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Talk therapy may be a helpful supplemental treatment for people with depression who have not responded to medication, a new study from the United Kingdom suggests.
Researchers found that people with depression who had not improved despite taking antidepressants were three times more likely to experience a reduction in their depression symptoms if talk therapy was added to their treatment regimen compared with those who continued to take only antidepressants.
The study is one of the first large trials to test the effectiveness of talk therapy given in tandem with antidepressants, the researchers said.
Up to two-thirds of people with depression don’t respond fully to antidepressant treatment, and the findings suggest a way to help this group, the researchers said.
“Until now, there was little evidence to help clinicians choose the best next step treatment for those patients whose symptoms do not respond to standard drug treatments," study researcher Nicola Wiles of the University of Bristol's Centre for Mental Health, Addiction and Suicide Research said in a statement.
The study followed patients for one year. Future studies should examine the effectiveness of this treatment combination over the long term, as patients with depression can relapse after treatment, the researchers said.
In addition, because some patients did not improve substantially when talk therapy was added, further research is needed to find alternative treatments for this group, Wiles added.
The study included about 470 people with depression who had not responded to antidepressants after six weeks of treatment. About half received cognitive behavioral therapy — a type of talk therapy — in addition to their usual antidepressant treatment, and half continued antidepressants without the addition of talk therapy.
After six months, about 46 percent of patients in the talk therapy group experienced at least a 50 percent reduction in their depressive symptoms. By contrast, 22 percent of people in the antidepressant group improved by the same amount. By the 12-month mark, both groups experienced similar rates of improvement.
Often, talk therapy is more difficult to access than medication, the researchers said. And people may not be able to afford the treatment if their health insurance does not cover it. Only about 25 percent of Americans with depression have received talk therapy during the past year, they said.
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talking therapy is very beneficial - if you can afford it ...
If one is a US Military Veteran the Spokane VA offers no help for Vets in distress, only lock-up if we get too depressed and out-sourced to the County Hosp. I am afraid of the VA "mental health system" where we are treated by civilian m.d's who have no idea what made Vets so depressed.
VAMC "mental health" has improved little since Jeraldo Rivera did his M.H. Expose in the early 1970. I wish I'd fled to Canada!
talk therapy worked for me. so well, in fact, that I am no longer on medication. In my opinion it should be the first course of action instead of medication.
You're exactly right -- it should be the first resort; for one thing, a person's depression may be reduced by dealing with past events and destructive thought patterns. But these days, too many just want a pill, and docs seem too happy to oblige. And it's hard not to wonder if money is driving that.
Psych meds without counseling seems like bad medicine.
I agree. Medication is cheaper though! Sometimes I think medication on board first...then you can get the full benefit/help from talk therapy.
Anti-depressants were originally meant to correct depression that was caused by a chronic physical ailment, i.e. a simple chemical imbalance in the brain.
However, if the depression is from a psychological cause (i.e. past trauma, unresolved emotional issues, etc), then the drugs only lessen the symptoms. The cause remains, and is allowed to fester and grow stronger as the months pass, until the symptoms grew too intense for the drugs to compensate.
IMHO, depression should be treated with light anti-depressants AND with therapy, as a combined treatment. Drugs alone won't solve the underlying cause, and therapy alone may not work if the patient lacks motivation due to their deep depression.
When using both treatments combined, however, the drugs lighten the patient's mood, giving them more motivation and makes it easier for them to see "the light at the end of the tunnel". With this, therapy becomes more effective at helping the patient resolve the underlying emotional trauma that caused the depression in the first place.
Take it from someone who's been there, and almost lost it all, if not for a good therapist. Therapy can be expensive, but it is more than worth it. Drugs will not save you, they will only hide you from your troubles for a brief time. Only by resolving your past with the help of a trained professional, can you move on with your life.
Maybe some laughter therapy would work. I know if I'm feeling down, laughter just picks me right up again.
No kidding. This is ass-backwards. Talk therapy should be the FIRST place you go. After all, talking it out and gaining insights and new perspectives actually causes improvement. Drugs just mask the problem. I am offended by the slant of this article. Apparently the writer of the article subscribes to the very dangerous and extremely limited viewpoint that drugs somehow "cure" trauma and PTSD and other problems caused by being human. Which is ridiculous. Start with talk therapy folks. It takes courage, it hurts, but being numb for decades on antidepressants is a waste of time and money and a life, because you lose your drive, your creativity, and your personality if the drugs DO work, and even more if the drugs do NOT work. AND, most of them are placebo anyway, according to the newest information, so you're basically being lied to and ripped off....not a good thing to happen between a "healer" and a client. The whole subject makes me furious. So many psychotherapists and psychiatrists are more mentally ill and out of balance than those who come seeking help.
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Drugs first, prescribed like candy...then only if all else fails, the very last resort, is talking. If your insurance will cover it. What's wrong with this picture?
Plenty.
Talk therapy is the only cure for depression and it is the cheapest cure there is for any diagnosed “illness”, ….. that is if you administer it yourself.
Just ask most any bartender and he/she will confirm said cure.
But you don’t have to talk to a bartender, but ya gotta “talk out loud” so that you can hear yourself talk.
So, talk to a wall, talk to a tree, talk to your pet, talk to anything you choose.
But ya gotta talk about … “the thing(s)” …. that is bothering you ….. and telling yourself to “quit it”, … “give it up”, … “it’s not worth worrying about”, …. and it’s best to do that “taking” the minute you sense that you are getting a wee bit depressed.
And just consciously “thinking” about … “the thing(s)” …. that is bothering you WON’T WORK …. because it is your subconscious “thinking” that is causing your depression. Just “thinking” about it will only exacerbate your depression.
Thus, by “talking” out loud you will sooner or later …. put the “quietness” on those subconscious thoughts.
And that is exactly why the above study on “talk therapy” achieved the successful results that it did.
Cheers
Very twisted comment.
The trouble with psychiatry: One shrink’s view
60 minutes did a great piece several months ago, featuring a Harvard psychologist who studies the placebo effect. He looked at all antidepressant research trials submitted to the FDA, not just those selected for publication. He found that for mild to moderate depression, antidepressants are no more effective than placebos. But they are helpful for those in the severe range of depression.
The British have since changed practice in their Public Health Service. Now, only those with severe depression receive medication as first line treatment. Those with mild to moderate depression receive talk therapy. In the US, drug companies, and their hired MDs are vigorously attacking the psychologist's findings.
Could it be that in England's socialized medicine system, the goal is to find the most effective and efficient treatments, whereas in the US's capitalist medical model, it's more about Big Pharma selling its products?
Excellent post Trout! I totally agree-American doctors are the REAL drug pushers-they reach for their RX pads way too quickly for me- they probably have stock invested in Roche etc...
You have good points, but this may not be so much about "capitalism vs. socialism", but rather a sign of how politicized things have become here, and how idealogues seem to always get their policies passed.
Thanks for the info --- I wasn't aware of British procedure. I imagine mental health isn't as big a mess over there as it is here.
@Trout,
I basically agree with what you have said, but wish to add a couple of points:
1) SSRIs (the only type of anti-depressants the study was actually concerned with) are highly differential in their effect. That is, a particular SSRI is expected to show inprovement in around 15-20% of mild to moderate depression and only around 20-22% of severe depression. That is the real basis of those who say that a SSRI works no better than a placebo. But current practice is to change SSRIs every 30-60 days until you hit one that does work. If you approach it that way, the improvement rate of SSRIs goes up to around 40-50% for mild to moderate depression and to around 70% for severe depression. This, however, is a practice that is extremely discouraged by insurance companies because it means a lot of "abandoned" prescriptions (ones where the patient did not take all the pills before getting another prescription for the same diagnosis.) Many physicians, especially psychiatrists, get around this by using samples.
2) It's not so much that physicians rush to get their Rx pad, but that insurance companies mostly do not pay for psychological services in this country or they cover such a small number of sessions that it is ineffective. Clinical psychologists actually get incredibly small reimbursement for their sessions, but the AMA and insurance companies are so arrayed against them that they feel helpless.
3) Both British and American health services prescribe SSRIs in amounts only slightly less than in the US. The difference is that they keep changing the SSRIs to find the one that is best for the patient and they require (not advise) talk therapy while this process is going on. This is generally considered the gold standard of care for moderate to severe depression. (Much of severe depression that cannot be addressed by any SSRIs are now referred to electroshock therapy --- also very controversial still.)
4) What confuses the issue for the British public health folks is that most of Europe has recognized that SSRIs are incredibly addictive. They are much more addictive than heroin or cocaine and are on a par with methamphetamine and nicotine. So British physicians are more cautious than Americans about giving a drug casually that is highly addictive. A plan to get the patient off SSRIs is always created at the same time as the treatment plan. A British patient must be in a situation where the risk of addiction is outweighed by the risk associated with depression.
5) Another area of concern here that has been addressed successfully in Britain and Canada is giving SSRI's to people under 26 or over 65. In both of these groups the SSRI is metabolized differently and stands a huge risk of making the depression worse. In Britain most youngsters or elders who quality for SSRIs are institutionalized at least initially so that the effects can be carefully monitored. Here I had a 16-year old cousin kill himself 3 weeks after starting Prozac. The physician who prescribed it simply did not know any better.
Hope that helps. SSRIs are not a magic bullet. They are highly differential and highly addictive, so a good bit of medical "art" is required to uyse them as a tool. But, in conjunction with talk therapy, SSRIs can be very effective when done right.
The effects of what the Professionals call “depression” is akin to ..... like when one gets that “tune” in their head that keeps “popping up” in their conscious mind no matter what they are doing and which makes them want to “hum it”, … “sing it”, or whatever.
Likewise, the same is true for those “urges” that “pop up” in one’s conscious thoughts that the Professionals are calling “habits”, ….. “addictions”, … etc.
People are “addicted” to coffee, soda pop, cigarettes, beer, country music, wacky tobacco, football, etc., etc., ….. because they have self-nurtured a “habit” of doing said.
And to “cure” an addiction or habit one has to self-nurture a per say “block” to prevent said “urge” from occurring. Lemon drop candy will work “great” for curing a “cigarette smoking habit”. And it’s a cheapy cure, also.
I think you need professional help.
Lavrn, ..... don't knock it ..... until you try it.
And besides, ...... I didn't charge anyone $150 for my learned opinion.
HA, one would think that after 100+ years ..... they would throw Sigmund Freud et el into the "trashbin" of snake oil medicine and embrace the new science and technology of the 21st Century.
Lavrn, read these 2 short articles, to wit:
What Makes You Uniquely "You"?
The brain… it makesyou think. Doesn't it?
One major point. It is much easier to talk to someone who knows what you are going through. All your friends and family, even your doctors may love and care about you but if they don't have first hand experience they just can't understand.
In 1995 I was diagnosed with clinical depression. I was very fortunate to find on line support groups. Here were people that understood. People that knew what I was going through. People that could give real support.
Doctors can listen, they can make suggestions but they have to stay detached from their patients. They can't get too close.
Family can listen, they can say they understand but they are too close. Too many other things can get in the way.
Strangers, who just happen to share depression worked wonders. Never meeting, never hearing their voice, never seeing them, just words on a screen. Nothing to get in the way of caring. We could all care about each other and support each other without any of the other things in life getting in the way.
Like I stated above, the “cure” is in the “to talk to”.
Talking to someone helps, but the only problem is, you will not divulge to that “someone” everything that is “bothering” you. Just like your “X” rated dreams, you ain’t gonna tell no one nothing about them.
Actually, it wasn’t the strangers that worked wonders, …. it was your reading of the “words on a screen". Both the reading of your own words and the words of strangers, that did the “wonder working”.
Reading the words works the same as hearing the words. Just like school, by reading the textbook you learned. But when the teacher talked about it ….. you learned it better. And if you wrote it down on paper, you learned it better n’ better.
This includes talking to yourself and God...a practice known as meditation. Mark Twain ( I think it was Mark) cynically said: Don't talk about your troubles with other people. Fifty percent of the people don't want to hear about your troubles and the other fifty percent are glad you have them.
Joe: LMAO!!!
Yeah, that's exactly what I wanted 15yrs ago. Psychologist listened for one session and told me I needed to make an appt with a psychiatrist to be put on medication. When I protested that all I needed was talk therapy she said no one gets seen without being medicated. Pathetic.
I know what you mean, because that's what my psychiatrist said to me as well. After going through an awful change of character with anti-depressants while others had no effect on me, I decided they weren't for me. Most psychiatrists lack empathy, so for me, talking to a friend who DOES care and will take me out to cheer me up works better than talking to a cold person who provides no help or means of a distraction from the blues.
Duh, I could have told you that...I don't need anti-depressants if I have friends or a boyfriend I can spend time with or talk to, especially if that person has been there and done that. I avoid medication at all costs, as it had very negative effects on my persona while taking it, unlike having a distraction or someone to unload on. I also keep a journal that I write in whenever I feel down and have no one around to reach out to, it helps to pour out your thoughts and find ways to keep relaxed (yoga, meditation, music, going to the beach and listening to the waves, watching the stars).
I was diagnosed with major clinical depression and believe it or not, have not been on medication for about 4 years yet here I am, still alive, fully functional, smiling, and coping with my depression with the things I listed above. The psychiatrist tried to brainwash me into believing I could not live without medication and would eventually off myself. Guess what, it's been 4 years and I did not commit suicide nor did I attempt to, and believe it or not, antidepressants CAN actually increase the risk of suicide (someone with clinical depression that I knew committed suicide shortly after starting meds). Kind of counter-intuitive that an anti-depressant would actually push you further over the edge, don't you think?
Well aren't you a lucky ducky you can slap yourself on a pretty face back to normalcy. That's not exactly how things work for us, severely disabled depressed patients. I'm on a cocktail on 3 medications that work some of the times, plus therapy, plus as you call watching the stars, journalizing, masturbating to the music and etc. As my shrink recently put it, I was short only of electro-convulsive therapy. We tried everything under the sun to arrive at the present combo. Sucks. Let's not pretend it's all in our heads okay? Oh, and btw, I also have amazingly supportive husband who's been putting up with my crap for the past 8 years, great best friend so it's not like I have noone to talk to. =)
Much of this relates to neuroplasticity of the brain. Western society has become so accustomed to believing a pill can solve all their woes when in fact the brain is more flexible that previously thought. Not much different than the socialization process that can alter a persons behavior long-term or permanently. The problem is the idea seems too simple and, therefore, people assume it is nonsense. The link between the organ called the brain and our "minds" is fascinating and it is shocking how little humanity really knows about this organ. The seat of thought is still the biggest mystery of all...how ironic.
I found out that depression isn't sadness, it's anger, resentment and rage. My husband has been in talk therapy for a while and now he doesn't act enraged and bitter 24/7. He's much better and I don't have to worry about him slugging my kid, etc. You have to find the right therapist, though. The first one just sat and let him vent, so he'd come home in a double rage after therapy. "Poor baby, tell me about it"-type therapy is awful. There are good therapists, though, who can keep your depressed family member from destroying you and everyone around you.
Thank God "Obamacare" will require insurance coverage for mental health.
SURE NUFF, …… the providers of goods and services to any citizen that complains of or is diagnosed with a “mental health problem” constitute a horrendous “voting block” because, my guess is, …… 80% to 90% of said “providers” are dependent upon government “funding” for their products and services.
“Obamacare” just increases their “Cash Cow” revenue earnings.
Their “Cash Cow” will soon be given "plenty more cash to consume".
Clinical studies show depressed patients have a nutritional imbalance that is different from non-depressed patients. The cure to depression could be as simple as eating better. #depression
#depression
Don't dismiss medication out of hand....I suffered for years from depression. Tried one medication, didn't do much. Finally got onto another medicine and it was amazing. I felt like my old self again. Stayed on those pills for about 5 years, and then stopped taking them, and I feel fine.
For some patients, medication can absolutely be the answer.
I am 50 years old and have suffered from depression since my teens. In 2009 my family talked me into seeking help and I was diagnosed with Schizotypal Personality Disorder. I was on every drug known to man, none worked. After diagnosis I was kicked out of the system by Utah. 47%er and told if I found Mormonism I would be cured.I am fighting to get help but,I am failing. Red states hate us and refuse to help us. Maybe someday!
Quit being depressed
because …… someone isn’t helping you by curing your depression. You are only exacerbating your problem by doing that
You have to cure it yourself. No one can cure your “depression”
for you.
Talk “out-loud”
to yourself, ….. to a tree, …. to a wall, …. to your pet, …… but not to your
beer. And talk loud enough so that
you can clearly hear what you are saying.
“Talk” about the thing(s) that is bothering you and
then tell yourself it’s silly to be worrying about it and to quit it. And do
that every time you start getting that “depressed feeling” and before long it
will quit “bugging” you.
That depends on the talking. Therapists are kind of like car mechanic. If you get a bad one, your car could fall apart. As a clinical Depression patient, I've had my share of peculiar therapists over the years.
Therapist 1. Told me to conform to my narcissistic mother
Therapist 2. Suggested I was a lesbian and recommended for me to break up with my boyfriend at the time.
Therapist 3. Told me after I suffered life-threatening pregnancy and birth, that really didn't matter my mind and body and soul were battered, as long as I produced a healthy baby!
Funny how this got flipped around. In the 1950's Carl Rogers showed us that talk therapy was preferred, and drugs the last resort. Then the drug lobby pushed antidpressants onto us, until we believed popping pills was better than human interaction. I'm glad to see the pendulum swinging the other way.