OK, if antidepressants, herbal or otherwise, aren’t the answer, what about talk therapy or a combination of drug and talk therapy? These are the usual trio of possibilities facing people with depression and, like Sandi, you’ve probably tried some if not all of them.
Somewhere between 250 and 500 types of therapy involve talk. The one most commonly used to treat depression and anxiety is cognitive behavioral therapy (CBT). Such therapies seem to work on brain chemistry in much the same way as antidepressants, though obviously without the same side effects. In a study by Dr.
Lewis Baxter at the UCLA School of Medicine, reported in The New York Times on August 27, 2002, patients with depression who responded to either a reuptake inhibitor like Prozac or CBT over ten weeks showed virtually the same changes in their brains.
Although this may seem surprising at first, it makes sense when you think about it. We tend to perceive thoughts as having no physical substance, but that’s far from true. A thought is in fact a physical thing, involving the exchange of neurochemicals and electrical energy. The dialogue between you and a therapist affects your neural circuitry just as a drug would,15 and the brain’s reaction to it is similar to the brain’s reaction to a drug—or a placebo. Interestingly, the effects of CBT, like antidepressants, also tend to wear off.
So why do both drug and conventional talk therapy work (when they do), and why don’t their benefits always last? To get an answer, we have to remind ourselves of the most powerful and defining aspect of human beings—relationships. We believe that relationships are the secret ingredient in all successful treatment.
When antidepressants and placebos work, it’s because of the relationship between the prescribing physician and her patient, aided by the brain’s propensity for self-fulfilling prophecy. If you believe it will work, it will (at least for a while).
This was a point made by Simon Wessely, professor of psychiatry, Kings College London, in a 1998 New Scientist article “Mostly in the Mind.” Wessely was one of the first to throw doubt on the claims of the drug companies about the efficacy of antidepressants in a study he did in 1977.
Humans are programmed (for reasons we’ll go into later) to put great store in authority figures and tend to believe what they are told. When you consult a therapist or a physician, you are strongly predisposed to believe what that authority figure says.
Many studies have shown that it’s not so much the therapeutic method, but the relationship between client and therapist that determines which treatments will be most successful. Talk therapy works best when this connection is strong and supportive and is liable to be effective only as long as the relationship remains so. When the client ceases to visit the therapist or stops believing in and trusting her, the old problems may resurface.
(extracted from) Creating Optimism: A Proven, 7-Step Program for Overcoming Depression, Based on the popular Uplift program, written by Bob Murray Ph. D., and Alicia Fortinberry, published by Mcgraw-Hill