[kennyc]

Effectiveness of Talk Therapy Is Overstated, a Study Says
By BENEDICT CAREYSEPT. 30, 2015

Medical literature has overstated the benefits of talk therapy for depression, in part because studies with poor results have rarely made it into journals, researchers reported Wednesday.

Their analysis is the first effort to account for unpublished tests of such therapies. Treatments like cognitive behavior therapy and interpersonal therapy are indeed effective, the analysis found, but about 25 percent less so than previously thought.

Doctors have long known that journal articles exaggerate the benefits of antidepressant drugs by about the same amount, and partly for the same reason — a publication bias in favor of encouraging findings. The new review, in the journal PLOS One, should give doctors and patients a better sense of what to expect from various forms of talk therapy, experts said, if not settle long-running debates in psychiatry about the relative merits of one treatment over another.

Five million to six million Americans receive psychotherapy for depression each year, and many of them also take antidepressant drugs, surveys find.
....

http://www.nytimes.com/2015/10/01/he...verstated.html

[hjames]

Kaiser Permanente is going to be jacking off to this article for a long time.

[Tauren]

Can't tell much from that article because they lump "depression" altogether, and there are different kinds. If your depression is strictly chemical, talk therapy is useless beyond learning about the illness. On the other hand, if your depression has kept you from making friends, a therapist may be the only person you have to talk to, and that would help a lot.

My depression is 100% chemical, but still going to counseling helped me learn how it worked and what it was doing to me. It probably saved my life to learn that I had an actual treatable illness.

Do you feel like meds work really well for you? I'm curious, because back when I had my first episode of depression, it felt really "chemical". My normal behavior changed. When I started taking medication, I felt like I had had my normal self restored.

Over the years, though, medication has ceased to work as well as it used to. I've developed unhealthy patterns of behaving. Therapy helps me to fight back against this. It's a far from perfect situation, but I need both the meds and therapy to remain even moderately functional.

I should probably add that somewhere in the middle of the depression story, I developed 2-3 autoimmune illnesses, so I have issues with lost career and income and the ability to do lots of things I used to enjoy to deal with as well.

[Tauren]

Yes, meds work great for me. I have never had an "episode" of depression - it's been lifelong. My behavior never changed, it was always severely depressed, from early childhood. Purely genetic depression seems to be sort of unusual but it happens. Runs in my family going back 3 generations at least.

I've had meds poop out on me. Lexapro only worked for a couple of years. You should talk to your doctor about that.

I would think therapy COULD help with unhealthy behavior patterns though.

Do you think it's possible the depression was actually an early manifestation of your auto-immune problems?

I have never had an "episode" of depression - it's been lifelong.

Wow, okay. I know people who've had that experience. With me, I can look back now and see some signs starting in my early 20s, but I basically "got sick" with a severe episode of depression when I was 25. It was almost as sudden as catching a virus.

Yes, I've had doctors and one psychiatrist say that depression and autoimmune disorders are very highly correlated and that it's not uncommon for the depression to show up first.

There's some mild anxiety on both sides of my family, but it's more the kind that responds to "exposure therapy" - I put that in quotes, because it seems like a fancy name for just doing what makes you anxious until it doesn't bother you anymore.

My doctor tweaks my meds from time to time, but by this point in my life, I've suffered career and relationship loss and income loss and loss of the ability to do most of the hobbies I used to do, so I have strong reasons for having situational depression and "adjustment disorder" now.

I feel like my depression is both biochemical and attitudinal now. I do think the biochemical element leads, though. If my meds aren't working at least halfway decently, it doesn't seem to matter how much therapy I go to. I get to the "I don't care" and "I'm too tired" stage.

Therapy doesn't help my depression, but it does help me handle my life.