5 Treatments for depression
The activity below provides an overview of antidepressant medications and psychological therapies that are available for depression, and is also useful for consolidating your learning in this section. Please note that there is no discussion associated with this activity. The questions posed, however, will help you to structure your thoughts as you reflect on the issues raised in the podcast. You might find it useful to take notes and write down your answers to individual questions.
Activity 4 How is depression treated?
Listen to the podcast below and note down your responses to the questions that follow. You might wish to listen to the entire recording first and review this again thinking specifically about the questions the second time around. Alternatively, you can consider the questions as you listen to the recording the first time around. Choose whichever approach suits you best.
Professor Mark Williams and Dr Danny Penman from Oxford University discuss how the treatment of depression has evolved to include antidepressant medications which directly affect brain neurochemistry, and psychological treatments including cognitive behaviour therapy. The podcast is part of a series on the ‘New Psychology of Depression’ from the Department of Experimental Psychology at the University of Oxford, produced in 2011.
Professor Williams says that ‘so much of our functioning, our eating, our sleeping, our mood’ is governed by the action of neurotransmitters in the brain. Depression can result when neurotransmitters are no longer in balance. Which two neurotransmitters that he refers to as having been studied extensively are important for antidepressant function? How do antidepressants affect the availability of these neurotransmitters within the brain?
Tricyclic antidepressants were introduced in the 1950s and 60s. Why are the ‘new generation’ of antidepressant drugs preferred over these earlier medications for the treatment of depression?
Professor Williams notes that about 60% of people will respond to antidepressant medication and recover from depression, and he refers to the STAR*D clinical trial which showed that changing medications can be useful to support treatment response. He also notes that antidepressant drugs can help in ‘severe’ forms of depression. What does he refer to as the ‘main problem’ with stopping taking antidepressant medications?
Depression tends to be episodic, ‘it comes, it’s crushing when it happens, but then you get over it’. What, according to Professor Williams, is the difference between a ‘relapse’ and a ‘recurrence’ of depression?
Psychological therapies can help to protect against relapse and recurrence of acute episodes of depressive illness. These include cognitive therapy, behavioural activation, interpersonal psychotherapy, psychodynamic psychotherapy and psychodynamic interpersonal psychotherapy, and problem-solving therapy for mild or acute depression. What does interpersonal psychotherapy involve, as described by Professor Williams?
Professor Williams explains that during the 1950s and 60s, with the recent availability of antidepressant medications ‘nobody thought that depression was the sort of thing that you could treat’ with a psychological approach. Irrational thoughts and negative thinking were considered a symptom of depression and that in order to treat depression the view at the time was that one would need to treat the underlying biological or psychodynamic problem first, and that ‘negative thinking,and so on,would naturally just dissolve’, and the thoughts 'clear up by themselves’. He refers to two major hypotheses that were proposed in the late 60s and early 70s that changed this view. What were they?
Is there a difference between ‘cognitive therapy’ and ‘cognitive behavioural therapy’?
Is it possible to know if someone would respond more favourably to cognitive therapy than to antidepressant medication?