Antidepressants, Therapy, Side Effects, and Efficacy


CNN’s The Chart is one of my favorite blogs.  I particularly look forward to Tuesdays when Dr. Charles Raison writes about the world of mental health and

Photo by JasonTromm

psychiatry.  A couple of weeks ago Dr. Raison responded to a question about the safety of long-term antidepressant use. Dr. Raison did a much better job than I can describing the recent findings on antidepressants, including their long-term use, use  in pregnancy, and their effectiveness compared to placebos.  What he didn’t write about (and he usually does) is how psychotherapy is used in treatment of mental illness.

Obviously, given my chosen field, I am a believer in the power of mental health counseling and psychotherapy.  While I am not at all anti-psychiatric medication (far from it) I do believe that no conversation about antidepressants is complete without at least a brief mention of psychotherapy.  The reason is that psychotherapy/counseling (the terms are interchangeable) are a crucial part of the treatment plan for all forms of mental illness that I know of.  Schizophrenia, depression, ADHD, bipolar disorder – they can all be helped by psychotherapy.  In fact, the latest research tells us that therapy is just as effective as medication (if not more so) for many mental health disorders.  Research also suggests that a combination of therapy and medication is the best course of treatment for several diagnoses including many types of anxiety and depression.

Other than being highly effective, perhaps the coolest thing about psychotherapy is its lack of side effects.  We’ve all heard the list of unpleasant side effects that can be experienced on psychiatric medications (sexual problems, stomach upset, headaches, etc).  But therapy’s list is comparatively short.  In fact, some would argue there are no negative side effects at all.  I’m not sure I’d go that far (for example, sometimes talking about painful experiences can be tough and cause thoughts about these experiences to increase in the short term), but I agree that the risks of therapy are dramatically lower than for medication.

With therapy’s efficacy and lack of negative side effects in mind, it makes sense why it should always be included in any discussion of mental health treatment.