Antidepressants greatly relieve the symptoms of depression. But can they replace psychotherapy?
More than 25 years ago, “happy pills” appeared that completely changed our attitude towards depression.
Antidepressants in the US and Europe have long been part of the lives of many people. Russia is moving in the same direction: about a third of Russians, our experts say, have at least once resorted to the help of sedatives and antidepressants.
New generation drugs are doomed to success: they have fewer side effects, and there are much more people with symptoms of depression who cannot cope with everyday stress. Does this mean that psychotherapy can now be dispensed with?
Relieve the condition
Antidepressants and anxiolytics are often needed solutions. If a patient comes in complaining of depression, the first thing the doctor asks is, “What do you mean by depression?” Usually he hears in response: “I feel tired all the time, I have no energy, I sleep very badly, I have lost my appetite.” More serious complaints are also possible: “I don’t deserve anything in life, I am overcome by very gloomy thoughts.”
After one consultation, such a patient usually leaves with a prescription because he has six of the characteristic symptoms listed in the Diagnostic and Statistical Manual of Mental Illness*. Based on this, medical treatment can be chosen.
“Perhaps such a patient also needs psychotherapy, which will make the effect of treatment deeper and more stable,” says psychiatrist Natalya Rivkina, head of the Clinic for Psychotherapy and Psychiatry at the European Medical Center (EMC). “The current standard of care for depression, anxiety disorders, stress reactions is a combination of drug therapy and psychotherapy.”
Drugs relieve symptoms, and psychotherapy, work with a psychologist helps to reveal internal conflict
For someone who is in a depressed state, having neither the strength nor the desire to work with a psychologist, antidepressants can provide invaluable help. Little by little, as he begins to feel better, with the gradual withdrawal of the drug, he can begin to work on the psychological cause of his depression.
“The main indication for prescribing a course of antidepressants is depression, but they also help those who live actively, work hard and cannot cope with constant overload,” says psychiatrist-psychotherapist Alexandra Yaltonskaya. “Drugs relieve the symptoms, and psychotherapy, work with a psychologist helps to reveal the internal conflict that led to psychological difficulties and achieve a lasting effect.”
Back to life
Some people, even suffering from depression, categorically refuse to take medication. Some have an irrational fear of them, someone considers the impact of “chemistry” on his personality unacceptable, for others there is something humiliating in taking pills that reduce anxiety, irritation, aggressiveness.
It’s not easy to depend on a drug that makes you feel psychologically better. Therefore, a more acceptable, liberating path is a course of psychotherapy. Some psychotherapists also object to taking antidepressants without considering the organic nature of their patient’s psychological problems. It is offensive to them that they cannot solve a patient’s problem without pills. And only when a psychiatrist and psychotherapist take a mutually open position, appreciate each other and understand the meaning of common efforts, this benefits their patients, helping to find a way out of the impasse.
Thinking and responsible doctors and psychotherapists are unanimous: psychoactive drugs are a partial solution that will be more effective in combination with therapy. “I honestly tell patients that drugs are the bridge between ‘I feel bad’ and ‘I feel good,’” admits clinical psychologist Ronald Pais. “And a person must go from one coast to another on his own.”
* Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Publishing, 2013).
Psychotropic drugs: what are they for?
Tranquilizers (anxiolytics). Possessing an anti-anxiety effect, they relieve tension and anxiety. Some also have a hypnotic effect, others do not (daytime tranquilizers). Taking these drugs for more than a month can cause addiction.
Sleeping pills. Increase the duration and quality of sleep. Accelerate the process of falling asleep or make sleep more sound. New generation drugs do not cause morning drowsiness, do not affect memory, and solve the problem of nocturnal awakenings. They can be taken for a long time.
Neuroleptics (antipsychotics). They have a therapeutic effect in cases of perceptual disturbances, hallucinations or delusions. They are also prescribed for the treatment of anxiety, mood swings, and insomnia. The drugs have side effects: coordination difficulties, weight gain, tremors. It is strictly impossible to take them on their own, without medical supervision.
Antidepressants. They are used not only for depression, but also for panic attacks, chronic pain, and eating disorders. A positive effect occurs after 10-14 days. They are usually prescribed for at least 3-6 months. Increase resistance to stress, endurance, improve mood. The use of certain drugs can disrupt concentration, reduce libido.