Can Therapy Help With Depression?

Yes – BUT … it may not work as quickly as medicine and it may not work every time.

If you see a medical doctor for depression the first thing your physician will want to do is rule out other causes. Is your thyroid too low? Is your blood sugar too high? Is depression a symptom of a medical disease? If so, the answer lies in correcting the underlying problem, after which the depression should resolve on its own.

Assuming you do have "normal" depression, your doctor may advise either medicine or "talk therapy" or both. Many patients prefer medication because it may be less expensive than counseling or work more quickly. It's also less of a hassle: depressed patients find it difficult to place their trust in a new professional, so often prefer to keep their treatment in the hands of their family doctor.

Other patients decline medication, not wanting to ingest chemicals into the body. Some are afraid of the stigma of antidepressant medication.

Depression is recognized to be caused by or related to a chemical imbalance in the brain. Certainly chemicals can affect moods: consider the effects of alcohol, street drugs, and even hormones.

At times the chemical imbalance seems to occur for no apparent reason at all (indigenous depression).

Other times the cause is well-defined: the loss of a loved one, a difficult divorce, job difficulties or other life stress. If bad thoughts or experiences can alter brain chemistry, thus causing depression, doesn't it make sense than good thoughts or ideas could lead to recovery?

Probably the best type of counselor is a psychologist, one skilled in helping patients recognize how stressful thinking is contributing to their condition. Such a counselor can guide you to improve your thinking and restore hope. A certified counselor or social worker may be helpful as well, but before committing to a prolonged counselling program, it is reasonable to check credentials.

On the other hand, a counselor who simply listens may be all you need. Too often people have no one to confide in to discuss these intimate issues. But while a trusted friend may be a good listener, he or she may tire of hearing your complaints before you've worked through your problem. A pastor or religious leader may be a better choice.

As a family physician I treat depression on a daily basis, usually with a combination of medication and brief counseling sessions. While I wish I had the magic words to make a person feel better immediately, what I focus on is restoring hope. That alone is half the battle.

If you choose counseling, commit to at least one session a week, more if possible. Give it a good month to start to make a difference. By then you should notice some improvement. If you don't, ask your therapist whether medication is a good idea. Whether taking medication or undergoing talk therapy, it usually takes a few to several months to feel normal again. Don't give up. You can feel better, not that long from now.

Copyright 2010 Cynthia J. Koelker, MD

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