There are many different opinions about whether psychotherapy, antidepressants, or a combination of the two is the most appropriate response to depression. As with most debated topics, there’s no single answer that applies to all people. But we do know that medication without therapy is generally the least effective: most people respond best to either therapy alone or therapy in partnership with antidepressants, at least for awhile. Repeated studies have shown the combined approach to be preferable for most patients.
Both psychotherapy and medications have played a changing role over time. Decades ago, therapy was considered ineffective and was widely dismissed; today it’s the first thing recommended for those facing depression, anxiety, or emotional turbulence in general. Not surprisingly, the public attitude toward medication is constantly evolving as well. For example, the number of kids prescribed stimulants for ADHD is on a steady rise, while the number of kids prescribed antidepressants is going down. This second fact comes from a recent report on depression among children and teens. After the FDA issued warnings that antidepressants could increase suicidal thoughts or actions in children and adolescents, both of those groups experienced a decrease in antidepressant use and an increase in psychotherapy.
Among adults, the use of antidepressants is also dropping, but not in the way you’d expect. According to a study published in European Psychiatry, the majority of people being treated for depression stop taking prescribed medication before it’s recommended that they do so. (No data was given on whether these patients were also involved in psychotherapy, and whether they continued to see a therapist as advised.) If a person is prescribed antidepressants and wishes to incorporate them into their depression treatment plan, it’s usually recommended that they take them for at least six months, so they really have a chance to work. But by even four months in, 56% of people had stopped with the treatment. It’s unclear whether they stopped because they felt better, saw no change, or felt worse. But one is clear: as our understanding of both therapy and medication progresses, our attitudes of each will continue to evolve as well.
© Copyright 2010 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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