Drugs aren't the whole answer in treating clinical depression

4/17/2005

The best-kept secret about clinical depression, which affects about 19 million adults in the United States every year, is that drugs are not the only effective treatment.

Psychotherapy also works, and has advantages over drugs.

Don t turn the page, or get turned off, because of misconceptions about that word, psychotherapy.

Many people think it involves years of pricey sessions with a psychoanalyst, maybe one who looks like Sigmund Freud or Helene Deutsch, searching for childhood roots of emotional problems in your unconscious mind. The therapist, they think, listens but offers little advice or comment aside from an occasional Hummm, that s interesting

The forms of psychotherapy used for clinical depression, and other common psychological disorders, are much different and more practical. They are brief and involve plenty of practical advice from the therapist. The therapist is a teacher, counselor, and coach. Patients even get homework assignments. Sessions focus on changing the specific kinds of thinking and behavior causing the disorder.

This brief, focused treatment -- termed cognitive therapy or cognitive-behavioral therapy (CBT) -- has been in the news. A major University of Pennsylvania study this month concluded that it is as effective as antidepressant medicine in treating people with moderate or severe depression.

Other studies also have reported good results with CBT for clinical depression. Some found that CBT combined with antidepressants is surprisingly effective in virtually eliminating the symptoms of depression.

Cognitive means thinking. Behavior is how people act. CBT is based on the idea that people with disorders like depression think in ways that cause unwanted behavior and feelings. Change the way people think about situations in life, and you change the way they feel and act when those situations occur.

CBT teaches patients to recognize and reject irrational, depressing thoughts that are causing unhappiness and replace them with more accurate thoughts which also are happier and less depressing.

People with depression, for instance, may have distorted thoughts about themselves ( I am useless. ), their lives ( Totally awful. ), and the future ( No sense in continuing because only bad things lie ahead. )

The therapist uses information from the patient s current life, past history, and future prospects is used to counter the distorted thoughts.

One of the fastest kinds of psychotherapy, CBT takes an average of 16 sessions compared to years for psychoanalysis. Studies show that about 75 per cent of patients benefit.

Millions of people in the United States take drugs like Prozac, Zoloft, Paxil, and Celexa for depression. They are wonderful medicines that change lives, and even save lives since there is a link between severe depression and suicide.

Antidepressants start working within a couple weeks and are unbeatable for convenience. You just swallow a pill.

Like almost all modern drugs except antibiotics, however, antidepressants don t cure the disease. You ve got to keep taking the medicine, paying the drug company, and putting up with side effects sometimes indefinitely.