DEPRESSION

Does Therapy Work for Depression?

By Temma Ehrenfeld  @temmaehrenfeld
 | 
May 02, 2023
Does Therapy Work for Depression?

Therapy might not be as affect for as many patients as researchers once thought. Antidepressants may be even less effective. Here's what you should know.

Depression is common but not easy to beat, and most of the common remedies aren’t as effective as the published scientific literature once suggested.

For example, when researchers analyzed data from a large U.S. government survey, they concluded that antidepressants might help patients at first but not improve their quality of life over time.

The team compared depressed patients who took an antidepressant to another group that didn’t and found no significant benefit from the drug.

 

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While psychiatrists say they regularly see patients benefit for medication, the same isn’t true for all patients.

Psychotherapy, on the other hand, seems to boost your chance of lasting improvement in depressive symptoms by 20 percent, according to a review led by Vanderbilt University’s Steven Hollon, PhD. 

Hollon and his co-authors analyzed the results of 55 grants funded by the National Institutes of Health. The grants funded randomized clinical trials to test treatments for major depression. About a quarter of the grants did not lead to published results. 

When the researchers added data from the unpublished studies, the benefits of psychotherapy dropped by 25 percent, almost the same bias that was found in favor of antidepressants during previous studies, the authors wrote.

Most of the studies in the review involved therapies in which the therapist and patient met weekly for up to an hour over several months. With an approach called cognitive behavioral therapy.

In other research, Hollon concluded that psychotherapy should be the first line of action against depression, since its effects are more enduring. Taking meds at the same time could slow recovery, he argues. 

If he’s right, the country needs a big change in its mental health system. One in eight U.S. adults had a prescription for antidepressants before the COVID-19 pandemic. In 2020 at the height of anxiety, that number rose by nearly 19 percent.

Pre-pandemic, nearly a quarter of women aged 60 and over took the medication. Most of them were fighting depression (some people get antidepressants for anxiety disorders).

Before the pandemic, less than a third of people taking antidepressants saw a mental health professional during the previous year. One reason is a shortage of mental health providers. Today, however, you may have more choices, including video conferences and even texts.

It’s also important to realize that many depressed people never seek help. Symptoms of moderate or severe depression can be very distressing and last a long time.

It’s common to have a combination of treatments, including medication, psychotherapy, and cognitive behavioral therapy.

You can overcome depression. 

If a job or relationship is dragging you down, you can learn to manage better — or get out of a bad situation.

Remedies that help your brain make new connections, notably ketamine and psychedelics, are more effective than antidepressants for some people.  

People with milder depression can see big benefits if they get more exercise, improve their diet, and spend more time with people and activities that help them feel better.

Some studies suggest that exercise is as effective as antidepressants. Meditation can often reduce anxiety. Lack of sleep is clearly linked to anxiety. A simple change in sleep habits could make a surprising difference. Diet can also impact your mood.

 

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Updated:  

May 02, 2023

Reviewed By:  

Christopher Nystuen, MD, MBA and Janet O'Dell, RN