Therapy for Depression
by Farrell Hannah
An article in the Spring 1997 edition of the “B.C. Psychologist” outlined some recent reviews of research comparing the effectiveness of psychotherapy versus medication alone, or both together, for the treatment of depression. It was concluded that certain psychological methods are as effective as medication for depression even when treating serious levels of depression, and that the psychological methods involved fewer medical risks than the biological methods, plus they had a better longer-term effect. Although medication may be useful in managing depression and it may seem like a quicker and easier treatment, when medication is used alone (without psychotherapy) the chance of relapse can be as high as 60 percent, and side effects are a concern to patient and physician alike.
A well-known research and clinical psychologist had outlined similar conclusions in his 1993 book "What You Can Change and What You Can’t." Martin Seligman, in his chapter on "Depression," has estimated that at any given time, approximately 25 percent of the population is enduring an episode of mild depression, and that "unipolar" (more serious) depression is just a more severe form of the more common, mild depression, different only in the degree of the negative changes of the thought, mood, behavior, and body states. Whether the depression is mild or more serious, recent researchers are concluding that cognitive-behavioral or inter- personal psychotherapies are among the few treatments that can work for depression reduction, providing significant relief to about 70 percent of depressed people.
What is cognitive-behavioral therapy? Simply put, it is a psychological method which aims to change the way a depressed person consciously thinks about such ideas as failure, defeat, loss, and helplessness, and to change the ways the person behaves when experiencing a depressed mood. First, the person learns to recognize the main automatic thoughts and behaviors that have become so well-practiced that they occur very quickly as self-talk or reactions and which result in a depressed mood. Second, the person learns to replace these, usually illogical or ineffective thoughts and behaviors with more rational, productive, or just plain healthy ones, which usually have a more positive and more hopeful aspect (rather than negative and pessimistic). Third, the person discovers that she/he can manage thoughts and behaviors, and therefore the resulting moods, rather than letting these aspects run or control the whole person. The person finds that she/he can regulate the place and timing and intensity of the mood.
What is interpersonal therapy? Again simply stated, and in relation to treating depression, it is a psychological approach used to focus on marital, family, and other relationships. Relationship problems which in the present contribute to a depressed state are the focus for the therapist who uses a solution-oriented approach to help the person or persons improve their interactions. Current conflicts, disagreements, frustrations, disappointments, and anxieties are the experiences requiring resolutions and relief. Whether dealing with unusually extended or intense grief reactions, excessive arguments or fights within families, difficult transition points in life’s stages of development (leaving home, divorce, retirement, for example), or underdeveloped skills in social interaction, the aim of an interpersonal therapist is again to help empower the person or persons through coaching in assertive communication and negotiation skills. A range of constructive emotional expression is encouraged, to replace aggressive or passive behaviors. Like the cognitive-behavioral approach, interpersonal therapy is intended to be relatively brief, averaging about 15 - 20 sessions over a period of perhaps three to six months. On average, a similar relief rate is found, with 70% of cases showing marked improvement.
If you are plagued almost daily by a low mood, you deserve to treat yourself to a more optimistic and positive set of thoughts and behaviors, just because you’re worth it as a human being. You would wish the same for a friend, so why not for yourself?
Some states of depression, including the condition now called Bipolar-Mood Disorder, are often treated with medication. If you talk with your doctor about your depressed mood, and about the possible benefits and side-effects of medication, ask for your doctor’s opinion about you seeing a qualified psychotherapist who uses cognitive-behavioral and/or interpersonal therapies. If your doctor doesn’t have information about these approaches, provide the doctor with a copy of this article! If you want to talk directly with a therapist and find out if he/she routinely uses these approaches, you can use this article as a guide for your inquiry.
