Depression treatment: both pharmacotherapy and psychotherapy are important
The combination of medication and psychotherapy is an internationally accepted principle in the treatment of depression. Scientific and standardized medication can make patients get rid of pain and restore normal function as soon as possible in the short term; psychotherapy, on the other hand, can gradually regulate and change the soil that makes people sick and reduce the risk of disease recurrence from a longer-term perspective.
1, depression drugs are safe enough, the chances of serious side effects are very small
There are two common reasons why people are more resistant to drugs.
One is the misconception of the disease. If you think you don’t need to take medication, you will be fine after a few days, in fact, this is a fluke, after all, depression is a minority of self-healing. Others hear that some people have not been cured by medication, but worsened, so they think that the medication is ineffective, which is not to understand a basic fact: the treatment process is not smooth. In the early stage of treatment, the condition itself is still developing and it takes time for the medication to take effect, so sometimes the condition seems to be aggravated after taking the medication, so it is easy to be mistaken that the treatment is ineffective or the medication has aggravated the symptoms, so the treatment is interrupted; in the recovery process, due to the influence of many factors, the condition often has a certain degree of fluctuation, not all are straight-line improvement, which is also easy to make people fall into the treatment ineffective This also makes people fall into the misconception of ineffective treatment.
Another, is the misconception about drugs, “medicine is three parts poison”. People today are generally resistant and wary of drugs, and this overinterpretation of “three parts poison” comes from two levels: first, the act of taking drugs itself means unhealthy for people, so they subconsciously avoid it; second, the increasing pressure of survival in the external environment makes people especially wary of health-related things, which is concentrated in the “seven parts cure” of drugs. In particular, the lack of professional common sense and the lack of trust in hospitals, many people resort to “drug manuals”, “doctor’s guide” and so on. “Once they see the possible drug reactions, they will be very afraid and reject the drugs as a matter of course.
Of course, drugs have certain toxic side effects, but clinical drugs are used only after rigorous research and clinical trials to determine their adequate safety. The side effects of most drugs are not as “three parts toxic” as people think, various antidepressants are safe enough, the chance of serious side effects is often calculated in ten thousand parts, even the common side effects are a few percent of the population, may not even “one part toxic Even the common side effects are a few percent of the population and may not even reach “one point of toxicity”.
In fact, under the guidance of a doctor, most patients are not affected by side effects or do not feel any side effects at all; even if there are common adverse reactions, most of them only appear at the beginning of the medication and diminish or disappear with continued medication or symptomatic treatment, and do not last. On the contrary, unregulated medication is prone to side effects.
2.Brain repair is slow, full course of treatment is the international common response
For depressed patients with their first episode, professional doctors usually recommend taking antidepressants for at least six months. Some patients do not accept this and feel that the medication time is too long, but they do not know that this is an international treatment strategy that has been proven by a lot of evidence and can maximize the “root” of depression, namely the “full course of treatment principle”.
The reason why it is not easily accepted is that most people have a simplistic concept of medication for their illness. For example, if you have gastroenteritis, you will get better in three to five days after taking medication, and you will rarely get sick again after you stop taking medication, so people naturally think that depression should be treated like other physical illnesses in a few days, and you will not get sick again.
However, for various diseases of the brain, especially mental or psychological diseases, this concept does not apply. The causes of most mental illnesses, including depression, are not as simple and clear as most physical illnesses such as enteritis; they are often the result of the long-term cumulative evolution of multiple causes. In addition, unlike the body organs such as stomach, intestines, liver and skin, which are very resistant and regenerative, the brain is very slow to repair once a problem occurs, often in months or years, as evidenced by the recovery process of stroke patients. Therefore, the treatment and recovery of depression and other brain diseases cannot be inferred from people’s impression of general physical diseases.
3, premature discontinuation of medication due to self-perceived improvement, with a high risk of relapse
It is easy to give a false impression to patients: after taking antidepressants for two or three weeks, they start to regain interest in life and feel better, so it is natural for them to think that they are well. In fact, this is not true. With the help of medication, the disorder in the brain is temporarily corrected, but it is only superficially cured. It’s like having a wound on your hand and being able to continue working after bandaging it, but it doesn’t mean that the wound has healed.
The reasoning is the same, except that the wound is in the brain and the treatment is slow to take effect and the brain is slow to recover. Most antidepressants require 2-4 weeks of continuous medication to take effect, and a few fast ones take a week. If the patient stops taking the medication after a few days or a month, he or she feels better, which is the same as removing the gauze before the wound grows well, at this time, even a small problem with little stress can easily stimulate the whole person’s state to decline, which seems to be a relapse of depression on the surface, but in fact, it is not completely well.
Therefore, the main reason why some patients’ depression keeps coming back after several treatments is that they do not receive scientific and standardized treatment. The first and foremost thing is to standardize the antidepressant treatment, i.e. adequate treatment dosage, and at the same time, make sure to take a full course of treatment, so that the brain has enough time to repair. Only when the brain state is stabilized and maintained for a long enough time, then the drugs are gradually withdrawn, so that it is less likely to relapse.
Some data can be used to support: depression patients who stop taking medication after their symptoms disappear for one month, the chance of relapse within one year after stopping medication is as high as 90%; those who stop medication after two or three months, the probability of relapse is still as high as 70% or 80%; if they continue to take medication for six months or more after their symptoms disappear, the risk of relapse will drop to less than 30%.
4. Medication alone is not enough, but psychotherapy is needed to change the susceptibility quality
Another reason why depression is prone to relapse is that it does not have a very clear cause like physical diseases, and there may be multiple causative factors, so it is not easy to treat the “root” at once.
What is clear now is that genetic factors, personal qualities, and environmental stressors can all influence the onset of depression. In particular, early developmental experiences, such as childhood trauma, frustrating experiences, and family relationships, have a significant impact on the quality of the individual and often lay the long-term roots of depression, which we call susceptibility, meaning that these factors make individuals more susceptible to depression than others. If we talk about the root of the disease, the susceptibility quality is one of the very important roots of the disease.
So, after standardized medication, the patient gets better, but the medication only enhances the mood tone, it does not eliminate or change these susceptibility traits in the personality. It is like a tree that is sick, and after medication or cutting off the sick branches, it is apparently well, but the cause of its disease is mainly in the soil where it grows, and if the harmful factors in the soil are not removed, they will act slowly and continuously, so after some time, the tree is sick again. Many patients use drugs at the same time, because they do not pay attention to personal psychological regulation, the existing personality, personality and other qualities of bad factors (such as unhealthy thinking, immature problem-solving methods and other susceptible qualities) are not reduced or eliminated, so even if the drug cured the symptoms at the time, he is still prone to re-offend in the future.
It is easy to understand why the strategy of combining medication with psychotherapy has become an internationally accepted treatment principle for depression. Medication is like a crutch that is used in stages after an injury, allowing us to quickly get rid of the pain and temporarily restore normal functioning; psychotherapy, on the other hand, gradually regulates and changes the existing unfavorable susceptibility qualities from a longer-term perspective, reducing the risk of relapse and obtaining lasting mental health from the root.