by PAUL BIEGLER
Spot the problem in this scenario. Richard* is stressed. While he’s a high-flyer (a Rhodes Scholar no less), he’s under the pump at work and has just moved his family across nations. The job is taking more than it’s giving back. He’s in a dark place – very down, unmotivated, ill-humoured and lacking energy – so oblivion seems enticing. Worryingly, he also has a family history of depression.
Richard visits his family doctor who refers him to a psychiatrist. So far, this is unremarkable – as depression management goes.
With relief, Richard enters the psychiatrist’s plush rooms, sighs, and prepares to unburden himself and submit to wise counsel. But he’s in for a surprise. Within minutes he’s told he has depression, needs medication, and will likely do so for life. He leaves with sample pack of antidepressants in hand, and troubles still firmly packed in kit bag.
If you’re like me, you see the problem quickly. Richard, and around 70% of the people who share his diagnosis, can implicate a psychosocial stressor in the genesis of his depression. But his doctor has failed to identify and address it, even though stressor-focused treatments are available.
Evidence-based psychotherapy, in particular cognitive behaviour therapy (CBT), is as effective as medication in the common, lesser grades of depression. You read that correctly – CBT is as good as drugs at relieving the lowered mood, hopelessness, fatigue, guilt, and poor concentration that figure in the depressive diagnostic checklist.
And not only does psychotherapy reduce psychic distress, it also tackles stressors. In addition, CBT tutors healthy scepticism about the negative perceptions that pepper the depressive psychological landscape. Such ideas cause undue pessimism and arise, almost always, from biased information processing. Challenging negative thoughts is a critical element in the therapeutic success of CBT.