When people think of ways to treat depression, typically medication would be the first thing to come to mind, and then therapy. Medication is used all over the United States for a variety of things, and it is often said that it is overprescribed. Still, little has been done about this issue, most likely because everyone likes to have a quick, simple solution to their problems. However, for depression, psychotherapy is much more beneficial in the long term because it is associated with fewer relapses and has fewer risks and side effects involved. Psychotherapy, otherwise known as talk therapy, is used to treat mental illness and involves talking to a psychologist about one’s problems in order to work through them and develop coping strategies. Although talk therapy is sometimes thought of to be a lot of “talk” and little results, it can be a powerful tool. As it was said in the New York Times, “We should be aware of the cultural trends that devalue psychotherapy and the listening healer and the unintended consequences that may ensue” (Sandberg). A combination of psychotherapy and medication has been found to be the most effective for treatment of depression.

My reasoning for choosing this topic of research, other than being a psychology major, is that I was have been diagnosed with depression and am was interested in the best forms of treatment. I started out solely using medication, and while it didn’t suddenly make me happy all the time, I found that it lessened the severity and frequency of my depressive episodes. About a year later, I started psychotherapy and did not see much benefit, most likely because I was not honest with my therapist. When I started seeing a new therapist, however, I found myself feeling legitimately happier as opposed to the numbness that the medication gave me. Through therapy I began to learn new coping strategies, and realized that disclosing all of the information that I normally never discussed managed to lift some of the burden. Although depression is not something can be solved easily or quickly, my personal experience showed that psychotherapy can do more to help people improve themselves than relying on medicine can, and should be the first choice of patients who have been diagnosed.

In recent years, there has been an emphasis on the biology of depression, which has improved the general view of medication. The perceived difference between medication and psychotherapy is that, in the eyes of the general public, medication affects the brain while psychotherapy affects the mind. However, psychotherapy has been shown to actually alter the brain’s chemistry (Sandberg). It does this through helping clients to change distorted patterns of thought and create new thinking and behavioral habits. As one psychoanalyst explained, “learning affects the ways in which the brain forms new connections” (Sandberg). This is a very important discovery because it refutes the argument that so many people have given against psychotherapy, which is that depression is a biological issue of too little serotonin in the brain, and therefore must be treated with biology.

An important component of psychotherapy is that it teaches patients skills that they can take with them even once they have stopped participating in therapy. One important skill that can be taught is mindfulness, which is an exercise in being completely aware. This is a form of grounding, which is a technique used to distract or deal with potentially harmful thoughts. When someone is taking medication for depression, it is common for the depression to still be present at times, even if it is in smaller quantities. Mindfulness, and other skills taught in therapy, can greatly help someone to cope when they are feeling depressed. It involves paying attention to one’s surroundings, such as the sounds that they hear, or the way that their clothes feel on their skin, or noticing anything else in extreme detail using the five senses. From there, someone can work up to noticing everything that is going on in their mind, including all of the thoughts and emotions passing through. Doing this is quite different than the usual response to sadness, which is attempting to distract from it. Instead, mindfulness works on being okay with every emotion that is going through one’s mind, and understanding where it comes from. This is important because it allows a person to come to terms with their sadness and create a new relationship to it where they can simply notice it and accept it rather than feeling like they need to do something about it, which could be harmful or even fatal. Mindfulness may seem like a small and insignificant way to deal with depression, but research shows that there is a significant decrease, about forty-three percent, in the number of relapses of patients who have learned this skill (Segal).

Mindfulness is one of many skills that do not require the use of medication but can still be effective in treating mood disorders. It has been said that if you are depressed, you must have a reason to feel that way, whether it is conscious or unconscious (Karon 184). This would suggest that even though depression means not having enough serotonin in the brain, it has a root cause in a person’s life that made it that way. Psychotherapy can get to the cause, rather than treating the symptoms as medication does. It is also important to realize that every individual is different, and therefore every case of depression is different. It is rooted in different causes, and there are a variety of feelings that someone with depression may be feeling, such as shame, anger, or numbness, all of which need to be addressed. Individualized treatment is incredibly important for this reason, and pills cannot cater to everyone’s specific needs. Therapy, on the other hand, comes in many different forms, such as Cognitive Behavioral Therapy (CBT), Psychoanalysis, or interpersonal therapy. Each of these go about treating depression in different ways, such as altering thinking patterns or figuring out new ways to go about dealing with relationships. Many therapists combine these forms of treatment and tailor it to each client, which is why it can be so much more helpful.

In one article published in 2007 in the Journal of College Student Psychotherapy, it was stated that the recovery rate for depressed patients on antidepressants was roughly only one third (Karon 180). This number is much smaller than most people would assume, and shows how difficult recovery can be, even using a method that has been tested and tweaked hundreds of times. However, this is not the main reason that medication should not be people’s first choice for treatment of depression. The main problem is that medication is overprescribed, and sometimes people are given medication that they may not need. It has been found that for depressed patients, combined treatment (medication and counseling) was significantly more effective than medication alone (Cuijpers 861).

Because of this, alternate treatments need to be used, which is where psychotherapy comes into play. Psychotherapy is much more effective for the long haul because it searches for the root of the depression and ways to deal with it, rather than just taming the depressive symptoms. This makes sense with the research that has also found that the relapse rate is much higher for depressive patients on medication than those who solely use psychotherapy (Karon 181). However, the majority of research on treating depression shows that a combination of psychotherapy and medication is more effective than either one alone.

One reason that many people choose medication over psychotherapy is simply because it is less expensive. Antidepressants can cost over one hundred dollars per month without insurance, but when buying generic versions, the cost is reduced greatly, and even more so with insurance. Psychotherapy, however, tends to cost more, although it also has a wide range. Typically it costs around one-hundred to one-hundred and fifty dollars per hour long session, which is often enough to send people straight in the direction of medication. Especially when someone goes once a week or every other week, which is often recommended to begin with, the price of therapy is simply not affordable for some people. This is a completely valid reason, although some may still find it more beneficial to do psychotherapy even if it is out of their price range, because they can reap the benefits in many aspects of their lives, including areas of work and relationships.

There are some cases, however, where medication is the most important form of treatment that someone can receive. This would include people with biological disorders such as schizophrenia and bipolar disorder, in which the biological factors would need to be reduced through the use of medication. These people can still greatly benefit from talk therapy, but if one form of treatment needs to be chosen, then pills would usually be the best option because of the abnormalities of the brain.

Another reason why medication may be favored over psychotherapy is that the effects are more immediate, while psychotherapy may take time. For this reason, in harsh cases, medication may be necessary if immediate action needs to be taken to avoid extreme consequences such as suicide. That is why it is often advised to take medication in combination with psychotherapy, so that the pain is reduced as quickly as possible, but people can still get to the root of their problems and learn coping skills.

Some people may argue that although there are risks associated with medication, there are also risks that come along with psychotherapy. These include codependence, self-focus and self-absorption, and labelling which may lead someone to act a certain way. For example, if a therapist asks leading questions to their client, perhaps about certain relationships, it may cause the client to believe things about that relationship that are not necessarily true, which can cause strain. Also, if the therapist unintentionally makes a suggestion that a client feels a certain way that they do not actually feel, such as lonely, or in extreme cases, suicidal, the client can start to feel and act that way. However, all of these risks would only be issues if someone sees a psychotherapist that was not properly trained or was simply not good at their job. These are rare cases, and with the right therapist, none of them would happen and the patient would only see improvement in their condition.

Also, some people with Major Depressive Disorder may find after a few sessions of psychotherapy that they do not feel any better, whether it is because they are with the wrong therapist, need more time in therapy, or some other factor. The resulting demoralization may worsen their condition if they decide to give up on therapy (Craighead 272). This can then make them switch to taking medication. This is why people need to keep an open mind when talking to a counselor, and realize that they may have to try a few before they find the right one. This is also why some people may need to start off taking medication immediately after their diagnosis, and then begin therapy.

The reason that psychotherapy creates lasting effects that cannot come from medication is that it strives to change the cognitions that go along with a person’s depression in teaching them different ways of thinking and preparing for the occurrence of depressive episodes. That way, patients learn how to cope day to day with their depression, because medication cannot solve their problems for them. Medication, on the other hand, is more of a way of numbing a person and lessening their symptoms, rather than improving their condition from its core.

Some of the side effects that can come from antidepressants, specifically SSRIs (selective serotonin reuptake inhibitors) include headache, nausea, trouble sleeping, weight gain, decreased sex drive, and suicide (Iliades). All of these side effects show how unnatural medication is and how our bodies have to adjust to taking them, which is often unpleasant and occasionally fatal when suicidal thoughts play a role. One reason that could explain the increase in suicidal behavior on antidepressants is that people have more energy to carry out a suicide plan when they are on the medication. These risks are just one reason why people diagnosed with depression should consider trying therapy first, or at the very least alongside medication.

Furthermore, a study conducted by David Healy in 2004 found that out of participants that had not been diagnosed with a psychiatric illness, ten percent became suicidal after taking an SSRI (selective serotonin reuptake inhibitor), or common antidepressant, compared to a different medication (Karon 181). Great Britain actually banned the use of antidepressants for children when they found that there was a dramatic increase in suicide for children on antidepressants (Karon 180). This is not to say that medication should never be used, because it can be lifesaving to some. Still, there are risks that come along with taking medication when it is not completely necessary, which are lessened greatly by partaking in psychotherapy.

The reason why the treatment of depression is so important is that this is a very widespread issue, especially in America. 1 in 10 adults have been diagnosed with depression in the United States. Therefore, we need to worry about the well-being of a tenth of our population; if not for humanity’s sake, then for the sake of the well-being of our country as a whole. Depression correlates with unemployment and divorce, neither of which are good for the country or its economy. Therefore, this issue affects everyone, not just those who are depressed. Also, this speaks to the issue of the overprescribing of medications, because it is not just antidepressants that are overprescribed, but the majority of medications. If medication is not truly necessary, it can add more health problems into the mix. It is important to try more natural ways of treating ailments before turning to medication, because medication is too risky and unnatural to be carelessly prescribing to so many people.
