Reply to comment

I also thought this was an interesting discussion, and I was wondering about some of the same points that Liz (and Elliot) brought up here – if drug therapy and CBT seem to be affecting/changing similar areas of the brain, it seems that they are working through similar mechanisms.  But if neurotransmitters are being affected in the same way by both of these treatments, I would think that side effects associated with drug therapies should also be present during CBT.  Like Elliot said, I really have no idea if this is the case, but I have trouble imagining (maybe just because I’ve never heard anyone mention it) that patients undergoing psychotherapy experience problems like “dry mouth” or “insomnia” that are apparently common in pharmacotherapy.  Dr. Yadin brought up the point that psychotherapy doesn’t have the negative effects that may be associated with drug treatments because it doesn’t act on the periphery, and I think that this fact alone is enough to make the argument that psychotherapies like CBT should at least be considered before pharmacotherapy.

I completely agree with the idea that drug therapy has become so popular because it seems like a quick fix to a problem.  If one of the symptoms of depression, for example, is a loss of energy then it is easy for me to imagine that someone with depression would be overwhelmed at the idea of putting in the time and effort to talk to a therapist and work through their problems.  And, like Emily said, it hardly seems ethical to force people to try therapy before drugs.  I also think that part of the reason that drug therapy has been so widely embraced is because we understand that if taking a drug fixes a problem this means that the problem is biologically based, and I think that this in turn de-stigmatizes many mental conditions.  I think that in the past there has been a sort of idea that if someone is depressed, has OCD, etc. that this is some sort of character flaw, or that they should just get over it.  If a patient actually needs a drug to fix the problem, however, then it seems more like a medical condition that the patient has no more control over than someone who takes medication for some physical illness.  However, at this point in time I think (or at least I hope) that the  majority of people understand that severe mood disorders (and other conditions) have a biological basis, so maybe people will begin to be more willing to try psychotherapy-based approaches again.

On a totally different note, I read the article that Marissa posted from BBC (“Is Depression Good for You?”) and it reminded me of a topic we covered in one of my classes last semester.  I don’t remember the specific articles or studies that we looked at, but it basically had to do with the idea that negative or depressed moods evolutionarily probably arose in response to conditions where something is wrong or needs to be fixed, and that in order to fix a problem we need to be able to think clearly and rationally.  To support this hypothesis researchers were showing that when people are upset or sad (however you measure that) they are better at memory tasks and solving problems than when they are happy.  Basically, it just seems to me like our culture is so focused on the idea that we should be happy all the time – but maybe when we’re not happy this is in fact adaptive, and by trying to “fix” it we’re not really helping the person.  Of course in cases of severe depression I think that something should be done, but it seems like it’s fairly easy to fall in the DSM category of “clinically depressed”, and maybe not everyone in that category actually needs clinical or (especially) medical help.