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Re: Burns NOT a med-basher

Posted by mattdds on November 24, 2002, at 1:32:54

In reply to Re: Burns NOT a med-basher, posted by Peter S. on November 23, 2002, at 23:09:52

Peter,

CBT, like all treatment for depression, is not a panacea. However you are incorrect to say that it is only effective for mild depression and anxiety. I realize that CBT may not have worked on severe depression *for you*, but to generalize this to the rest of the population flies in the face of a lot of good evidence.

Many new studies have found the following:

1. CBT is indeed just as effective as antidepressant medication for SEVERE depression, as well as mild to moderate depression.
2. It has better long term outcome, in terms of fewer relapses
3. It may be less expensive if one considers that, since relapse usually follows discontinuation of a medication, they must be continued indefinitely.

Keep in mind, that just because CBT did not work for your (severe) depression, which is unfortunate, it is poor logic to say that this is how it is for everyone. Here is a link to a study performed at the U. Penn psychiatry department:

http://www.upenn.edu/pennnews/releases/2002/Q2/derubeis.html

CBT is not for everyone, and it is not easy work; definitely much more difficult than taking medication. This is where proper patient selection comes into play. There was a study done that showed positive correlations between the self-efficacy trait and good outcome with CBT. People who had lower self-efficacy did not fare as well.

I have noticed that bringing up CBT on this board usually elicits the following typical responses:

1. It is only good for mild depression (simply not true)
2. It ignores the “biological basis” or “chemical imbalance” aspect of depression (this seems to *really* hit a raw nerve, like we have this need for our illness to be legitimately “medical”)

You wrote:

“I still get the feeling that he believes if you try hard enough to do the exercises then you can beat any kind of depression. I completely disagree.”

I certainly did not get that from reading his stuff. But, conversely, some people (many on this board, apparently) have a go with nearly every conceivable med combo, and still no results. Why is this never brought up? Yet we’re so quick to bring up CBT’s shortcomings.

Bottom line: Get well, using whatever method works! (CBT or otherwise!)

Matt


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poster:mattdds thread:128568
URL: http://www.dr-bob.org/babble/20021122/msgs/129019.html