Shelley Fields, psychotherapy, psychotherapist, Counselor, Chapel Hill, PittsboroShelley Fields  
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Depression is not uncommon in the United States. 18 million people suffer from it every year. Depression can flood a healthy mind with negative thoughts such as: “I have bad luck.” “I don’t deserve to be happy.” “I always do it wrong.” A person suffering from depression may experience difficulty sleeping or sleeping too much, problems with eating, lack of energy, feelings of hopelessness, and an inability to feel pleasure or enjoy him or herself.

Many people who are considering treatment for depression have heard stories about the magical properties of antidepressants. Antidepressants are often effective for relieving the symptoms of depression. However, a recent article in the Jan 6, 2004 edition of the Wall Street Journal by Sharon Begley compares the effectiveness of antidepressant medications with psychotherapy to relieve depression. It cites research indicating that patients completing a course of psychotherapy without medication have better long-term results than patients who experience initial relief from antidepressants but don't continue to use them.

A new study conducted by neuroscientists in Canada found that cognitive-behavior therapy causes changes in brain activity that are the reverse of the changes caused by antidepressants. This study, published in the January issue of the Archives of General Psychiatry, shows that medication reduces activity in the emotional or limbic center of the brain. Cognitive-behavior therapy quiets over-activity in another part of the brain, the cortex, seat of higher thought.

Cognitive-behavior therapy works by teaching patients not to ruminate endlessly about minor setbacks. They are taught to identify destructive beliefs: “there is no point in even applying for the job”; “I’ll never find anyone to care about me”; and come to recognize how they to magnify their disappointments into calamities and tragedies. They learn to test the accuracy of those beliefs and see that they are often unrealistically pessimistic.

So, while antidepressants damp down activity in the lower limbic regions, where stress and negative emotions originate, cognitive-behavior therapy teaches the brain to respond to those signals in a healthier way, and that has a more lasting effect.

Because of the different areas of the brain affected by each method of treatment, often the combined use of both antidepressants and cognitive-behavior therapy has the best short- and long-term results in the treatment of depression.