Talk therapy

A series of studies demonstrates a synergistic effect between drug therapies and psychodynamic talk therapies. The effectiveness of each form of therapy used independently is less than their combined use in the case of major depression. See A. Solomon, The Noonday Demon An Atlas of Depression (New York Scribner s, 2001) E. Good, Chronic Depression Study Backs the Pairing of Therapy and Drugs, New York Times (May 18, 2000) L. Altshuler et al., Treatment of Depression in Women A Summary of the Expert Consensus Guidelines, of Psychiatric Practice 7 (May 2001) 185-208. Kleinman, Rethinking Psychiatry p. ii. 

Cheryl R. is a 28-year-old married woman with two children under three years of age. She has been referred by her family doctor, who has been treating her depression for nine months with fluoxetine 20 mg daily. Her physician states that medication adjustment is not indicated and thinks "talking therapy" will be beneficial. Her psychiatric history is negative for hospitalizations, and she has never been in therapy. She describes a "lifetime of sadness" with periodic episodes of suicidal ideation during late adolescence. 

Figure 1.3 Sigmund Freud, pictured here, is considered by many to be the father of psychiatry. He described mental disorders as a conflict between the id and the ego, and believed that mental issues could be resolved through talk therapy only. Scientists have since found that antidepressants can often alleviate the symptoms of depression when talk therapy proves unsuccessful in doing so. Sometimes a combination of antidepressants and talk therapy proves successful in alleviating the symptoms of depression.

However, given Jennifer s apparently low resilience and family history, she probably couldn t rely on talk therapy alone. Almost certainly she would need some kind of biological intervention, though not necessarily medication. Diet, nutritional supplements, exercise, and conscious breathing might be enough to boost her production of serotonin and other brain chemicals. 

Sarah was unusual among my patients, many of whom come to me eager for the antidepressants about which they ve heard so much. Both physicians and psychiatrists have come to view such medications as Paxil, Zoloft, and Wellbutrin as true wonder drugs, medicines that have succeeded where traditional talk therapy and other approaches have failed. Even Prozac, despite the rash of bad publicity that it got for a while, continues to enjoy a reputation as a cure-all for anxiety and depression. 

Psychotherapy Set of techniques for treating mental illnesses that consists of a variety of talk therapies. 

Were you given any treatment (e.g. talking therapies or medication) ... 

There seems to be a discrepancy in who gets referred for talking therapies. If you re from a wealthy background, or perhaps more articulate, you may be offered counselling. Our black counterparts seem to have more problems accessing counselling than non-black people. It s getting better now, but it still needs a lot of work. 

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