Combining Talk Therapy and Antidepressant Medication

photo (11)An article in next month’s issue of JAMA Psychiatry will support combining talk therapy and antidepressant medication in treatment of depression. Merging talk therapy (cognitive therapy chosen in this study) and medication treatment worked better than medicine alone in relieving severe non-chronic depression (1). The antidepressant treatment group in this study saw a 62% improvement while the medicine plus cognitive therapy group saw a 73% improvement. Not outstanding differences between groups, but every little bit helps to someone stuck in a depression.

These results fit well with what most counselors see on a daily basis. In cases of severe depression, people do not have the clear thinking necessary to find solutions to every day hassles. Medications often help to clear these impediments to effective talk therapy.

Results also fit well with what most psychiatrists recommend. Medications are often not enough. In the book BTD (2), I discuss the importance of combining talk therapy, centered on adjusting expectations, with medication treatment.

If you have been doing talk therapy for several months and remain depressed, see a psychiatrist. If you have been trying medications for several months and are not getting better, see a professional counselor. In breaking the grip of depression, combining these two treatments can be better than either one alone.

(1) Pre-released online: Effect of Cognitive Therapy With Antidepressant Medications vs Antidepressants Alone on the Rate of Recovery in Major Depressive Disorder: A Randomized Clinical Trial. Steven D. Hollon and others. JAMA Psychiatry. Online August 20, 2014. doi:10.1001/jamapsychiatry.2014.1054

(2) Breaking Though Depression (see tab above)

Encouragement for Periods of Depression

125There are dark clouds.
There are blue skies.
You have to know that there are blue skies beyond the dark skies.
Right now, clouds obstruct your view.
Right now, you have to know with intuition and faith, that good days are a reality and when the clouds pass you will experience again the joys of a beautiful day.

The key is to know that bad days will pass – better days will come.
It happens.
As you wait through cloudy days, hang onto a long-range vision and focus your mind on faith.
Strength will rise and clouds will part.

Robin Williams – Drunk on Despair?

Photo source: UptownMagazine.com

Photo source: UptownMagazine.com

Outside appearances can be deceiving. A great actor made many of us smile, chuckle, and overflow with laughter. Few people would list him as one of the people we suspect of being depressed, yet Robin Williams died one week ago of apparent suicide. Somewhere underneath, he struggled with and succumbed to hopelessness.

Depression can be an illness of the brain, an injury to neurons, an imbalance of biochemistry. In Breaking Through Depression (BTD), I describe a process in which repeated stressors injure the brain, leading to depressive illness.

In my conversations with people who struggle with thoughts of suicide, I have come to think of depression as a chemical imbalance that is similar to the intoxication produced by excessive alcohol use. In this state of chemically-induced confusion, people form false impressions of their value and potential. Chemically overpowered and drunk on despair, they become sick of themselves and their lives, believing a lie that they tell to themselves – that loved ones would be better off without them. This has always been untrue of the people I have counseled who have survived the loss a loved one to suicide.

Severe depression with its suicidal notions can most often be relieved with professional treatment and patience. Quite often people look back with wonder, questioning: “How did I ever get to that place in my life?” For others, thoughts of suicide persist but are balanced by the awareness of goodness in life and their value to others. Suicide is often the wrong short term solution to a long term, yet treatable, illness.

If you or a loved one are struggling with depression, get help! Tell your friend, your doctor, your pastor or priest, your mother or your brother – tell somebody! Then seek professional help and learn more about this hidden illness by reading a book like BTD