Effectiveness Of Depression Disorder Treatments

Pharmacotherapy And CBT For Depression Disorder Treatment

What Is The Effectiveness Of Depression Disorder Treatments?

A depressive disorder is where an individual has ongoing blues and is persistently filled with feelings of sadness and worthlessness. They also do not have the desire to take part in activities that brought them joy and pleasure before. Therefore this is a medical condition that affects the body, thoughts, and mood. This is an illness and thus it cannot be wished away by the person affected by it and if the individual does not seek treatment it can last for a long period. Therefore an individual can seek different forms of treatments to remedy the form of depression that they are facing. One route of treatment that can be taken is pharmacotherapy. This is where a medical professional treating the depression patient prescribes a number of pharmaceutical drugs that are meant to manage the symptoms of depression and therefore manage the disease. Cognitive Behavior Therapy (CBT) is another course of treatment taken for depression patients. This is a form of psychotherapy which deals with the problems causing the depression treating them and also boosting happiness in the patient. It boosts happiness by modifying the patient’s mood, thoughts, behavior, and emotions (Cuijpers et.al 2014, pp. 63).There exist debates whether CBT is more effective than pharmacotherapy and this essay will cover this by comparing articles on these two treatments .  Effectiveness Of Depression Disorder Treatments Essay Paper

Depression disorder is quite common and affects a huge chunk of the world’s population and in Australia specifically, it affects more than 1 million adults yearly and 45 % of the population will affect a form of mental health issue in their lifetime. Therefore because of this its necessary for there to be treatments to help these individuals bein affected by this. Depression is not a condition where an individual can just wish it away they have to find ways to cope with the symptoms and treatments like pharmacotherapy and CBT have been successful (Gibbons et.al 2016, pp. 910). Pharmacotherapy is used to treat depression but there are studies which show that when it is used alone it does not effectively treat these symptoms associated with depression. This treatment can have negative side effects on the patients such as the patient losing weight, increase in suicidal thoughts, sexual side effects and sedation which can mildly or severely impact a patients value of life. These studies suggest that the therapy should be supplemented with CBT because patients can learn coping strategies they can use in future, therefore, depression patients get the best treatment possible. However, others disagree and suggest that pharmacotherapy can be an effective treatment for depression on its own. Therefore this is an important subject that should be discussed in depth and a conclusion be made on the best course of treatment for patients to be prescribed (Millan, Goodwin, Meyer-Lindenberg and Ögren 2015, pp. 634).

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The Need To Combine Pharmacotherapy And CBT Treatments For Depression Disorder

Depression is quite common in Australia, therefore, the Australian health system has taken steps to have treatments in place for this condition. There are guidelines in place which help medical professionals deal with mood disorders these guidelines are called the Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (Malhi et.al 2015, pp.1090). This gives clear and up to date guidelines in regards to how to manage mood disorders like depression in Australian hospitals and this is informed by evidence from clinical treatments using these methods (Solomon, Proudfoot, Clarke and Christensen 2015).

The first article is called “Long-term effectiveness and cost-effectiveness of cognitive behavioral therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care”. It is an article about a study carried out to find out the effectiveness of treatment of treatment-resistant depression with pharmacotherapy being supplemented with CBT. Although CBT is an effective treatment there is no evidence that exists which shows how it affects a patient in the long term and this study was meant to find this out. This study showed the long-term cost-effectiveness of using CBT as compared to pharmacotherapy. Also, this article shows that 50% of depression patients do not respond to pharmacotherapy, therefore, CBT is an effective course of treatment for these patients. Hence, due to these findings, the article suggests that more patients with drug-resistant forms of depression should be referred to use CBT in conjunction with the pharmacology (Wiles et.al 2016, pp 140).

The second article “Cognitive Behavioral Therapy for Depression Medication” talks about how CBT has been used to treat depression. It states that CBT is commonly used as a standalone treatment when the case of depression is mild and lasts for a short period of time however when it in its severe form pharmacotherapy is used in conjunction with pharmacotherapy. It shows that there are advantages of using a combination of both treatments in patients and the pros are seen more inpatients suffering from more chronic forms of depression (Thase, Kingdon and Turkington 2014, pp. 238). They work together in that pharmacotherapy may give relief and deal with earlier symptoms of depression while CBT improves them symptoms of depression for a long period. CBT deals with symptoms such as anxiety and procrastination helping the patient follow a strict schedule, therefore, the patient will take their medication at the right time and thus making pharmacotherapy more effective. Also, it has been seen that CBT reduces instances of hospitalization. Pharmacotherapy then helps CBT n that the medication given can help the patient increase concentration, increased energy and help maintain good sleep patterns which will all help CBT to be more effective (Halverson 2018).

Guidelines For Managing Mood Disorders In Australia

The third article called “Efficacy of Pharmacotherapy and Psychotherapy for Adult Psychiatric Disorders” talks about the results of a study carried out to find out the efficiency the two treatments, pharmacotherapy, and psychotherapy, for depressions in adults. There is an existing debate about how effective the treatments for psychiatric disorders really are and whether CBT and pharmacotherapy are the treatments that should be primarily used. This study concludes that many trials have been carried out to find out how effective these treatments are on their own and they have found that they are both quite effective on their own. However, there are few studies that have been carried out to find out whether using a combination of both treatments to treat depression and if it’s effective (Mergl et.al 2018). Most people just compare studies on the efficiency of using the treatments on their own indirectly which can have wrong results. Thus this article suggests that more studies should be carried out to find out if using both treatments in conjunction is effective. Also, research should focus on finding ways to combine both treatments so that they can both be effective rather than focusing on which treatment is more effective (Huhn et.al 2014, 710).

The fourth article called “Advantages and disadvantages of taking anti-depressants”. Antidepressants are the most common type of drugs that are used in pharmacotherapy treatment of depression. It also states that it can be used to treat a variety of other conditions like stress and anxiety. Different kinds of antidepressants work for different kinds of people depending on the severity and type of depressive disorder that they suffer from. Therefore for one to know which one works for them they use the drugs for a given time to find the best fit for them (Karyotaki et.al 2016, pp. 150). The drugs have many benefits for the patient when prescribed like they sooth an individual so much so they can handle different situations they would not have without them. Many individuals who take these drugs give the feedback that they were less nervous and had fewer negative thought, therefore, showing it improves the quality of an individuals life. These drugs can have negatives also like; weight gain, dry mouth, tremors and increased suicidal thoughts. However, these symptoms have been shown to stop after one week of using the drugs and if they persist the doctor can minimize these side effects (Depression Is Real 2018).

Research On The Effectiveness Of Combining Pharmacotherapy And Psychotherapy For Depression Disorder Treatment

The fifth one is “Can Cognitive Behavioral Therapy for Anxiety and Depression Be Improved with Pharmacotherapy? A Meta-analysis”.  The publication talks about the analysis combination therapy of using pharmacotherapy and psychotherapy. It finds that this combination works well together to treat depression in most cases. This works mostly for patients with chronic depression or who are at risk of relapsing into depression. It states that the different types of depression may require different types of treatment and it might be a combination of the treatments or on its own (Shou et.al 2017, pp. 465). Even though combining both treatments have shown to be effective in the short term, it can cause limitations to the results achieved by using CBT alone. Therefore, this publication suggests that combining the treatments for depression patients should not be what doctors resort to first. However, there are considerations that should first be made, like the level of treatment and how severe the depression is, before deciding to use a combination of both treatments (Tolin 2017, pp. 730).

The final article is called “Psychotherapy or Medication – Which Should You Choose?”. In today’s culture, most people are always watching the television which is filled with advertisements on pharmacotherapy for depression. Most people are bound to have heard about this form of treatment for depression.  Most of these ads make it seem that this treatment is as easy as popping a pill and feeling relief and therefore will see no point of CBT. Therefore this article gives options for treatments and reasons to choose therefore one can get information before opting for one form of treatment. Reasons to choose CBT to include; first of it is not addictive, also individuals get to learn lifelong skills which are used in any situation and also it helps patients overcome their triggers reducing chances of relapse (Shulman et.al 2018). The reasons given to choose pharmacotherapy include; they offer quick and short-term relief for symptoms of depression and it can be cost-effective as it most often covered by most insurance. However it has drawbacks including; these drugs have side effects,  they are prescribed using trial and error method and also there is fear that the patient may get addicted to the drugs. Another option given is a combination of both which the article states that there is evidence to show that it gives best results to the patient (Rosen 2017).

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Pros And Cons Of Anti-Depressants

These articles give different views about the different course of treatments for depression. The articles that support a combination of CBT and pharmacotherapy all agree that they have a variety of benefits over using the treatments on their own. One benefit that can be seen is that using a combination of these treatments have long-term benefits for the patient. This can be seen in that they will work to offer relief to the symptoms of depression and at the same time they teach the patient life skills which they can use to cope with future situations. Therefore the patient is given healthy strategies to cope with any issues they may face in future(Nakagawa et.al 2017, pp.1130). Also, these therapies work together well whereby the drugs given to relieve symptoms like lack of sleep and stress will help the patient while going through CBT treatment. The skills learned in CBT like following a schedule will help the patient have more adherence to the medications given. Another benefit is that the patient will have no reason for the treatment not to work because combining the treatments will deal with any issues that may arise in the course of treatment. These articles state that this course of treatment is effective in that it can reduce the incidences of relapsing depression, therefore, reducing the amount of time one has to be hospitalized (Vittengl et.al 2016, pp. 483).

On the other hand, some of the articles give reasons why depression patients should only use pharmacotherapy treatment. This is where only medication is used and these reasons include the negatives of a combination of CBT and Pharmacotherapy. First is that combining the treatments can be quite expensive and the reason being that it is a relatively new strategy therefore little evidence exists of its long-term effectiveness. Therefore, many insurance companies will only cover medication therapy making this the cheaper option. Another reason is that some depression disorders do not require a combination of the treatments but just prescription of medication (Amick et.al 2015). Therefore not all cases of depression should be prescribed this as it will have negative effects on the progress of the treatment. Another reason that can be seen in these articles is that even though there are side effects related to medications prescribed, they can resolve on its own after one week. If the symptoms persist there are methods like adjusting the medication which the doctor can take to reduce these effects (Szuhany, Kredlow and Otto 2014, pp. 130).

The Importance Of Finding The Right Treatment For Depression Disorder

These studies on the subject whether a combination of CBT and pharmacotherapy is more effective than pharmacotherapy on its own has a variety of strengths and limitations. The first strength is that as there are many patients who are affected by depression, therefore, there were many people who could take part in the studies whose findings would then be beneficial to a whole group of people. Another strength is that by doing these studies the findings will help a lot of people who are affected by depression. Therefore there is a lot of funding for these kinds of research as a lot of people are affected by depression one way or the other. Also, in the current world, especially Australia mental health issues lie inequity in access of mental health treatment are now being recognized as a major health issue, therefore, this means governments will offer support to carry out such research (Tolin 2017, pp. 730).

Some of the limitations of these studies include; first, not all participants were truthful in the other forms of treatments that they were part of. These treatments if not included in the findings could have skewed the conclusions made by the studies. Also, some of these studies had more male participants, therefore, it was not a balanced study. The results then were not efficient to be applied to the population where we find more women suffering from depression than men.  Another limitation is that some of these studies had limited resources t work with like the number of CBT specialists present and also people trained to offer a combination of both treatments. Also, there were few resources to enable face to face collection of data and therefore they used postal questionnaires which could result in these individuals lying about their answers thus skewing the results of the study (Tolin 2017, pp. 730).

In conclusion, I believe that a combination of both treatments will be more effective in treating depression as evidenced by a majority of the articles. Even though this has negatives, the benefits for the patients far outweigh them. Therefore this shows a need for more studies to be done with the aim of showing what the benefits are so that more doctors can start using this method. Also, the studies should cover how this combination can be done effectively so that it achieves the best results for the depression patient. Therefore I agree with the clinical question posed.

Conclusion

References

Amick, H.R., Gartlehner, G., Gaynes, B.N., Forneris, C., Asher, G.N., Morgan, L.C., Coker-Schwimmer, E., Boland, E., Lux, L.J., Gaylord, S. and Bann, C., 2015. Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis. Bmj, 351, p.h6019.

Cuijpers, P., Sijbrandij, M., Koole, S.L., Andersson, G., Beekman, A.T. and Reynolds, C.F., 2014. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta?analysis. World Psychiatry, 13(1), pp.56-67.

Halverson, J. L., MD., 2018. Cognitive Behavioral Therapy for Depression. [ONLINE] Available at: https://emedicine.medscape.com/article/2094696-overview. [Accessed 4 July 2018].

Huhn, M., Tardy, M., Spineli, L.M., Kissling, W., Förstl, H., Pitschel-Walz, G., Leucht, C., Samara, M., Dold, M., Davis, J.M. and Leucht, S., 2014. Efficacy of pharmacotherapy and psychotherapy for adult psychiatric disorders: a systematic overview of meta-analyses. JAMA psychiatry, 71(6), pp.706-715.

Karyotaki, E., Smit, Y., Henningsen, K.H., Huibers, M.J.H., Robays, J., de Beurs, D. and Cuijpers, P., 2016. Combining pharmacotherapy and psychotherapy or monotherapy for major depression? A meta-analysis on the long-term effects. Journal of affective disorders, 194, pp.144-152.

Malhi, G.S., Bassett, D., Boyce, P., Bryant, R., Fitzgerald, P.B., Fritz, K., Hopwood, M., Lyndon, B., Mulder, R., Murray, G. and Porter, R., 2015. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian & New Zealand Journal of Psychiatry, 49(12), pp.1087-1206.

Mergl, R., Allgaier, A.K., Hautzinger, M., Coyne, J.C., Hegerl, U. and Henkel, V., 2018. One-year follow-up of a randomized controlled trial of sertraline and cognitive behavior group therapy in depressed primary care patients (MIND study). Journal of Affective Disorders.

Millan, M.J., Goodwin, G.M., Meyer-Lindenberg, A. and Ögren, S.O., 2015. Learning from the past and looking to the future: emerging perspectives for improving the treatment of psychiatric disorders. European Neuropsychopharmacology, 25(5), pp.599-656.

Nakagawa, A., Mitsuda, D., Sado, M., Abe, T., Fujisawa, D., Kikuchi, T., Iwashita, S., Mimura, M. and Ono, Y., 2017. Effectiveness of Supplementary Cognitive-Behavioral Therapy for Pharmacotherapy-Resistant Depression: A Randomized Controlled Trial. The Journal of clinical psychiatry, 78(8), pp.1126-1135.

Shou, H., Yang, Z., Satterthwaite, T.D., Cook, P.A., Bruce, S.E., Shinohara, R.T., Rosenberg, B. and Sheline, Y.I., 2017. Cognitive behavioral therapy increases amygdala connectivity with the cognitive control network in both MDD and PTSD. NeuroImage: Clinical, 14, pp.464-470.

Shulman, B., Dueck, R., Ryan, D., Breau, G., Sadowski, I. and Misri, S., 2018. Feasibility of a Mindfulness-Based Cognitive Therapy Group Intervention as an Adjunctive Treatment for Postpartum Depression and Anxiety. Journal of Affective Disorders.

Solomon, D., Proudfoot, J., Clarke, J. and Christensen, H., 2015. e-CBT (myCompass), antidepressant medication, and face-to-face psychological treatment for depression in Australia: a cost-effectiveness comparison. Journal of medical Internet research, 17(11).

Szuhany, K.L., Kredlow, M.A. and Otto, M.W., 2014. Combination psychological and pharmacological treatments for panic disorder. International Journal of Cognitive Therapy, 7(2), pp.122-135.

Thase, M.E., Kingdon, D. and Turkington, D., 2014. The promise of cognitive behavior therapy for treatment of severe mental disorders: a review of recent developments. World Psychiatry, 13(3), pp.244-250.

Tolin, D.F., 2017. Can Cognitive Behavioral Therapy for Anxiety and Depression Be Improved with Pharmacotherapy? A Meta-analysis. Psychiatric Clinics, 40(4), pp.715-738.

Vittengl, J.R., Jarrett, R.B., Weitz, E., Hollon, S.D., Twisk, J., Cristea, I., David, D., DeRubeis, R.J., Dimidjian, S., Dunlop, B.W. and Faramarzi, M., 2016. Divergent outcomes in cognitive-behavioral therapy and pharmacotherapy for adult depression. American Journal of Psychiatry, 173(5), pp.481-490.    Effectiveness Of Depression Disorder Treatments Essay Paper