The Enneagram Guide to Medication and Mental Health

The decision to take psychiatric medication is deeply personal, and your Enneagram type influences how you approach this choice.

Each type has unique fears, hopes, and patterns when it comes to medication. Understanding these patterns can help you communicate better with healthcare providers, make informed decisions, and manage medication more effectively if you choose that path.

This guide explores how each Enneagram type typically relates to psychiatric medication, common concerns, and strategies for navigating this aspect of mental health care.

Understanding Medication Through the Enneagram

Why Type Matters in Medication

Each Enneagram type brings different:

• Core fears about medication
• Motivations for considering it
• Resistance patterns
• Compliance tendencies
• Side effect sensitivities

The Three Centers and Medication Attitudes

Body/Gut Center (8, 9, 1): Focus on control and physical effects Heart Center (2, 3, 4): Concern about identity and image Head Center (5, 6, 7): Analyze extensively, fear mental changes

Type 1: The Perfectionist and Medication

Type 1’s Relationship with Medication

Core Fears:

• Being “weak” for needing help
• Medication as moral failure
• Loss of control over thoughts
• Becoming “imperfect” chemically
• Side effects disrupting order

Common Resistance Patterns:

• “I should fix this myself”
• Researching exhaustively
• Trying everything else first
• Rigid medication routines
• Catastrophizing side effects

What Works for Type 1s

Medication Approach

• Frame as tool for better functioning
• Emphasize increased self-control
• Start low and go slow
• Detailed tracking systems
• Regular review schedules

Helpful Medications Often Include

• SSRIs: For anxiety/depression with minimal side effects
• Buspirone: Non-addictive anxiety relief
• Wellbutrin: Depression without sexual side effects
• Extended-release formulations: Consistent effects

Natural Alternatives Type 1s Often Prefer

• Structured therapy (CBT)
• Meditation programs
• Exercise regimens
• Nutritional psychiatry
• Herbal supplements (with research)

Working with Psychiatrists as Type 1

What You Need:

• Detailed explanations
• Clear expectations
• Side effect probabilities
• Success metrics
• Exit strategies

Communication Tips:

• “I need to understand exactly how this works”
• “What’s the evidence base?”
• “How will we measure success?”
• “What’s the plan if it doesn’t work?”

Red Flags to Watch:

• Perfectionism about dosing
• Hiding side effects
• Self-adjusting doses
• Stopping abruptly

Type 1 Medication Success Story

“I resisted antidepressants for years, thinking I should be strong enough. When I finally tried them, I was amazed—my inner critic got quieter, not because I was numbed, but because my brain could finally access self-compassion. I track my mood daily and work closely with my psychiatrist. Medication didn’t make me perfect; it made me human.” - Anonymous Type 1

Type 2: The Helper and Medication

Type 2’s Relationship with Medication

Core Fears:

• Being “selfish” for focusing on self
• Medication changing their caring nature
• Others seeing them as needy
• Losing ability to help
• Being a burden

Common Resistance Patterns:

• “Others need it more”
• Helping others before self
• Hiding mental health needs
• Taking medication inconsistently
• Prioritizing others’ opinions

What Works for Type 2s

Medication Approach

• Frame as enabling better care for others
• Emphasize maintaining empathy
• Connect to values
• Include loved ones appropriately
• Regular check-ins about needs

Helpful Medications Often Include

• Sertraline (Zoloft): Gentle, good for anxiety
• Escitalopram (Lexapro): Minimal side effects
• Lamotrigine: Mood stabilization
• Gabapentin: Anxiety without dependence

Natural Alternatives Type 2s Often Prefer

• Group therapy
• Heart-centered meditation
• Volunteering (with boundaries)
• Massage/bodywork
• Connection-based healing

Working with Psychiatrists as Type 2

What You Need:

• Warm, caring provider
• Permission to prioritize self
• Validation of struggles
• Collaborative approach
• Family involvement options

Communication Tips:

• “I’m worried about how this affects my relationships”
• “Will I still feel empathy?”
• “How can I help my loved ones understand?”
• “Is it okay to need this?”

Red Flags to Watch:

• Giving meds to others
• Skipping doses for others
• Not reporting side effects
• People-pleasing with provider

Type 2 Medication Success Story

“I felt so guilty taking antidepressants—wasn’t I supposed to be the caregiver? But my therapist helped me see that self-care IS caring for others. On medication, I can still feel deeply, but I’m not drowning in everyone’s emotions. I’m a better friend and mom because I’m stable.” - Anonymous Type 2

Type 3: The Achiever and Medication

Type 3’s Relationship with Medication

Core Fears:

• Appearing weak or broken
• Reduced performance
• Others finding out
• Losing competitive edge
• Identity without achievement

Common Resistance Patterns:

• “I don’t have time for this”
• Hiding medication use
• Wanting quick fixes
• Stopping when functional
• Image management

What Works for Type 3s

Medication Approach

• Frame as performance enhancement
• Emphasize functionality
• Quick-acting options
• Discrete management
• Success metrics

Helpful Medications Often Include

• Modafinil: Wakefulness without jitters
• Bupropion: Energy and focus
• Vyvanse: ADHD with less crash
• Propranolol: Performance anxiety

Natural Alternatives Type 3s Often Prefer

• Executive coaching
• Biohacking approaches
• Performance nutrition
• High-intensity exercise
• Mindfulness for success

Working with Psychiatrists as Type 3

What You Need:

• Efficient appointments
• Results-focused approach
• Privacy assurance
• Practical solutions
• Minimal disruption

Communication Tips:

• “I need to maintain my edge”
• “How quickly will this work?”
• “What about my performance?”
• “Can we be discrete?”

Red Flags to Watch:

• Medication abuse for performance
• Not reporting struggles
• Image over health
• Stopping when “successful”

Type 3 Medication Success Story

“I saw medication as failure until burnout forced my hand. Starting Wellbutrin was like lifting a weight off my chest—I could still achieve, but without the desperate edge. I’m actually MORE successful now because I’m not running on anxiety. I tell other Type 3s: it’s not cheating, it’s smart.” - Anonymous Type 3

Type 4: The Individualist and Medication

Type 4’s Relationship with Medication

Core Fears:

• Losing their depth/uniqueness
• Becoming “ordinary”
• Emotional numbing
• Creativity loss
• Identity change

Common Resistance Patterns:

• “Suffering makes me authentic”
• Fear of happiness
• Rejecting “normal” solutions
• Inconsistent compliance
• Romanticizing illness

What Works for Type 4s

Medication Approach

• Honor their uniqueness
• Emphasize emotional range
• Artistic/creative framing
• Individualized approach
• Meaning-making included

Helpful Medications Often Include

• Lamictal: Mood stability without numbing
• Seroquel (low dose): Sleep and mood
• Ketamine therapy: Rapid relief
• Lithium (low dose): Gentle stabilization

Natural Alternatives Type 4s Often Prefer

• Art/music therapy
• Depth psychology
• Plant medicine (legal)
• Somatic experiencing
• Creative expression

Working with Psychiatrists as Type 4

What You Need:

• Provider who “gets” you
• Validation of uniqueness
• Collaborative creativity
• Depth understanding
• Flexible approaches

Communication Tips:

• “I’m afraid of losing myself”
• “Will I still feel deeply?”
• “What about my creativity?”
• “I need to stay authentic”

Red Flags to Watch:

• Stopping during stable periods
• Romanticizing symptoms
• Medication splitting
• Identity crisis fears

Type 4 Medication Success Story

“I thought antidepressants would make me a happy robot. Instead, they gave me the stability to actually USE my depth. I still feel everything—I just don’t drown in it. My art has actually improved because I can channel emotions instead of being consumed by them.” - Anonymous Type 4

Type 5: The Investigator and Medication

Type 5’s Relationship with Medication

Core Fears:

• Mind alteration/control
• Dependence on externals
• Unknown effects
• Losing mental clarity
• Forced vulnerability

Common Resistance Patterns:

• Exhaustive research paralysis
• DIY approaches first
• Minimal effective dose
• Hoarding information
• Avoiding psychiatrists

What Works for Type 5s

Medication Approach

• Full information provided
• Start very low
• Patient control
• Minimal side effects
• Exit strategy clear

Helpful Medications Often Include

• Low-dose SSRIs: Minimal intervention
• Strattera: Non-stimulant focus
• Buspar: Non-addictive anxiety
• Micro-dosing protocols: Control maintained

Natural Alternatives Type 5s Often Prefer

• Nootropics
• Meditation retreats
• Solo therapy
• Research participation
• Biofeedback

Working with Psychiatrists as Type 5

What You Need:

• Competent provider
• Research discussion
• Minimal appointments
• Email communication
• Autonomy respected

Communication Tips:

• “I’ve researched extensively”
• “I need to understand the mechanism”
• “What does the research say?”
• “I prefer minimal intervention”

Red Flags to Watch:

• Self-medicating
• Hoarding medications
• Not reporting effects
• Isolation during trials

Type 5 Medication Success Story

“I spent two years researching before trying an SSRI. I started at 1/4 the normal dose and tracked everything. To my surprise, it didn’t dull my mind—it actually freed up mental energy I was using to manage anxiety. I still think deeply; I just don’t spiral.” - Anonymous Type 5

Type 6: The Loyalist and Medication

Type 6’s Relationship with Medication

Core Fears:

• Side effects
• Addiction potential
• Wrong medication
• Provider betrayal
• Making things worse

Common Resistance Patterns:

• Reading all warnings
• Seeking multiple opinions
• Starting/stopping frequently
• Catastrophizing effects
• Testing providers

What Works for Type 6s

Medication Approach

• Slow, careful titration
• Regular check-ins
• Clear protocols
• Support system
• Predictable effects

Helpful Medications Often Include

• Lexapro: Well-studied, predictable
• Hydroxyzine: As-needed anxiety
• Gabapentin: Non-addictive option
• Extended-release: Consistent effects

Natural Alternatives Type 6s Often Prefer

• Structured therapy
• Support groups
• Exercise programs
• Routine-based healing
• Community approaches

Working with Psychiatrists as Type 6

What You Need:

• Trustworthy provider
• Consistent availability
• Clear communication
• Evidence-based approach
• Patience with questions

Communication Tips:

• “What are all the risks?”
• “How do I know it’s working?”
• “What if something goes wrong?”
• “Can I trust this process?”

Red Flags to Watch:

• Googling obsessively
• Multiple provider opinions
• Stopping from fear
• Not reporting concerns

Type 6 Medication Success Story

“My anxiety about taking anxiety medication was ironic. I grilled my psychiatrist for three sessions before starting. She patiently answered everything. Now on Lexapro, I realize my constant worry wasn’t ‘being prepared’—it was suffering. I still plan, but I don’t panic.” - Anonymous Type 6

Type 7: The Enthusiast and Medication

Type 7’s Relationship with Medication

Core Fears:

• Feeling limited/trapped
• Emotional dulling
• Loss of joy/excitement
• Dependency
• Facing pain

Common Resistance Patterns:

• “I don’t need it, I’m fine!”
• Trying briefly, stopping
• Preferring “natural highs”
• Multiple substances
• Avoiding emotional work

What Works for Type 7s

Medication Approach

• Frame as expanding options
• Emphasize maintained joy
• Combination approaches
• Flexible regimens
• Quick effects appreciated

Helpful Medications Often Include

• Wellbutrin: Energy without mania
• Vyvanse: Focused energy
• Mood stabilizers: Prevent crashes
• As-needed options: Flexibility

Natural Alternatives Type 7s Often Prefer

• Adventure therapy
• Multiple modalities
• Movement-based healing
• Travel/exploration
• Varied approaches

Working with Psychiatrists as Type 7

What You Need:

• Engaging provider
• Options presented
• Flexibility
• Quick appointments
• Positive focus

Communication Tips:

• “Will I still feel joy?”
• “I need flexibility”
• “What about my energy?”
• “Keep it interesting”

Red Flags to Watch:

• Medication non-compliance
• Mixing substances
• Chasing highs
• Avoiding emotional depth

Type 7 Medication Success Story

“I avoided medication because I thought it would cage me. ADHD meds changed everything—I still have enthusiasm, but I can actually FINISH things. Mood stabilizers helped me realize: true joy comes from depth, not just novelty. I’m more alive, not less.” - Anonymous Type 7

Type 8: The Challenger and Medication

Type 8’s Relationship with Medication

Core Fears:

• Loss of control
• Appearing weak
• Vulnerability
• Dependence
• Being manipulated

Common Resistance Patterns:

• “I can handle it myself”
• Power struggles with providers
• Secret use if any
• Stopping abruptly
• Minimal doses only

What Works for Type 8s

Medication Approach

• Frame as taking control
• Emphasize strength
• Patient autonomy
• Direct communication
• Power maintained

Helpful Medications Often Include

• Testosterone (if low): Energy/strength
• Modafinil: Alertness/power
• Low-dose mood stabilizers: Control
• As-needed anxiety meds: Choice

Natural Alternatives Type 8s Often Prefer

• Intense physical exercise
• Martial arts
• Leadership coaching
• Wilderness therapy
• Strength-based approaches

Working with Psychiatrists as Type 8

What You Need:

• Strong, direct provider
• Respect for autonomy
• No condescension
• Collaborative power
• Honest communication

Communication Tips:

• “I need to maintain control”
• “Be straight with me”
• “I make the final decision”
• “Don’t treat me as weak”

Red Flags to Watch:

• Not disclosing use
• Power struggles
• Stopping without telling
• Denying need

Type 8 Medication Success Story

“Asking for antidepressants felt like surrender. My psychiatrist reframed it: ‘You’re taking control of your brain chemistry.’ That clicked. On medication, I’m not weaker—I’m strategic. I have MORE power because I’m not fighting myself. Real strength includes getting help.” - Anonymous Type 8

Type 9: The Peacemaker and Medication

Type 9’s Relationship with Medication

Core Fears:

• Conflict with providers
• Making wrong choice
• Others’ opinions
• Change/disruption
• Being difficult

Common Resistance Patterns:

• Going along passively
• Not voicing concerns
• Forgetting doses
• Avoiding decisions
• Minimizing symptoms

What Works for Type 9s

Medication Approach

• Gentle encouragement
• Simple routines
• Automated reminders
• Minimal side effects
• Gradual changes

Helpful Medications Often Include

• Sertraline: Gentle activation
• Wellbutrin: Energy without anxiety
• Trazodone: Sleep support
• Extended-release: Simplicity

Natural Alternatives Type 9s Often Prefer

• Gentle yoga
• Nature therapy
• Acupuncture
• Meditation
• Body-based healing

Working with Psychiatrists as Type 9

What You Need:

• Patient provider
• Encouragement to speak
• Validation of needs
• Simple protocols
• Regular check-ins

Communication Tips:

• “I tend to minimize”
• “Ask me directly”
• “I need encouragement”
• “Help me decide”

Red Flags to Watch:

• Not reporting problems
• Passive compliance
• Forgetting frequently
• Others deciding

Type 9 Medication Success Story

“I went along with medication for years without really engaging. When I finally spoke up about side effects, we found the right fit. Wellbutrin woke me up—not anxiously, but like morning sunshine. I realized: advocating for my needs isn’t conflict, it’s self-care.” - Anonymous Type 9

Universal Medication Principles

Questions for Any Provider

1. Mechanism: How does this work?
2. Timeline: When will I see effects?
3. Side Effects: What’s common/rare?
4. Interactions: With other meds/supplements?
5. Exit Strategy: How do I stop safely?

Managing Medication by Type

Body Types (8,9,1): Focus on physical effects and control Heart Types (2,3,4): Address identity and relationship concerns Head Types (5,6,7): Provide information and mental clarity focus

Natural Alternatives by Center

Body Center: Physical practices, somatic work Heart Center: Relational therapy, creative expression Head Center: Meditation, cognitive approaches

Making Your Decision

Consider Medication When

• Therapy alone isn’t enough
• Functioning is impaired
• Safety is concerned
• Quality of life is poor
• You’re ready to try

Medication Is One Tool

Remember:

• Not a sign of weakness
• Not necessarily forever
• Works best with therapy
• Your choice always
• Can be life-changing

Finding the Right Provider

Look for someone who:

• Respects your autonomy
• Understands your concerns
• Offers collaborative care
• Provides clear information
• Supports your decision

Integration and Holistic Care

Medication + Type Work

• Use type insights for communication
• Address type-specific fears
• Build on type strengths
• Monitor through type lens
• Integrate with growth

Whole Person Approach

Consider:

• Therapy alongside medication
• Lifestyle modifications
• Social support
• Spiritual practices
• Regular reassessment

Conclusion: Your Choice, Your Journey

Medication is a deeply personal decision that intersects with your Enneagram type in unique ways. Understanding your type’s patterns can help you:

• Communicate effectively with providers
• Address your specific concerns
• Make informed decisions
• Manage medication better if you choose it
• Find alternatives that resonate

There’s no “right” choice—only what’s right for you at this time. Whether you choose medication, natural alternatives, or a combination, let your decision be informed by both your type’s wisdom and professional guidance.

Remember: Seeking help, in whatever form, is an act of strength. Your Enneagram type shows you how to seek help in a way that honors who you are while supporting who you’re becoming.