Therapy V Antidepressants 1


There’s a reason depression can be so difficult to treat: Scientists are still figuring out exactly how and why it strikes. An article recently published on discussed a new report in Nature by Emily Anthes who explores why therapy and drugs sometimes work — and sometimes don’t.

Depression doesn’t just give you a temporary case of the blues. It’s linked with physical changes in the way the brain works. Two major areas of the brain bear the brunt of those alterations: the prefrontal cortex, which sits behind the forehead and extends about a quarter of the way back on the head, and, below that, the amygdala, a nugget-shaped chunk of brain.

Antidepressants, often considered the go-to treatment for people with depression, target only one of those problem areas — the amygdala. That could help explain why just 22% to 40% of people with depression get full relief from antidepressants.

Cognitive Behavioral Therapy — a very specific type of talk therapy — appears to affect the other area, the prefontal cortex.

Both regions seem to be key players in depression. While the prefrontal cortex helps us exercise self-control, which we need to avoid dangerous bouts of negative thinking, the amygdala helps us process emotions, allowing us to feel joy, anger, and sadness.

In healthy people, the prefrontal cortex checks the amygdala, keeping us from constantly getting so upset we punch a wall or so sad we can’t stop crying. People with depression likely have an under-active prefrontal cortex, which takes away the natural check-and-balance system, and an overactive amygdala, which makes them more prone to sweeping emotions.

Since it appears to stimulate the prefrontal cortex, the thinking goes, cognitive behavioral therapy could help depressed people who don’t respond well to antidepressants.

Research backs up this idea. Two recent randomized, controlled trials (the highest study standard used to evaluate a method of treatment) found cognitive behavioral therapy to be a useful, cost-effective alternative to antidepressants. Another, much smaller study found that, when compared to people who stopped taking antidepressants, people who stopped cognitive therapy were less likely to plunge back into full-fledged depression, meaning the treatment could have longer-lasting effects than traditional medications.

Scientists still don’t know exactly what goes wrong in the brains of people with depression. While many depressed people experience similar symptoms — from constant feelings of worthlessness to distorted, unrealistically negative views about the world — the underlying mechanisms that cause those symptoms can vary from person to person.

As a result, people with depression respond differently to different treatments. While antidepressants can be a miracle cure for some, cognitive behavioral therapy — or a combination of both therapy and antidepressants — might work better for others.

Article taken in part from

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