“Is therapy alone sufficient for depression?”
I have depression and want to get rid of it. Is therapy alone sufficient for depression?
8 Answers
Councelor/TherapistPsychologist
Therapy can be effective for many, but often a combination of therapy and medication is recommended for optimal results. For more information, please contact your mental health provider or, if you are in Texas, schedule an appointment with Mid Cities Psychiatry.
You would have to get evaluated to see if therapy alone is sufficient for depression. Some people need medication to treat the depression while doing therapy but others don't.
In depression, biological and psychological factors are often intertwined. Major Depression is recognizable to most clinicians: the stony, humorless, frowning face, the sleep and appetite disturbances, the profound negativity and obsessive worry about financial ruin, the agitation, the hopelessness, the suicidal thoughts. This presentation requires anti-depressant medication (provided no organic cause exists and a bipolar diathesis has been addressed). Common antidepressants include SSRI's, SNRI's, and bupropion, and often improvement is seen within 3 weeks or so.
Other patients will present with more of a mix of issues, including unresolved grief states, substance abuse or addiction, divorce and family problems, PTSD and dissociation due to childhood trauma, and character pathology, especially in their intimate relationships. These patients can be extremely depressed, hopeless, and suicidal, and yet often don't respond to the usual treatment strategies. Psychotherapy is essential for these depressed patients. They frequently have disordered attachments and extreme life events that damage their self-esteem, their sense of security in relationships, and even their right to exist in this world. Their profound insecurity makes every interaction with others fraught with fear and the conviction that they will always be rejected. Their negativity bias creates self fulfilling prophesies which confirm their sense of being unlovable making them a perpetual outsider. When they are treated with anti-depressants, some do improve in their depressive symptoms. But for others who don't improve. their lack of response to the medication can be for them evidence of their defectiveness. These people often live in survival mode where everything is a matter of life and death, and the drama that goes along with it. In treatment, they need to establish a positive, trusting relationship with a therapist who understands their struggles with compassion and without being judgmental.
Many of these patients will initially not respond to anti-depressants. However, as their ability to begin to have a healthy therapeutic relationship grows, another trial of an antidepressant will often succeed as their ability to imagine that they can heal increases. Anecdotally I have found that medications that are dopaminergic like bupropion and dopamine agonists are especially helpful in that dopamine increases their desire to connect to other people.
Overall, it's relatively easy to take an anti-depressant and much harder to be in therapy. So, often it is worth a trial of an anti-depressant, because when one has Major Depression, it is almost impossible to benefit from psychotherapy. Being treated for depression with medication facilitates the therapeutic process.
Other patients will present with more of a mix of issues, including unresolved grief states, substance abuse or addiction, divorce and family problems, PTSD and dissociation due to childhood trauma, and character pathology, especially in their intimate relationships. These patients can be extremely depressed, hopeless, and suicidal, and yet often don't respond to the usual treatment strategies. Psychotherapy is essential for these depressed patients. They frequently have disordered attachments and extreme life events that damage their self-esteem, their sense of security in relationships, and even their right to exist in this world. Their profound insecurity makes every interaction with others fraught with fear and the conviction that they will always be rejected. Their negativity bias creates self fulfilling prophesies which confirm their sense of being unlovable making them a perpetual outsider. When they are treated with anti-depressants, some do improve in their depressive symptoms. But for others who don't improve. their lack of response to the medication can be for them evidence of their defectiveness. These people often live in survival mode where everything is a matter of life and death, and the drama that goes along with it. In treatment, they need to establish a positive, trusting relationship with a therapist who understands their struggles with compassion and without being judgmental.
Many of these patients will initially not respond to anti-depressants. However, as their ability to begin to have a healthy therapeutic relationship grows, another trial of an antidepressant will often succeed as their ability to imagine that they can heal increases. Anecdotally I have found that medications that are dopaminergic like bupropion and dopamine agonists are especially helpful in that dopamine increases their desire to connect to other people.
Overall, it's relatively easy to take an anti-depressant and much harder to be in therapy. So, often it is worth a trial of an anti-depressant, because when one has Major Depression, it is almost impossible to benefit from psychotherapy. Being treated for depression with medication facilitates the therapeutic process.
Therapy can be sufficient to treat depression for some people. Other people find they do best with therapy combined with medication. It's not possible to tell what you might need or discover that you want (even if you think you know, for instance, that you'd never want to be on medication).
Therapy in conjunction with medication typically yields the best treatment outcomes for depression. Melanie Sholtis, Psy.D. Licensed Psychologist (240)-210-9003
It depends. Talk therapy can be extremely helpful for people who struggle with depression. If, after some period of time (which varies from person to person), a person's mood is not improving, a consultation with a seasoned medical/psychiatric professional may be recommended. In general, research seems to indicate that a combination of therapy and medication is the most effective treatment for depression.
The research literature indicates that cognitive behavioral therapy (CBT) provides roughly equivalent rates of improvement for people with major depression compared to those who take an antidepressant. However, the research literature indicates that those people with depression who improve as a result of CBT usually worsen with respect to their depression after they stop CBT. I think that any single antidepressant will provide benefits for 60 - 70% of people with depression. Any single antidepressant has a 30 - 33% chance of getting the depressed person to remission within 8 weeks (so the person no longer meets criteria for major depression). The exception is for the antidepressant, Trintellix. The clinical trial data for the Trintellix were that 50 - 60% of the depressed people taking it achieved remission within 8 weeks. The research literature indicates that the people with depression who do best (greatest improvement and largest percentage of people who improve) both undergo therapy with CBT and take antidepressant medication. And medication options include successive trials of antidepressants, combinations of antidepressants, addition(s) of medication that can make an antidepressant work better (including ketamine and Spravato), transcranial magnetic stimulation (TMS), and, for those whose depression is severe and unresponsive to treatment, electroconvulsive therapy (ECT).
What a great question. Way to go - proactive, motivated, inquisitive, and determined.
No. While a significant component of a treatment plan, the general consensus is that therapy alone is not sufficient to treat depression. Please know that I am not a PhD. I am an M.A. level school psychologist and practitioner. After extensive training, most in the profession agree with me. We place emphasis on therapy and yet realize it is not sufficient to treat if used as the sole treatment. The challenge is deeper. Also, some had mild forms of depression co-occurring with other forms of stress. Others had more severe forms that could have resulted in major depressive disorder.
1. Addressing thoughts and concerns to identify truth and remove error is the best way to start. Among the areas to consider (where erroneous thoughts might have crept to cause frustration) are those areas that can be a source of comfort and support if healthy, legal, and wise: faith and spiritual matters; worldview; health; humanity; perceptions about the human body; perceptions about people; relationships; finance; emotions (of course); and more.
2. Most clinicians now recommend a multi-modal approach to treating depression. This is true for other ailments.
3. I recommend a wellness approach to treatment:
a. whole health approach, which acknowledges the human body is a connected unit of systems with all body systems interconnected. This approach considers exercise, healthy eating, physical boundaries, rest, and medicinal options (only if absolutely necessary);
b. spiritual and faith connection;
c. supportive community of friends and family;
and
d. positivity while staying realistic, honest, and humble
Great question! Please ask if you seek to answer more questions.
No. While a significant component of a treatment plan, the general consensus is that therapy alone is not sufficient to treat depression. Please know that I am not a PhD. I am an M.A. level school psychologist and practitioner. After extensive training, most in the profession agree with me. We place emphasis on therapy and yet realize it is not sufficient to treat if used as the sole treatment. The challenge is deeper. Also, some had mild forms of depression co-occurring with other forms of stress. Others had more severe forms that could have resulted in major depressive disorder.
1. Addressing thoughts and concerns to identify truth and remove error is the best way to start. Among the areas to consider (where erroneous thoughts might have crept to cause frustration) are those areas that can be a source of comfort and support if healthy, legal, and wise: faith and spiritual matters; worldview; health; humanity; perceptions about the human body; perceptions about people; relationships; finance; emotions (of course); and more.
2. Most clinicians now recommend a multi-modal approach to treating depression. This is true for other ailments.
3. I recommend a wellness approach to treatment:
a. whole health approach, which acknowledges the human body is a connected unit of systems with all body systems interconnected. This approach considers exercise, healthy eating, physical boundaries, rest, and medicinal options (only if absolutely necessary);
b. spiritual and faith connection;
c. supportive community of friends and family;
and
d. positivity while staying realistic, honest, and humble
Great question! Please ask if you seek to answer more questions.
