Antidepressants help balance neurotransmitters, while therapy identifies negative thought patterns. Combining them may yield the best results.
If you live with depression, finding the right treatment can be paramount for your well-being and quality of life.
Two types of treatments are considered the most effective for depression: antidepressant medication and psychotherapy.
These approaches have been extensively researched and can be used either alone or in combination.
In 2020, an estimated
For many people, depression, at least partially, stems from negative thought patterns. During psychotherapy, you and your therapist will identify and challenge any thoughts and behaviors that are negatively impacting your life.
Psychotherapy is also a good option for people who prefer not to take medication or who don’t respond well to it.
Research findings: antidepressants vs therapy
At the 8-week assessment period, both cognitive therapy and antidepressant use outperformed placebo. At the end of the 16-week treatment phase, there were no differences in response rates between therapy and medication, with 58% of both treatment groups showing improvement.
After 16 weeks, remission rates were slightly better for the antidepressant group: Of those taking antidepressants, 46% reached remission, compared with 40% of the participants in therapy.
Antidepressant medication outperformed CBT in reducing the following symptoms:
- depressed mood
- feelings of guilt
- suicidal thoughts
- mental anxiety
- general somatic symptoms
Some evidence suggests that combining psychotherapy and medication may be more effective than either treatment alone.
Overall, 72.6% of the participants who received combination therapy recovered, compared with 62.5% of those in the antidepressant-only group. Those with more severe symptoms of depression benefited even more from the combination treatment.
For instance, participants using a combination of therapy and medication had an 81% recovery rate compared to only 51% of participants using antidepressants alone.
In addition, those who were given combination therapy experienced fewer serious side effects compared to those taking only antidepressants.
The two most effective types of psychotherapies for depression include cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT).
CBT is the most widely-known and most rigorously tested of all types of psychotherapy.
CBT is based on the premise that inaccurate and harmful beliefs play a major role in causing depression. Correcting these dysfunctional thinking patterns can reduce both present and future depressive episodes. CBT focuses on thinking patterns and modifying behavior rather than exploring past experiences.
IPT is another good option for treating depression, especially if you believe your depression is related to your relationships (not just romantic). This therapy is a targeted short-term treatment (12-16 weeks) designed to improve mood symptoms by enhancing interpersonal functioning.
It’s based on the premise that depressive symptoms and relationship problems are often intertwined and constantly affecting each other.
Regardless of the therapy you choose, it’s important to stick with it for a while to reap the benefits.
The most commonly used antidepressants for depression include the following:
- selective serotonin reuptake inhibitors (SSRIs)
- selective serotonin noradrenaline reuptake inhibitors (SNRIs)
- tricyclic antidepressants (TCAs)
Less commonly prescribed antidepressants include the following:
- selective noradrenaline reuptake inhibitors
- selective noradrenaline/dopamine reuptake inhibitors
- adrenergic alpha-2 receptor antagonists
- monoamine oxidase (MAO) inhibitors
- melatonin receptor agonists and serotonin 5-HT2C receptor antagonists
The pros of antidepressants:
- less expensive than therapy
- simple to do; involves no extra time
- regulates brain chemicals like serotonin and dopamine
Cons of antidepressant medication:
- may result in side effects
- may take 2-8 weeks to see a difference
- may take a few tries to get the right medication
- some people may develop suicidal thoughts, particularly young people
- may be difficult to stop taking, causing discontinuation symptoms
Psychotherapy and antidepressant medications are two key interventions for treating depression.
Each approach has successfully treated millions of people, and research has shown that they’re particularly effective when used together.
While it’s very important to make an informed choice and do your own research, be sure to consult with a doctor about which approach might be right for you.