3 Misconceptions About Treating Depression

Not only in the street, but also in media that are supposed to be specialized and rigorous, some misconceptions about the treatment of depression are defined . These ideas respond in part to the interests of the pharmaceutical industry and are disseminated under the cover of citizen ignorance that gives them the nature of truth, without questioning the word of certain figures of reference.

In this sense, these wrong ideas and arguments, lacking scientific foundation, are not innocuous. They contribute to the fact that patients themselves do not demand psychological treatment or they favor that doctors and psychiatrists do not offer it or do not refer them to qualified and trained psychologists to apply them.

Let’s go with the top 3 misconceptions about treating depression.

3 misconceptions about treating depression

Depression is not cured with psychotherapy

For example, the DMedicina portal, associated with the newspaper El Mundo, states that “there is no study that shows that psychological techniques eradicate major depression. […] Regarding major depression, the only thing that has been shown to be effective is drug treatment ”. It is curious how, as soon as we search, we find several studies, serious and rigorous, that contradict these statements with results.

Furthermore, we are no longer talking about individual studies, but about meta-analyzes (studies that collect data from several individual studies and analyze with statistical techniques what would be the result of a joint contrast). These types of studies are very valuable for drawing general conclusions : they not only use a large sample, but also include different subsamples.

Examples of this type of meta-analysis that demonstrate the efficacy of psychotherapy to cure depression would be that of Cuijpers, Berking et al. (2013) or the most recent by Johnsen and Friborg (2015). In the latter, the researchers incorporated 43 different studies into their analysis. They found that, at the end of Cognitive Behavioral Therapy, 57% of patients could be considered “cured” of depression.

On the other hand, it is true that Cognitive Behavioral Therapy is the most frequent and on which more studies have been carried out, hence it usually has a great weight in meta-analyzes. However, there are other therapies that have been shown to be effective in the treatment of depression, and that we could consider as well established treatments, according to the criteria of the APA (American Psychological Association). They would be the following:

• Behavioral activation therapy (or behavior therapy).
• Cognitive-behavioral therapy.
• Problem solving therapy.
• McCollough’s cognitive-behavioral analysis psychotherapy system.
• Rehm’s Self-Control Therapy.

On the other hand, an equally false and widespread sub-idea, related to this point, would be the one that states that psychotherapy would only be effective to treat mild or moderate depression, but not to treat a serious one. For example, contrary to this idea, Driessen, Cuijpers, Hollon and Dekler (2010), based on the results of one hundred and thirty-two studies, did not find that the variable severity of depression influenced the differences between people who had received a therapy and those that had belonged to the control condition (the interaction of the severity of the disease variable with the benefit of psychotherapy was not significantly different from 0).

In light of the results, we can affirm that the idea that psychotherapy is one of the wrong ideas about the treatment of depression, as is the idea that psychotherapy is useless in cases of major depression. Another issue in relation to this last idea is that, in the case of the most serious patients, pharmacological treatment could be postulated as an invaluable help for the patient to start the more balanced / compensated therapy.

Psychotherapy is less effective than drug treatment

For example, in the meta-analysis cited earlier by Cuijpers, Berking et al. (2013) there are at least 20 studies comparing the efficacy of pharmacological treatments for depression and cognitive behavioral therapy and it was found that the effect size of the difference was practically zero (g = 0.03). Furthermore, this absence of differences was independent of the evaluation procedure used and the pharmacological treatment applied (the interaction between the factors was not significantly different from zero).

It is convenient to make a clarification in this regard. Studies comparing the results of interpersonal therapy with pharmacological treatment would show a slight trend in favor of certain pharmacological treatments. In any case, this last data must be viewed with caution, since the number of studies is much smaller than those that compare the effect of cognitive behavioral therapy with pharmacological treatment.

Thus, the thought that psychotherapy is less effective than pharmacological treatment would be another of the misconceptions about the treatment of depression

Treatment for depression is long

First, let’s specify that “long” or “short” will depend on where we estimate the line that divides the two extremes to be located. Currently, let’s think that the time frame in which they place the therapies (those that we have previously listed as effective) is about 16-20 sessions spread over 3-4 months. Of course, there are always special cases in which brief psychotherapy becomes very brief or lasts over time.

In any case, in no case, do any of the therapies that we have indicated as effective establish an intervention plan that lasts more than 6 months. If the results obtained in this period are not obtained, the situation would have to be re-evaluated. Not all psychotherapies work for all patients in all conditions. On the other hand, as with, for example, surgical operations and surgeons, not all psychologists have the same ability to treat all disorders from the same angle.

In any case, studies tell us, for example, that the average of successful cognitive behavioral therapy for depression is 15 sessions (Cuijpers, Berking et al.). In this section, relapses should be isolated, since they can occur for many different reasons and do not always have to do with psychotherapeutic intervention. Within this diverse box of reasons that can favor a relapse we find: a traumatic event, maladaptive family dynamics or configuration of habits that lead to isolation or social marginalization.

There are more misconceptions about treating depression than we have discussed here. In this sense, psychologists have known in many cases to investigate and develop effective therapies, but we have not known how to expose them to society. On this path we still have a lot of work to do.

Bibliographic references

Cuijpers, P, Berking, M. et al. (2013). A meta-analysis of cognitive behavior therapy of adult depression, alone and in comparison with other treatments . Candian Journal of Psychiatry.

Cuijpers, P., Hollon, SD et al. (2013). Does cognitive behavior theraphy have an enduring effect that is superior to keeping patientson continuation pharmacotherapy? An meta-analysis . BMU OPen, 3.

Sanz, J. and García-Vera, MP (2017). Misconceptions about depression and its treatment (II) . Roles of the psychologist. Vol. 38.