Are anti-depressants the best way to treat depression?

Antidepressants only work for some people and even then the drugs work best if the individual is in therapy.
Antidepressants only work for some people and even then the drugs work best if the individual is in therapy.

The 2013 OECD snapshot of the 33 OECD countries tells us that Australia is the second highest prescriber of antidepressant drugs. Only Iceland, with its seasonal depression risk, is higher. In 1990, one in eighty Australians were taking antidepressants. Now the figure is one in eleven. That is an increase of over 700% in twenty-three years.

Anti depressants are used to treat depression. Depression is “a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty with thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal thoughts or an attempt to commit suicide” (Merriam Webster’s Medical Dictionary).

The current medical view is that depression is not caused by one factor. Rather, a combination of biological, genetic and psychological factors are involved. Difficult life circumstances can trigger a natural psychological or biological tendency for depression.

Are drugs the best way to treat depression? In some instances drugs can be useful. When biological factors are involved, drug intervention can break the cycle of long-term depression. Unlike doctors and psychiatrists, psychologists cannot prescribe drugs. Research indicates that depression is best treated with a combination of treatments. Counseling is one effective treatment. Drugs, if well tolerated, are another.

We work from an assumption that depression is the result of emotional numbing. Numbing the emotions is an unconscious strategy or defense people use to avoid psychological pain. Over time this low level of emotional functioning can turn into depression. Emotional pain is experienced physically in the body. It can hurt dreadfully and that is why we try to avoid it. Numbing our emotions avoids this awful pain but it also deadens positive feelings like joy, love and feelings of connection. Gradually the depressed person can withdraw. Life becomes gray and meaningless. Still, they may remember happier times, reminding them that their lack of feeling and motivation is not how they are “supposed” to be. This comparison can lead to despair and thoughts of suicide.

If the depression has not led to a complete numbing and the person seeks treatment, good results can be accomplished without the use of drugs. The patient needs to get in touch with the underlying pain and face the issues – past, current or both – which give rise to the painful emotions. An intellectual understanding of these issues is not enough. To return to emotional health, the patient needs to also work through the painful emotions. After suppressing these emotions so effectively, they are not easily accessed just through sheer will. The individual need to agree to the idea of the emotions surfacing. As the patient builds confidence in his or her ability to cope with the intensity of the emotions, the feelings will surface.

When the underlying emotions are released and the depression lifts, individuals often make major attitudinal and lifestyle changes. Upon reflection, they see the depression as a turning point in their lives, an opportunity to change for the better. They soon forget the difficulty and pain they experienced on the journey to increased happiness.

Here is an example of a patient who presented with depression. He had been prescribed drugs for several months but the depression returned soon after he stopped taking them. Although only in his early thirties, he had been made redundant once and feared it might happen again. During therapy, fears of a second redundancy were triggering feelings of rejection, first experienced in childhood. After working through his emotions and understanding their genesis, his motivation and clarity of thought improved so strongly that he became a national leader in his field. He accomplished this less than a year after he first consulted us.

For some people, undertaking psychological treatment can be more appropriate than taking prescribed drugs. In dealing with depressing through therapy, one may reap unexpected benefits.