Is Medication or Psychotherapy Effective for Depression?
Researchers at Emory University suggest that a scan of an area of the brain called the insular cortex will be decisive in determining whether a depressed patient will benefit from psychotherapy or antidepressants. This area, located just above the ear, is known as one of the areas that govern emotions.
According to the researchers’ data, psychotherapy is most beneficial for those whose insular cortex consumes excessive glucose. They suggest that antidepressants are more effective in depressed patients, where this part of the brain is more passive and therefore consumes less glucose. “If our results are confirmed by other tests, then it will be the first objective determination to choose a treatment method for depression,” says Dr Helen Mayberg, one of the research team.
best depression treatment
According to US researchers, there is currently no way to predict which treatment method would be best for a depressed patient. Usually, doctors use one method, if that doesn’t work, they try another method. An article by Emory University researchers, published in the health journal “JAMA Psychiatry,” suggests that in less than 40 percent of people with depression, the first course of treatment is successful.
The German Guide to Combating Depression recommends that severe depression be treated with both medication and psychotherapy, and that antidepressants should not be used in mild depressions. Doctor Wolfgang Maier states that the guide probably does not take 100% account of which doctor the patient consults. Because, according to Maier, the patient usually takes psychotherapy if he consults a psychotherapist, and antidepressants if he goes to his family doctor. However, sometimes the patient can benefit from both treatments if he goes to a psychiatrist. Maier emphasizes that both methods are used only in well-managed psychiatry clinics of hospitals.
Too many antidepressant prescriptions
The number of people taking antidepressants in Germany has quadrupled compared to 10 years ago. Experts point out that this trend continues to increase at an annual average rate of 10 percent. For this reason, critical voices began to rise that many patients were using drugs unnecessarily. Dieter Best, President of the German Association of Psychotherapists, is among those who agree with this criticism. “Family doctors prescribe these drugs especially to older women without making a definitive diagnosis,” Best says. Best states that one out of every four women over the age of 80 in Germany currently takes antidepressants. But, according to Best, the problem with these women is the lack of social relationships and loneliness. For this reason, Best recommends that family physicians spend more time with their patients and their relatives and make a well-founded diagnosis. “Not everyone who is unhappy is depressed,” Best says.
There are also arguments that the commercial interests of pharmaceutical companies are behind doctors’ prescribing so many antidepressants. But Doctor Wolfgang Maier, from the Department of Psychiatry and Psychotherapy at the University of Bonn Medical Faculty Hospital, opposes this. Maier said, “Bullshit. Why overuse medication, and I could argue that psychotherapy is overused, but both would be wrong. I think very few antidepressant prescriptions are written. Antidepressants are effective drugs against depression. Nowhere is it documented that psychotherapy is a better form of treatment. On the contrary, severe depressions should be treated with antidepressants. Otherwise, there is a risk that the patient will attempt suicide.”
Although depression can be seen at any age, it occurs twice as often in middle-aged and women as in men. If left untreated, the risk of chronicity and recurrence increases. Feelings of grief, grief, hopelessness and helplessness are intense and continuous, which can disrupt the daily life of the depressed person. The person not only slows down mentally and physically, but also complains of lack of energy. As with all psychiatric disorders, biological, psychological and social events also play an important role in the emergence of depression. Sometimes medication, sometimes psychotherapy, and sometimes both methods are used in the treatment of this disorder.
Is It Medication?
Today, effective drugs that are safe to increase the levels of neurochemicals such as serotonin and noradrenaline in the brain, which are thought to be responsible for depression, that provide ease of use once a day and do not have side effects such as sleepiness and drowsiness, are frequently used in treatment. Because anxiety often accompanies depression, medications are very effective in controlling this situation, eliminating depressive mood symptoms such as unhappiness, hopelessness, helplessness and grief, and relieving attention and concentration difficulties. Medical treatment quickly and effectively improves the patient’s deteriorated quality of life and social and occupational performance. In cases where there is depression in the family, a history of previous depressive episodes treated with medication, depressions caused by a general medical condition (such as head trauma, hormonal disorders, post-surgery) and intense anxiety, it is important to prefer drug treatment first.
Psychotherapy?
Psychotherapy comes to the fore in the treatment of recurrent depressions that have been previously treated with medication, in cases where drug use is not possible, in depressions caused by life events (such as divorce, loss of spouse or job or change), and in patients with sub-threshold chronic depressive mood. There are many psychotherapy techniques such as classical psychoanalysis, psychoanalytic therapies, supportive psychotherapies, cognitive behavioral therapies. These methods are very helpful in finding and revealing the unconscious causes of the situations that lead to depression, in using the coping skills of the patient, in recognizing and defining the difficulties experienced. Eliminating learned helplessness and teaching people to change their negative view of themselves, their environment and the future play an effective role in psychotherapy treatments. Recognizing depression, learning how to fight it, changing the negative perception in cognitive data and information processing related to various life events are discussed in psychotherapies. The vicious circle between negative thoughts and depression is tried to be shown to the patient. Dealing with problems in a healthy and realistic way, testing them, and developing healthy and alternative thoughts in the face of life events are essential in the psychotherapy of the depressed patient. However, it should not be forgotten that psychotherapies are long-term treatments. Many studies show that a combination of medication and psychotherapy is often more effective.
depression medication
While medication may seem like the most recommended treatment for depression, it may not be the most effective. Because depression is not caused by a chemical imbalance in the brain. Although medication can help relieve some of the symptoms of moderate to severe depression, it does not cure the underlying problem and is not usually a long-term solution. In addition, antidepressant group drugs have many side effects and the process of quitting the drug can be difficult.
If you’re on medication for depression, don’t ignore other supportive treatments. Lifestyle changes and psychotherapy can help you recover from depression as well as prevent its recurrence.
Side effects of depression medications
The side effects of antidepressants can cause problems at first, but the drugs start to work after a few weeks of regular use. Therefore, it is necessary to continue despite the side effects. Over time, these effects will decrease. During the first few months of treatment, you may need to see your doctor at least every 2 to 4 weeks to keep track of how the medicine is affecting you.
Recommendations for patients with depression
Exercise: Regular exercise can be as effective as medication in treating depression. During exercise, the release of serotonin, endorphins and other feel-good brain chemicals increases. Also, exercise triggers the formation of new brain cells, like antidepressants.
Get social support: Strong social networks reduce isolation. Loneliness is the main risk factor for depression. Stay in regular contact with friends and family or join a course or group. Volunteering allows you to help yourself while helping others.
Conclusion
Among psychiatric disorders, especially depression, when treated effectively, it results in almost complete recovery. Although most patients do not want to be treated with medication, the decision to treat depression with medication or psychotherapy is made by the physician. Studies show that people with depression who are treated only with medication get sick again over the years. As with all psychiatric treatments, medical methods offer limited treatment opportunities in depression. For this reason, it is important to start an appropriate psychotherapy technique together, considering the individual’s mental state, education level and the time he can spare for treatment, as well as appropriate drug treatments for careful evaluation of the patient, elimination of emergencies and rapid improvement of the deteriorated quality of life.
