Can depression be cured without medication?
Is it possible to treat depression without medication, only with psychotherapy?
Major depression is one of the most prevalent mental disorders worldwide, together with those belonging to the category of anxiety. In parallel, the use of antidepressants is becoming increasingly common in society.
Increased demands in many areas of life, the enduring economic crises we have had to face and a long etcetera of circumstances have made a decisive contribution to this.
In this article we will go into the question of whether depression can be cured without medication, which necessarily implies knowing in advance if it can be cured without medication.This necessarily implies knowing in advance how this common mood disorder manifests itself.
What is depression
First of all, it is important to note that depression and sadness are not two equivalent realities. The former describes an emotion that belongs to the normal range of human experience and has been forged throughout the evolution of our species by its adaptive properties. Depression, however, is a significant clinical phenomenon that can profoundly compromise the quality of life of the sufferer. They are, therefore, different.
The core symptoms of major depression are sadness and anhedonia (severe difficulty in experiencing pleasure), and one (or both) of these must be present for a diagnosis to be made. The sufferer feels emotionally despondent most of the time, which coexists with a substantial loss of interest in engaging in previously rewarding or meaningful activities.
It is relatively common for people with depression to occasionally think about taking their own lives, or for a series of thoughts related to death or dying to burst onto the scene in their minds. There may also be persistent fatigue that lasts for most of the day, and which is related to the depression.and that is related in a reciprocal way with the difficult emotions that characterize this psychopathological alteration of the state of mind.
Some people come to refer alterations in executive processes such as attention or concentration, all of them dependent on the activity of the prefrontal cortex, which ends up manifesting itself vehemently through the hindrance in the ability to make decisions. Likewise, rumination may be frequent (obsessive thoughts that are perceived as intrusive) and with contents consistent with the mood (guilt, failure or pessimism about the future).
Finally, important changes may arise in habits that are necessary for the care of the body, such as eating (which may result in weight gain or loss) or sleep (due to excess or deficit).such as feeding (which may result in weight gain or loss) or sleep (due to excess or deficit). At the psychomotor level there are occasionally some additional alterations, perceived as slowing or acceleration of movement and/or thinking, which may have an echo in the way we interact with others.
These symptoms should last for two weeks or more and alter the quality of life of the person, or generate deterioration in the areas of functioning that are relevant to him/her. Likewise, it is important to confirm that you have never it is important to confirm that the person has never had a previous manic episode.otherwise the appropriate diagnosis would be Bipolar Disorder Type I (whose treatment requires stabilizers or anticonvulsants). With this knowledge at our disposal, we can go into the initial question: can depression be cured without medication?
And then... can depression be cured without medication?
Pharmacological treatment and psychotherapy are the two great tools we have to combat depression. we have to combat depressive disorder. The efficacy of both has been extensively studied in the scientific literature on the subject, and comparative studies have even been frequently carried out to try to elucidate which of these modalities provides a superior benefit to people who decide to opt for them in a case of need.
The most recent studies on the issue, including the comprehensive meta-analysis by the National Institute for Health and Care Excellence (NICE, 2017), indicate that. the effect of antidepressants is slightly superior to that of a placebo.This is one of the most frequent measures used to determine the therapeutic quality of a chemical compound. However, numerous criticisms have been raised by different authors concerning the interpretation of these results.
Generally, the use of psychotropic drugs should be chosen for severe cases of depression, which would allow a more efficient balancing of the balance between the benefits and harms that may result from their use. They are not usually recommended for minorsand extreme caution should be exercised in pregnant women, epileptics or people with clear suicidal ideas. The Latin locution primum non nocere (the priority is to do no harm) is used to represent the search for this balance.
Monoamine oxidase enzyme inhibitors (MAOIs-A), which are practically out of use.The tricyclics reduced depressive symptoms significantly but increased the risk of hypertensive crises when combined with the intake of foods rich in tyramine (through an abrupt increase in noradrenaline). Tricyclics, considered the most effective in reducing the symptoms of depression, generate a long list of side effects associated with the blockade of muscarinic, histaminic and adrenergic cholinergic receptors.
Selective serotonin reuptake inhibitors (SSRIs) were the first Antidepressant drug synthesized specifically for the purpose of acting on mood, as this therapeutic application was discovered by chance. SSRIs are a family of six different drugs that have better tolerability and adequate efficacy, but are also associated with side effects on sexuality and gastrointestinal activity (as these are two functions regulated by the neurotransmitter they affect).
Thus, the use of psychotropic drugs is an option that the patient should evaluate together with the doctorThe use of psychotropic drugs is therefore an option that the patient must evaluate with the physician, taking into account the severity of the symptoms suffered and the potential side effects of the compound. A balance in which the search for equilibrium prevails, and in which the use of psychotherapy should perhaps be prioritized in those cases in which it is possible. However, whatever the choice, psychological treatment should be present (at least as a combined treatment).
How can psychological treatment help to combat depression?
Psychotherapy should be the priority in cases of mild or moderate depression, and its use should also be considered in more severe cases in a harmonious combination with the use of psychotropic medication that the person may require. Ultimately, there is always a percentage of patients who do not respond substantially to one or the other treatment strategy, so that opting for the most appropriate treatment strategy may be the best option.Therefore, opting for the use of both approaches at the same time (in severe cases) has proven to be the most effective.
Psychological treatment provides the person with a series of tools for lifeThe purpose of psychological treatment is diverse (depending on the needs detected): to better understand depression and its causes, to restructure distorted thoughts that may mediate the most difficult emotions, to learn problem-solving strategies, to incorporate pleasant activities into daily life, to enhance the use of social resources, to facilitate the expression of discomfort, and so on and so forth.
The main advantage of psychological treatment over the use of psychotropic drugs is that, being at least as effective in cases where its application is recommended, it reduces in a much more evident way the tendency to relapse (which is very frequent in this pathology). It does, however, entail a series of significant lessons learned that are incorporated into the pool of strategies already available to the person, and which enable him or her to deal with future stress and adversity.
Nevertheless, psychological treatments require an active effort to get better, something that must occasionally be encouraged before and during the intervention.This should occasionally be stimulated before and during the intervention, as there are many patients whose state of physical and emotional despondency hinders this willingness. It is also necessary to put into practice a series of tasks outside the consultation itself and to be patient with regard to improvement (which may come somewhat later than with SSRIs, which require two to three weeks for this).
Perhaps the very fact that the benefit of psychotherapy is not immediate, together with the need to articulate a sustained effort for self-care, has motivated the extensive use of antidepressants in our society and the limited availability of other strategies in the health system. In order to enter into the process implicit in a psychological treatment (which usually lasts 20 sessions per week), we must equip ourselves with the necessary motivation, which must also be stimulated by the therapist.
Beyond the psychological and pharmacological treatment itself, there are also some recommendations based on healthy lifestyleswhich have proven to be effective in improving mood in a simple way. Here are some of them.
What else can I do to improve my mood?
The scientific literature has found evidence of a number of habits that can be helpful for those who are depressed.
Some studies have shown that engaging in prosocial activities, such as volunteering for worthy causes, can substantially improve mood. Spending time with those around us with whom we have a constructive bond can also be helpful, as it would allow us to express our emotions and to be listened to attentively and sympathetically. It would allow us to express the emotions that we harbor and to be the object of an attentive and sympathetic listening..
In case our emotional symptoms are due to the fact that some relevant purpose of our life is not developing in the way we think it would, it may be useful to reinterpret objectives to turn them into a succession of small steps more easily achievable, keeping the ultimate goal after the corresponding achievement of the preceding links. By doing so, small reinforcements are small reinforcements are introduced that maintain behavior and motivation toward the goal..
The practice of physical exercise, especially aerobic exercise (since there is still insufficient data on anaerobic exercise), has also been shown to be a potent natural antidepressant, as have walks in the sunlight, which stimulate the production of melatonin from the pineal gland (a hormone widely found in the animal kingdom), helping to reduce the insomnia that often coexists with depression.
In conclusion, depression does not imply deficiencies in any aspect of character or way of being, as all people are susceptible to it at some point in their lives. In case you consider that your symptoms are compatible with it, do not hesitate to ask a professional, do not hesitate to ask a health professional to assess what would be the most advisable therapeutic option. (pues esta siempre está sujeta a un análisis en profundidad de la persona, la intensidad de sus síntomas, sus necesidades y sus circunstancias).
- Cipriani, A., Furukawa, T., Salanti, G., Chaimani, A., Atkinson, L. y Ogawa, Y. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. The Lancet, 391, 1357-1366.
- Morley, J.E. (2017). The Effectiveness and Harms of Antidepressants. Journal of the American Medical Directors Association, 18(4), 279-281.
(Updated at Mar 28 / 2023)