Many people struggling with depression or anxiety have been prescribed anti-depressant medications, such as Ciprolex, Celexa, Zoloft, Paxil and Effexor. These medications can occasionally be a life saver, especially in cases of severe depression symptoms such as sleep problems; being unable to get out of bed, get dressed, washed, etc.; being unable to work; difficulty meeting parental responsibilities; or intense feelings of despair, self loathing, worthlessness and guilt. Taking anti-depressant medications in the short term for severe depression has contributed to saving lives and enabled people to keep up with the demands of daily living.
However, research over the past three to five years indicates that anti-depressants are no more effective than placebos for mild to moderate depression. In 2010, the Journal of the American Medical Association (JAMA) reported that, except in cases of very severe depression, anti-depressants are over-prescribed and ineffective. JAMA also cited the ‘placebo effect’ as the source of any symptom relief for mild to moderate depression. The impact of the placebo effect has also been corroborated recently through a study completed at Harvard medical school. Furthermore, the identification of the role of the placebo effect undermines claims that depression is caused by a ‘chemical disorder’ of the brain, such as a deficiency in the neurotransmitters serotonin and norepinephrine.
Even in the case of severe depression – where symptom alleviation has been linked to anti-depressant use – the reason they work is also the source of their weakness in the long run. Anti-depressants are only prescribed after the problem has taken root, making patients more vulnerable to relapse if the medication is withdrawn, and therefore dependent on drugs to cope. For medications relieve symptoms only, and do not prevent future incidents of depression and anxiety.
Anti-depressant medication has also been found to have serious side effects for some people, including an increase in suicidal thinking, mania and severe physical health problems, especially amongst the elderly. Long term use of several anti-depressant medications, including Prozac and Zoloft, has also been associated with tardive dyskinesia, a form of irreversible brain damage that produces tics and tremors.
Why Counselling is the Best Bet for Anxiety or Mild to Moderate Depression
On the opposite side of the spectrum, studies have been coming out for years that support the idea that counselling is as effective as anti-depressants, especially cognitive behavioral therapy. I would argue that counselling is in fact more effective and beneficial than anti-depressants, for a number of extremely significant reasons. Perhaps most importantly, counselling focuses on recovery from anxiety or depression and the prevention of future episodes of anxiety or depression through the development of psychological resiliency skills supported by constructive lifestyle changes. In other words, counselling teaches folks to make permanent positive and effective changes from the inside out, helping them become more independent and self reliant, and therefore more confident and less likely to relapse. Here’s how it works:
- Counselling teaches problem solving skills, such as how to overcome negative beliefs, assumptions or expectations that are the hallmark of depressed or anxious thinking.
- Counselling helps people learn to cope better and develop a more optimistic perspective through taking actions that enable them to feel self-empowered, such as becoming more assertive or taking steps towards life goals in spite of feeling fearful or pessimistic. As depressed or anxious people take action in spite of their difficulties, and start to achieve some positive results, they begin to feel genuinely better about themselves as people, which enhances their psychological well being in the long run.
- Counselling focuses on helping people build stronger support systems and relationships that will strengthen and protect them psychologically.
- Counselling teaches people how to calm their autonomic nervous system, which is the foundation for stress management and anxiety reduction.
- Counselling, in combination with positive lifestyle changes, including healthy diet and regular vigorous exercise, has been demonstrated to produce lasting anti-depressant and anti-anxiety effects.
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Glynis Sherwood – MEd, Canadian Certified Counsellor, Registered Clinical Counsellor, specializes in recovery from Anxiety, Depression, Grief, Family Scapegoating, Low Self Worth and Addictive Behaviors.