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If our therapist determines that our addiction may be connected with underlying causes such as depression, anxiety, obsession, OCD, or even hyper-sexuality (which is a common condition in lust addicts), he may send us to be evaluated by a psychiatrist for medication that can help us significantly in these areas.

As a side note of interest, one good therapist said that he never puts a client on medication for depression before having them try a rigorous regimen of exercise for about three months. In most cases, the depression disappears as a result of the physical activity, and exercise routinely outperforms antidepressants in controlled studies.

If medication turns out to be necessary, this is nothing to worry about, as millions of people around the world take medications for these type of issues. The medications can truly make a difference in the long term, and with today’s medical advances, the side effects are often negligible. Rabbi Twerski wrote to someone who contacted him through our network:

In order to have both physical and emotional health, we require proper nutrition. If we lack certain essential vitamins and/or minerals, we develop "deficiency syndromes". For example, lack of iron and B vitamins may cause depression. If a child was raised by abusive parents, who, in addition to being unkind to the child, deprived him of proper nutrition, he may be very depressed as an adult. A physician who examines the person may diagnose the nutritional deficiencies and prescribe the missing vitamins and minerals. The person may say, “How are those going to remove the pain of the abuse?” The answer is that the vitamins and minerals will remedy the deficiencies, and he will have to get therapy to deal with the consequences of the abuse.

There is a special section of our website that provides some medical ideas that can help us in this struggle, ranging from “alternative” medications which can be purchased over the counter or in health food stores, and down through the more conventional medications that often require a psychiatrist’s prescription.

SSRI medication can sometimes be useful in this struggle, since our addiction is often connected with OCD or other compulsive behaviors (even if we don’t experience this in other areas of our lives). These type of drugs can help take off the "edge" of the obsession and help us deal with the "void" and depression that is often felt in withdrawal. Often these kinds of medications can be like holding on to a lifesaver, while swimming in the stormy sea. While we still have to do the swimming ourselves, the medications can help keep us afloat.

In many cases, we can slowly get off the medications as we make more progress. A period of eight months to a year on these kinds of medication is often enough to help us break the cycle of addiction for long enough to continue maintaining our sobriety without them. However, getting off the medications requires close follow-up and approval from the psychiatrist. These kinds of medications can never be stopped suddenly, but rather in gradual increments.

There are also times when certain medication can prove to be counter-productive. Therefore, while on medication we should be undergoing therapy and close follow up.