Forum: Talk Therapy or Meds?

Talk therapy – specifically cognitive-behavioral therapy – can be as effective as medications. In fact, the research can be interpreted as supporting the idea that it is much MORE effective than meds. Here’s why. First, CBT has no negative side effects. None. Compare that to even the most benign of antidepressant medications. And remember that side-effects often lead to dropout. Second, the efficacy research on medications can be quite misleading. The drug companies – that for the most part foot the bills for this research – exert great control over what gets published. Not surprisingly, research that shows little to no effect from medications rarely sees the light of day. Also, “drop-outs” are not included in the data. Since that is the single biggest problem with drug treatment, that seems ludicrous. If dropouts are included in the numbers, the treatment efficacy of drugs drops off precipitously. Finally, while the research shows a greater treatment effect from CBT alone, as compared with medications alone, the combination of the two seems to result in FASTER recovery. If nothing else, combining CBT with meds makes it more likely that the patient will stay on his or her prescribed meds.

Talk therapy and medication tend to run neck and neck in the short run in terms of efficacy, but talk therapy may pull ahead in the long run. Still, as a professional counselor, I believe many people need both.

It is not true that talk therapy has no negative side effects. A poor or unethical therapist may easily harm a patient, scarring him/her psychologically for life. It is very important to make sure you have a competent therapist who also feels right to you. All the certifications in the world are not enough if the therapeutic relationship is uncomfortable.

There are many types of talk therapy. While CBT is in vogue right now, it is not always the right therapy for a specific individual. The best therapists know how to use a variety of therapeutic styles so as to tailor treatment to each individual.

It matters what causes the depression as to what helps. Sometimes as Jesus said, “the spirit is willing but the flesh is weak. Then meds and nutrition can help a lot! At other times the sane response to a lousy life or lifestyle is depression and a therapist may be able to help someone learn better coping skills or just provide emotional support. I agree with the earlier comment. Therapy can have REALLY bad side effects. It happened to me and decades later I am just beginning to consider therapy again if I could afford it and find anyone who understood me which is iffy. For me it was literally abusive and traumatic! Cognitive therapy can be crazy-making if the Therapist doesn’t realize there are undiagnosed problems such as social learning disabilities and/or health problems. I have sleep apnea, Asperger’s syndrome and bad allergies. My counselor thought allergies were psychometric. (They know now bone marrow recipients will develop the exact same allergies as their donors once their new immune systems kick in), and no one believed me about the sleep apnea because I wasn’t allergic to the sleep clinic they tested me at. I was being disbelieved about the sleep apnea, the effect the allergies were having on them and blamed for “rudeness” I could not help due to the undiagnosed Asperger’s syndrome. I am extremely face blind (prosopagnosia). Being told the reason I could not tell people apart was because I “always had my nose in a book,” was not helpful. I’m hyperlexic and reading was fighting sensory deprivation in me since I wasn’t getting much emotional support from what remained forever a crowd of strangers. I had “new kid in school jitters” every single day of my education since I could not tell who people were. Being told the reason people didn’t like me was because I was rude and if I would quit being rude people would like me is crazy-making to someone who unknowingly cannot read or respond to facial expressions or control the tone and pitch of their voice. It would be like telling a dyslexic teenager, “the reason you don’t read well is you don’t read well. if you start reading well you will be reading well.” After watching the two Cupid TV shows and the movie and K-PAX books I saw how therapy is SUPPOSED to be. So I would consider finding a “Claire-Bear” again. But so far none I could afford I consulted even knew what Asperger’s syndrome is, never heard of prosopagnosia, never met anyone who found eye contact threatening instead of being considered a sign of interest and kept interpreting my need to look away from it as evasive behavior. We do better if the Therapist sits next to us and looks away from us than if he or she sits across from us and stares at us. Neurotypicals are the only primates that find eye contact comforting. They are the odd ones out here. We Aspergians just like Chimps and Gorillas and Orangs go into threat mode when stared at. It’s not a phobia. It is hard wired into us by having smaller amygdales. That’s no way to start a therapeutic relationship! I always felt like I was being accused of evil when they questioned me. I realize now it was because they were staring at me. I realize now they meant it to mean “I’m interested in you.” My autistic brain interpreted that is “I am being punished.” Incidentally medication works very well for me and I never had any side effects other than to my pocket book but I eat right too to help it along. (Eat like Jesus ate, lots of b vitamin enriched foods and omega 3 enriched foods and/or take suppliments.) That really helps!