When Medication Might Help With Chronic Stress

Sometimes the weight of what is happening in the world exceeds what the mind and body can absorb on their own. When poor sleep, persistent worry, or feeling down become chronic rather than occasional, medication can serve as a bridge that makes everything else tolerable again.

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There is no shortage of advice about managing stress: exercise, limit the news, talk to someone, practice mindfulness. For many people, those strategies are enough to keep them balanced during stressful times. But for some, the symptoms take on a life of their own. Poor sleep compounds the tension, deepening the low mood and making it harder to do the things that would otherwise help. At that point, the problem is no longer just the external stressor. The body’s own stress response has become part of the difficulty.

Under sustained pressure, sleep architecture changes, mood-regulation systems become depleted, and the nervous system can get stuck in patterns that do not resolve on their own, even when circumstances improve. For people in that position, carefully considered medication support can improve our emotional ecosystem enough that other resources, including therapy, relationships, exercise, and time, can do their work.

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The symptoms we see most often

The people who come to us for medication support in these situations generally describe something like this:

• Waking at three in the morning with their mind already running, unable to get back to sleep
• A persistent low mood or flatness that has lasted longer than it should
• Trouble making everyday decisions, like what to wear or eat for dinner
• A hum of tension and worry, even in moments that should feel ordinary
• Feeling “blah” or down in ways that are hard to explain to people around them
• Physical symptoms of stress, including headaches, gastrointestinal complaints, neck pain, and fatigue, that have no clear medical cause
• A growing sense of indifference toward things they used to find fun or meaningful

These experiences often arrive together rather than separately. Poor sleep feeds a low mood. Persistent worry disrupts sleep. Feeling down reduces the motivation to do things that relieve tension. Medication support, when appropriate, addresses the underlying dysregulation rather than treating each symptom in isolation.

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Medication as a bridge, not a destination

Many of our patients come to us with a clear preference: they want the least intervention necessary, for the shortest time that is clinically appropriate. That preference is entirely reasonable, and it shapes how our prescribers approach care.

For situational stress, anxiety, poor sleep, and low mood that are rooted in external circumstances rather than long-standing psychiatric conditions, medication is often most appropriate in a time-limited format. The goal is to stabilize the symptoms enough that the person can engage more fully with their life, their relationships, and any therapeutic work they are doing. When circumstances improve and the person has built or rebuilt their coping resources, tapering off is usually straightforward.

We hear two concerns from patients most often. The first is a worry about not feeling like themselves. This is worth taking seriously, and our prescribers do. Finding the right medication and the right dose is a collaborative process, not a one-size prescription. The second concern is about discontinuation. For most patients, this is not an issue, but for those who are sensitive to it, we offer careful, supported tapering with close follow-up. Neither concern should be a reason to avoid discussing whether medication might help.

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Who we see for medication services

Our medication services are available to three groups of people, and we want to be clear about this because many group practices limit prescribing to their own therapy clients.

We provide medication support to:

• Clients who are also in therapy at Kentlands Psychotherapy, where our prescribers and therapists can collaborate directly as part of an integrated treatment approach
• Clients who have a therapist outside our practice, we are glad to coordinate with that provider as a collaborative part of your care team
• Clients seeking standalone medication management, without therapy, for whom medication monitoring and support alone is the appropriate level of service, and can be transferred to a primary care PCM if requested, once a care plan has proven to be a good fit

Our Client Care Coordinators can help you think through your particular needs before you schedule anything.

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Meet Our Psychiatry Prescribing Team

Kentlands Psychotherapy employs an MD psychiatrist and a doctoral-level psychiatric nurse practitioner (PMHNP), both with more than 20 years of experience in mental health. This matters more than it might seem. Many group practices offer medication services through master’s-level prescribers with significantly less clinical training and experience. Our prescribers bring a depth of knowledge that is more commonly found in hospital or academic settings than in private practice.

Our psychiatric team meets twice monthly for peer consultation and to review current psychopharmacological research. That structure ensures that the care our patients receive reflects both accumulated clinical experience and current best practice.

Our practice operates under the medical directorship of a board-certified psychiatrist with specialized expertise in trauma, which informs how our entire clinical team thinks about the relationship between external stressors and physiological symptoms.

Russell Carr, MD Medical Director	Brent Donmoyer, PMHNP Middle Schoolers and above	Adrian Kress, MD Ten-year-olds and above

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Common questions

Will I feel like myself on medication?

This is one of the most common concerns we hear, and it deserves a direct answer. The goal of medication for situational stress, poor sleep, tension, and low mood is to restore your baseline, not to alter who you are. If a medication makes you feel unlike your healthy self, that is important clinical information and something to address with your prescriber promptly. Finding the right fit is a process, and your experience matters throughout it.

How long will I need to take it?

For symptoms that are rooted in external circumstances rather than long-standing conditions, medication is often genuinely short-term. Many patients use it for a defined period while circumstances stabilize or while they build the coping resources to manage without it. Your prescriber will discuss realistic expectations with you at your initial appointment, and the plan will be reviewed regularly.

What if I want to stop?

For most patients, discontinuing medication at the right time is straightforward. For those who are more sensitive to the process, we provide careful tapering support and close follow-up throughout.

Do I need to be in therapy to receive medication services?

No. While we believe that therapy and medication together often produce better outcomes than either alone, we do not require therapy as a condition of medication services. Some patients prefer medication management as a standalone service, and we support that choice.

I already have a therapist. Can I still see your prescribers?

Yes, and we welcome it. Our prescribers are experienced in working as part of a collaborative care team alongside outside providers. With your permission, we are glad to coordinate with your existing therapist.

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Ready to talk with one of our prescribers? We are glad to help you figure out whether medication support makes sense for you.

Request an appointment

Or call our office. Our Client Care Coordinators are available to answer your questions and help you find the right fit.

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Kentlands Psychotherapy · Gaithersburg, Maryland · Serving Montgomery County and the greater I-270 corridor