Take a Pill or Talk it Out?

In a study published in the Archives of General Psychiatry a group of individuals suffering from depression was treated with either medication, cognitive therapy or a placebo. Cognitive therapy, as defined by the National Alliance on Mental Illness, is an empirically supported treatment that focuses on negative patterns of thinking in an attempt to reprogram the inner message into a more positive one that doesn't deride the patient and drive them into depression. The results of the study showed that 46 percent of people on medication and 40 percent of people undergoing cognitive therapy were in remission from their depression. The conclusion drawn by the research was that cognitive therapy may be as effective as medication in the initial treatment of moderate or severe depression.

These researchers stress that the effectiveness of therapy depends greatly on the level of the therapist’s experience or expertise. So it’s important to find a therapist that meets your needs and has experience with your particular issues in order to best treat your depression. Also, remember that treatment and its effectiveness will differ from therapist to therapist, so the human element can affect your outcome.

Medication Side Effects
Unfortunately antidepressants can have some unpleasant side effects. It is also normal for people to try several different medications in a quest to find the one that works best for them. Different medications have different side effects but those commonly reported are nausea, insomnia, anxiety, restlessness, decreased sex drive, dizziness, weight fluctuation, tremors, sweating, fatigue, dry mouth, diarrhea, constipation, and headaches. There’s also a risk that in some people, medication may exacerbate depression rather than alleviate it. The U.S. Food and Drug Administration requires that all depression medications include a warning label about the increased risk of suicide in children and young adults. These side effects may sound frightening, but scary but rest assured that medication has helped millions of people overcome their depression without causing major side effects. It is important to note in order to raise awareness in case they do crop up though.

Medication Withdrawal
The other side effect of taking medication is the withdrawal symptoms you might experience when you stop talking them. As a first rule you should never stop taking a medication "cold turkey" and always consult your doctor before making the decision to stop treatment. Some of the withdrawal symptoms include anxiety, mood swings, flu-like symptoms, irritability, insomnia, nausea, vomiting, dizziness, stomach cramping, electric shock sensations, and muscle spasms.

Does Therapy Have Side Effects?
Therapy has no discernible physical side effects but it does take time out of your day. You can expect treatment sessions to last the better part of an hour. It is also essential to find a therapist you like and feel comfortable with. As mentioned previously, your outcome can depend on your therapist’s experience and expertise in the areas that you need help. There is a financial component to therapy as well. Be sure to check with your insurance provider about the benefits you are afforded under their coverage. In some cases they may have a limit of the number of sessions you can attend in any given period of time.

Questions For You and Your Doctor:
Asking the right questions can help greatly in your decision to pursue one course of treatment over another.

  • Is my depression severe enough to justify drug treatment?
  • Is medication the best option for treating my depression?
  • Am I willing to tolerate unwanted side effects?
  • Do I have the time and motivation to pursue other treatments such as therapy and exercise?
  • What self-help strategies might reduce my depression?
  • Are there any medical conditions that could be causing my depression?
  • What are the side effects and risks of the antidepressant you are recommending?
  • Are there any foods or other substances I will need to avoid?
  • How will this drug interact with other prescriptions I’m taking?
  • How long will I have to take this medication?
  • Will withdrawing from the drug be difficult?
  • Will my depression return when I stop taking medication?

Beyond medication and therapy, there are things you can do for yourself that can contribute to a better outlook and healthier life. Exercise, meditation, and stress management are all useful techniques that can really make a difference. So consult your doctor and discuss all of your options, weighing the risks and rewards. Once you are comfortable and have made a decision, you’ll be on your way to feeling better.