity. You’re given medication before a TMS session that primes your brain to respond better to the procedure.[9] A good analogy might be putting primer on a wall before painting it; the medication in this case primes your brain to accept the TMS treatment to produce better results.
TMS and adjunctive therapy options work better for some people than others. Like any other intervention, there are potential side effects (though generally mild, like a headache) as well as potentially prohibitive costs (insurance might not cover the procedure).[8] Nevertheless, TMS treatments are an option for getting relief from your symptoms when more traditional therapies don’t fully work.
Integrative Mental Health Add-On Treatments
Some of the most effective add-on treatments, like lifestyle and complementary approaches, can be done on your own. These methods work differently from those discussed earlier, as they target the relationships, daily habits, and environments that shape your mental health from the outside in. And the evidence supporting many of them is stronger than you might expect.
Evidence-Based Non-Traditional Mental Health Therapies
One of the best lifestyle treatments for mental illness is regular exercise. For example, exercise can be as effective as medication or counseling for relieving depressive symptoms in some people. Activities that offer real benefits include:[10]
- Walking.
- Yoga.
- Tai chi.
- Strength training.
Meditation is beneficial if you have anxiety, chronic stress, or depression.[7][10] Likewise, sleep interventions, like CBT for insomnia and light therapy, are both research-based treatments that help resolve sleep issues, and, as a consequence, can help reduce some of the symptoms of depression and anxiety, among others.[2][10]
Changing your diet is another approach worth your while. Studies show that eating highly processed foods can disrupt the balance of bacteria in your gut, which causes inflammation that travels to your brain.[10]
This connection between gut health and brain health, known as the gut-brain axis, suggests that following an improved diet alongside your mental health treatment gives you a greater chance of reducing depressive symptoms.[10]
These approaches are low-cost, low-risk, and usually have few barriers to access. You don’t need a prescription, and starting with just one or two of them can make a big difference in your mental health treatment.
These integrative mental health add-on treatments complement professional care and help you take some control over your own recovery.
Get Personalized Mental Health Combination Treatment Plans
The reality of living with a mental illness is that it can feel overwhelming, especially if you’ve tried many treatments with little in the way of success. But as we’ve explored here, you can get better by supplementing what you’re already doing with other treatment approaches.
Mission Connection specializes in helping people like you navigate the complexities of adjunctive therapy mental health options. If standard care hasn’t delivered the results you want, let us help you explore additional treatment options.
Our expert clinicians create personalized treatment plans that combine a variety of approaches to address your mental health needs. We offer flexible outpatient programs that work with your schedule, including:
- In-person treatment at our locations in California, Virginia, and Washington.
- Telehealth services.
- Hybrid programs that combine in-person and virtual care.
When you’re ready to connect with us and discuss the next step, call us at 866-833-1822 or get started online. You don’t have to figure this out on your own.
