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Psychotherapy vs Medication


          Both medication and psychotherapy are used to treat anxiety and depression. They can be used together, but one is often used to the exclusion of the other. When used together, they can complement each other. However, I will argue here that between the two, psychotherapy is usually the more effective.

           Medicines can bring symptom relief, which can be very welcome but is often limited. To illustrate. Shedler (Aftab, 2020) reported on a a recent, comprehensive study by Cipriani et al. (2018). This study was a meta-analysis including 21 antidepressants. It found that, although there had been some improvement with the medications, the average patient was still clinically depressed enough to met the qualifications to join another study as a depressed patient.

           In contrast, the body of research has repeatedly shown that the effects of psychodynamic therapy are considerable, long lasting, and even increase over time (Shedler, 2010). There are also no physical withdrawal symptoms when discontinued (See Stopping Antidepressants on the page Specific Personal Concerns as well as Effectiveness under About Therapy). 

          Another kind of comparison between psychotherapy and medication involves a passive-active dimension. Taking medication is a passive process for the recipients, who put pills in their mouths, swallow, and experience their effects. Psychotherapy needs an active approach to work. The therapist doesn't  provide the treatment while their patients, in turn, sit there and accept it. The patient must at least make an equal or better contribution. As Shedler (Aftab, 2020) said in his conversation with Aftab, "A therapist may suggest connections or raise hypotheses for consideration, but it is a mutual process of discovery. The patient is the final arbiter of his own experience, always (p.?)" (I deal with this issue on the page Therapy Partners and its Update on my Blog).

REFERENCES

Aftab, A. (2020) Psychoanalysis and the re-enchantment of psychiatry: Jonathan Shedler, Ph.D. Psychiatric Times, July 29, 2020.

Cipriani, A., Furukawa, T. A., Salanti, G. et al. (2018). Comparative efficacy and acceptability of 21 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: A systematic review and network meta-analysis. Lancet, 391(10128), 1357-1366.

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109.


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