If you’re like most people with depression, you probably should be engaging in two simultaneous treatments — some type of psychotherapy combined with an antidepressant medication. That is, if you have moderate to severe depression and you’ve had it for less than 2 years.
So says yet another study confirming what we’ve now known for decades… The study, published in JAMA Psychiatry, found that you can expect full recovery from such a depressive episode when you employ the full double-barrel of depression treatment.
Yet most people don’t — they opt for one or the other, but not both at the same time. In making this choice, most people are short-changing themselves… And their chances at recovery from depression in a shorter period of time.
Back in the late 1990s, I wrote this article about whether you should choose psychotherapy, medications or both for depression (since updated). What I wrote nearly 20 years ago remains true today:
Combined treatment of psychotherapy and medication is the usual and preferred treatment of choice for depression. […]
Medication alone should be your last choice and only used as a last resort. Although you will likely gain some short-term relief of the most outward symptoms of your depression, the above-cited [scientific] meta-analyses and multiple studies have shown that medications don’t work very well in the long-term.
And yet psychotherapy utilization rates for depression treatment are at an all-time low. More people are simply turning to antidepressant medications — without even considering psychotherapy.
But now’s the best time to try psychotherapy. In fact, it’s never been a better time to give it a go.
A federal law passed a few years ago guarantees your right to access all types of mental health treatments, including psychotherapy. And the Affordable Care Act has expanded that access, even to people who previously couldn’t afford insurance.
Why should you bother with psychotherapy if you have depression? Well, the new study found that 4 out of 5 people suffering from moderate to severe depression (Hamilton rating scale score of 22 or higher) experienced full recovery when treated with cognitive behavioral therapy (CBT) and antidepressant medication. ((The study talks about “Beck’s model of cognitive therapy,” but this is the same as what we now refer to as simply cognitive behavioral therapy or CBT.)) If you have mild depression, medication performed apparently just as well as the combined approach.
As a side note, look at how long it takes people to recover from a single episode of depression. We all too often imagine people with depression taking a pill and feeling better a few weeks later. Yet the data show that even after a year and a half (18 months), only 50 percent of people are approaching full recovery from depression. And even with the gold standard combined treatment approach, we’re still at less than 80 percent of people recovering after 42 months (3 and a half years!).
Are there challenges to getting good psychotherapy?
Absolutely. The first therapist you see may not be the best one for you or your needs. You may not know it’s a good fit until 3 or 4 sessions into your therapy treatment. And telling your life story to more than one professional over the course of a few months can be daunting even under the best of circumstances.
Seen in that light, critically and rationally searching for the right therapist fit while depressed can be downright overwhelming. I get it — it’s not easy.
But few things worth doing in life are. If you’re like most people, you didn’t get a great relationship or a great job by just skating along, waiting for it to happen.
You also didn’t ask for your depression to happen to you. But that’s no reason to give up on yourself — or give up on getting the best treatment you deserve.
If you’ve been spinning your wheels with depression, now’s the time to get help. Reach out to someone today.
Steven D. Hollon, PhD; Robert J. DeRubeis, PhD; Jan Fawcett, MD; Jay D. Amsterdam, MD; Richard C. Shelton, MD; John Zajecka, MD; Paula R. Young, PhD; Robert Gallop, PhD. (2014). Effect of Cognitive Therapy With Antidepressant Medications vs Antidepressants Alone on the Rate of Recovery in Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2014.1054.