Monday, December 6, 2010

Managing Depression

If you're chronically mildly to moderately sad/depressed, these things often help:
  • 10-12 sessions of cognitive-behavioral therapy.
  • Regular exercise
  • Cutting down on abusives: alcohol, pot, cocaine, etc.
  • An outlet: help others and/or do something creative: write, act, paint, play music, etc.
Note that I've omitted antidepressant drugs. Often they don't work, stop working after a while, and/or have side effects that outweigh the benefits (weight gain, sexuality inhibition, even anxiety increase.) It may be wise to see if the above strategies work well enough without medication. If not, see a psychopharmacologist to discuss if it's worth a trial on an antidepressant.


Anonymous said...

Both Rational Emotive Behavior Therapy (REBT) and Cognitive Behavioral Therapy (CBT)treat depression.

I favor REBT to CBT for many reasons, the most significant of which are:
1. REBT addresses the philosophic core of emotional disturbance as well as the distorted cognitions (the focus of CBT) which derive from this core. Consequently, it is more powerful than CBT in this way. As you change your basic philosophy, the cognitive distortions are eliminated as a byproduct.
2. REBT highlights the significance of secondary disturbance (SD) which is often the largest factor in life-long (endogenous) depression, severe anxiety, and panic attacks. SD refers to getting depressed about being depressed. As far as I can tell, CBT completely ignores SD.
3. REBT maintains that all anger is destructive and teaches individuals appropriate, yet unangry, effective assertiveness. CBT views some anger as healthy and, although it teaches assertiveness, fails to address uprooting the philosophic core of anger.
4. REBT presents an elegant solution to the self-esteem problem. It teaches unconditional self-acceptance (USA), rather than any kind of self-rating, "authentic" or otherwise. Most CBT therapists focus on bolstering their clients' self-esteem.
5. As a consequence of these powerful differences and others, the average duration of my REBT therapy consists of 8 - 10 sessions, shorter than most CBT.

Michael R. Edelstein

ST said...

Also a case for psycodynamic therapy ... "not the psychoanalysis from Freud's day"; chair not couch, months opposed to years, gains made after therapy ends.

I just ran across the article in Scientific American Mind magazine comparing it to CBT.

This is not the full article, but as the issue gets older, it may become fully available:

A quick summary of comparisons between PDT and CBT general approach are:


PDT=treats the whole person
CBT=treats symptoms or diagnosis

PDT=emphasizes examined live
CBT=emphasises measurable results

PDT=SUCCESS is symptom improvement plus fuller, richer life.
CBT=SUCCESS is measurable scores on questionnaires or frquency of behaviors.


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