Psychotherapy for Treatment of Depression

Taking antidepressant medications plus psychotherapy appears to be the best treatment for moderate to severe depression.

Gold Standard for Treating Depression (part 13)

Numerous studies have asked the question: "what role can psychotherapy play in the treatment of depression?". The findings are positive. Two large-scale studies have strongly suggested that the combination of medications and psychotherapy yield better outcomes. A large study of treatment of adults (2. Keller, et al.2000) found response rates in severely depressed individuals as follows:

• Medication alone: 55%
• Psychotherapy alone: 52%
• A combination of medications and psychotherapy: 85%

In another large study supported by the National Institute for Mental Health (3. March, et al., 2004), adolescents were treated with psychotherapy alone, antidepressants alone and in combination. Response rates were: 43%, 61% and 71%, respectively. This is good news for people with depression.

Because primary doctors are now the main prescribers of medications and usually do not have the resources or time for the contact the Star*D project suggests, a trained psychotherapist can make a very large contribution to your depression treatment plan. Adding psychotherapy to existing medication treatment greatly increases your chance for recovery by

• helping you recognize and change unrealistic thoughts caused by depression,
• providing a safe place for you to discuss the problems you feel that cause depression or that are caused by depression,
• helping family and friends understand the illness and
• helping you to find ways to end the isolation and loneliness often associated with depression.

Antidepressants alone cannot offer all of this help. It makes sense that a combination of two such powerful treatments could increase your chance of remission. For some people, medications often regulate their brain chemistry to a point where a person can actually use the skills taught by psychotherapy.

What are My Psychotherapy Choices?

There are three specific psychotherapy practices that have been found to help depression.

1. Cognitive Therapy

Cognitive therapy helps people examine and change how they think about and respond to internal thoughts and outside situations. These changes can significantly reduce or help a person tolerate depression symptoms. Unlike some other psychotherapy techniques, cognitive therapy focuses on current problems and difficulties as opposed to, for example, looking at a person's childhood. Instead of focusing on the past, the focus of cognitive therapy is to improve a person's immediate state of mind.

An example would be how a person responds to the thought, "My life is hopeless and I will never get better." Cognitive therapy teaches a person to examine the reality of the thought and then counteract it with a more realistic thought such as, "I'm very depressed right now and it makes sense that I feel hopeless. The reality is that I don't feel hopeless when not I'm depressed and I can get better.

2. Interpersonal Therapy

Some people experience depression because of problematic relationships. Interpersonal therapy has been found to be effective for people who have poor communication, conflict resolution and problem-solving skills. The better they can improve these areas, the better chance they have of leaving the situations that cause the depression or at least deal better with those they cannot change.

3. Behavioral Therapy

This therapy helps people change the behaviors that cause their depression as well as offering suggestions for behavior that could improve their mood. For example, a person who isolates his or her self because of depression is encouraged to get out more in order to counteract the depression. This also helps when a person is depressed because they are lonely and need contact with people but are not sure how to start the process.

In this therapy, there is strong encouragement for a person to become more socially involved, strengthen ties with supportive family and friends, and make choices that decrease depression. Some examples include exercising with a friend, joining a group such as a church group, going to the movies, and simply becoming more active in life.

video: Depression Treatment Interviews w/Julie Fast