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Seeking Professional opinion on best possible treatment for mental illnesses.
Dec 22, 2003

Dear Dr. Horwath , I thank you greatly for taking the time to respond to my question , and those of us who are dealing with different mental illnesses which have plagued us over the durations of our lives.

This question is directed in the area of the best treatment for different mental illnesses , including depression , and most notably , anxiety , which seems to be around in great abundance across this mental health forum.

What is the most effective treatment of both of these conditions , rather , getting into more detail , would psychotherapy by itself , have the potential to treat depression or anxiety , or would you need the added benefit of antidepressants to win an uphill battle?.

Just before I leave , in a simple yes or no fashion , are there long term effects of drug therapy?.

Thanks very much ,

James

Response from Dr. Horwath

I'll focus on depression. The serious form of depression - known as major depression - refers to having a persistently depressed mood for more than 2 weeks, along with symptoms of hopelessness, helplessness, excess guilt, insomnia or hypersomnia, loss of appetite or increased appetite, loss of interest, loss of pleasure, agitation, fatigue, diminished concentration and/or suicidal thoughts.

People who have persistent symptoms such as these, along with a diminished ability to work and social withdrawal, definitely need treatment. The fastest and most effective treatment for such a depression is antidepressant medication. After some of the symptoms begin to respond to medication, persons with depression will often benefit from psychotherapy, with the goal of recovery from the effects of the depression on their lives, and also with the goal of developing more effective ways of handling the occupational and interpersonal problems that often contribute to the onset of depression.

Some people with milder and less persistent depression will sometimes respond to a form of therapy known as cognitive therapy for depression. But in most cases, I would recommend seeking a psychiatric opinion and recommendation regarding antidepressant treatment. The most convincing and extensive evidence we have indicates that the antidepressants now available are extremely effective and quite safe for most people.



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