Media Opinions; CBT and Depression

I read an article in the Independent earlier today on the effectiveness of CBT (Cognitive Behavioural Therapy) in treating depression. Here in the UK, the prescription of anti-depressants has been widely criticized, many articles have been written about the potentially harmful side effects, how they are overprescribed, and questions have been raised asking whether they actually work or whether it’s a placebo effect that causes people to feel just that little bit better. After such articles, doctors have been less willing to prescribe medication and now turn to CBT as their first choice of treatment. Now it seems that this shouldn’t be first choice treatment either.

CBT is a type of therapy which concentrates on behaviour and assumptions. It aims to get people to change negative feelings into more positive ones by suggesting new ways of looking at things, replacing the irrational thoughts with more rational and self-helping ones. According to the cognitive theory of depression written by the psychiatrist Aaron Beck, depressed people think the way they do because their thinking is biased towards negative interpretations. These negative thoughts follow a type of pattern and through CBT, a depressed person is helped to break these trends and change their perception on events in their life. According to the facts and numbers, it works. One course of CBT is likely to produce 12 extra months free of depression. So why is it getting criticized?

It was described in the article as a quick fix to the problems depression causes. Unlike other forms of therapy, it doesn’t look deeply into the cause of the depression in the first place. Also its effectiveness at treating major depression is put to question. Personally, I can see where they are coming from. Even though CBT wasn’t suggested to me, looking back, my school counsellor seemed to use those types of techniques. She focused very much on dealing with my feelings there and then rather than why I was feeling them. She would often tell me to try and look on the more positive side of things, try to tell me that I had more reasons to feel happy than sad. Now I’m not saying this is the best example of CBT, I decided long ago that my school counsellor must have gotten her qualification from a Christmas cracker so using her sessions as an example isn’t the most accurate thing in the world, but I’m not sure that CBT would be the best treatment for me. To me it does seem like it just treats the symptoms rather than treating the cause. But I can’t argue with the facts. CBT has been proven to work and I think for mild or moderate depression it should be considered a first choice, if it’s right for the patient that is. For sufferers of major depression and bipolar...in my opinion, no. If someone is having frequent suicidal thoughts for instance, you have to look into why they feel like they do, delve a little deeper than just treating the emotions felt.

Reading the article brought to light another concern for me. Depression is a hard thing to diagnose correctly and an even harder thing to treat. There isn’t a ‘one treatment fixes all’ solution. The media are very quick to point out problems in the treatment and diagnosis. Obviously CBT works, but just not for everyone. Anti-depressants work for some people but not for everyone. The first sign of a treatment not working, the media seem to jump on it. I’m not sure doctors know what the best cause of treatment is anymore and I can’t see how all these articles are going to help. For someone who thinks that they are potentially depressed, aren’t they going to be put off by all this confusion? I have to admit, when it comes to anti-depressants, I have been influenced by the media’s dislike towards them. After reading article upon article highlighting the down points of taking them, I’m currently stubbornly going against my doctors’ opinion and taking a substitute option instead which are anti-anxiety tablets. Anxiety isn’t even a major part of my depression. I know I’m slowly coming around to the idea of taking anti-depressants, after being told by my counsellor, my doctor and Henrik, I’m starting to accept that I may need them. But how many others have also been influenced? How many others are putting off seeing a doctor due to things written and reported by the media? I say they should start telling people how these treatments are helping people rather than concentrating on the negative side of it all. Personally, I think the media need to book themselves in for their own session of CBT.