Rice 1

Taylor Rice

Professor Lisa Tyler

ENG 1201-506

28 March 2021

What is the best treatment for depression?

Depression has taken over a great amount of people's lives all around the world.

About 17.3 million people living in the US will be diagnosed with major depressive

disorder every year (DBSA). Out of all of the many different treatments created for

depression, which ones are the most effective? This mental strain is harsh and tough to

overcome. Depression is the cause of almost 70% of suicides in America every year

(DBSA). Depression is a battle that many people face at least once in their lives and

although there is no proven cure, there are treatment options that help ease the effects

of depression. Cognitive-behavioral therapy is the best treatment for most people with

depression because it is safe for all ages, the patients don’t have to worry about the

harms of pills, and it has one of the best success rates.

The history of depression is full of trial and error. In an article named “The History

of Depression”, it describes the timeline of depression. The first documented signs of

depression were found in B.C.E. Ever since this discovery, there have been many

different ideas of causes and treatments for depression. The first thought was that

depression was caused by demons and needed to be treated by priests. As time went

by, the treatments got progressively more violent. Bloodletting, abuse, no food,
 Rice 2

exorcisms, and insane asylums were all treatments used on patients. Some were even

tracked and murdered for their depression when witchcraft was big. But through all of

this violence, some doctors started to believe that depression wasn’t just some magic

that needed to be killed. More research was done and doctors finally started to form

techniques that people use to treat depression today. Different forms of therapy came

into play including cognitive-behavioral therapy towards the 1900’s. In the 1950’s,

antidepressant medications began to emerge.

There are many different treatment ideas to research and consider when finding

the best treatment option for depression. Out of all treatments, escitalopram and

psychotherapy are the most commonly used, but there are other forms of treatment that

help depression to consider like vitamin D.

Vitamin D was also brought into consideration in hopes that the vitamins would

boost the patient’s mood, therefore, helping their depression. In an essay written on

vitamin D, it lists many different studies performed on the relation of vitamin D and

depression. Many people all over the world lack proper intake of vitamin D. Research

shows that nutritional deficiencies have been related to certain mental illnesses

including depression. Many tests have been performed, where different groups received

vitamins or placeboes. Results varied, but one idea has come from these tests. The

categories of people that are at the most risk of having a vitamin deficiency are also the

categories said to be the most at risk for depression (Penckofer 2011). So even if

vitamin D doesn’t cure depression, the two categories seem to be related to one

another.
 Rice 3

A piece on Depression and its effects on daily life goes into detail about what

antidepressants do. Antidepressants work by leveling certain neurotransmitters in your

brain. This makes patients show improved depression symptoms (Greenlaw 2010). This

treatment option can be very effective, but has its downsides. Many people with

depression discontinue taking their antidepressants given the many possible side

effects, cost, and believing that antidepressants aren’t needed anymore. In a study, the

results show that around 42% of people with depression stop taking their medication

before 30 days. It is around 52% of people with depression that stop their medications

before 60 days (Penckofer 2011). Patients that take the course of treatments correctly

still might not see results. Antidepressant effectiveness has a good chance of

deteriorating over the course treatment. Patients that have had multiple occurrences

with this illness can have a relapse rate of up to 80%. This means that the

antidepressant medications stop working over time (Penckofer 2011). It is common for

patients to stop their medications when faced with so many possible setbacks listed in

previous sentences.

On the Healthline website, there was an article named “Interpersonal Therapy”

which showed the viewers what this type of therapy is like. Interpersonal therapy works

by helping to improve the patients relationships and social interactions. This therapy

wants patients to build their relationships and face the troubles that are causing their

depression. The therapy starts with a discussion to figure out the best course of action

for the patient. Meetings are an hour long and usually goes for about 20 meetings.

Depression has a chance of messing up your relationships. Interpersonal therapy works

to stop this from happening.

 Rice 4

An article titled “Interpersonal Psychotherapy: Principles and Applications” further

explains what interpersonal therapy is. The therapist interacts with the patient to make

them feel heard and then encourages change. Interpersonal therapy supports the

patient in solving their personal struggles with an experience or person. During this

therapy, the therapists ensure that the illness is not any of their doing and that emotions

and life outcomes go hand and hand. Many people gain depression when their

interpersonal world adjusts for the worse. Interpersonal therapy works to rebuild that

adjustment.

The treatment process is about 12 to 16 weeks long. This period of time is

separated into three steps beginning, middle, and end. The beginning works to address

the problem of depression and reinstate the two main concepts of interpersonal therapy.

The middle works to find the main problem of the patient and make a course of action to

solve this problem. And the last part works towards helping the patient feel ready to

continue the exercises on their own (Greene 2020).

So what is Cognitive-behavioral therapy and how does it work? In an article titled

“Treatment and Management”, Cognitive-behavioral therapy is said to work by rewiring

the brain and changing the habits of bad thinking. Many people with depression see

themselves, their life, and their future as useless and a lost cause. Many people with

depression think low of themselves, so Cognitive-behavioral therapy works to find and

change those thoughts.

To add to the previous information, a piece on different depression treatments

further explains how cognitive-behavioral therapy works. He explains that people with

depression often think low of themselves or their circumstances. This way of thinking
 Rice 5

can take over the mind to create a continuous cycle of negative thoughts.

Cognitive-behavioral therapy works to stop this cycle and bring positivity into play which

boosts the patient's mood. It locates the problems and habits and works to fix them. It is

a unique form of psychotherapy because it tackles negative mental and physical habits

(DeRubeis 2009).

There are normally six stages in this treatment. First, identifying the problems to

make an appropriate outline Second, help the patient think of ways to fix these

problems. Third, putting these new, healthy ways of thinking into action. Fourth, making

sure the patient knows how valuable this therapy is by creating a foundation. Fifth,

ensuring that the patient is and will stay on course. Sixth, continuous check ins to make

sure the patient is doing well without the therapy treatment (Behera 2014).
 Rice 6

These bubbles of thought show someone with depression receiving negative feedback and how they feel,

what they think, and how they react. This is just one example of what depression patients go through.

The mental strain of depression has affected people of all age groups. This is

why it is so important that depression treatments reach patients of all ages.

Interpersonal therapy doesn’t necessarily have age restrictions, but it is only effective on

patients with specific circumstances (Holland 2021). In an article written on Lexapro, it is

said that antidepressants like escitalopram (Lexapro) have an age restriction of 12

years or older. Although this meets most ages, the side effects of the medication can be

dangerous for people of any age. Patients on medications like escitalopram need to be

monitored in case of extreme side effects. Cognitive-behavioral therapy however,

doesn’t have an age restriction and works on most patients with depression. It is proven

to be useful for all ages (Greene 2020). An essay on the elderly with depression helped

explain the process of Cognitive-behavioral therapy in elderly. This form of therapy has

been proven to be a favorite for most almost all ages. It has been proven to be a better

treatment for older adults as well as having long lasting results. But

Cognitive-behavioral therapy doesn’t just help with depression in older adults, it also

can help anxiety and insomnia. Researchers have developed a way to transform

Cognitive-behavioral therapy to work for the elderly. The therapist must shift their point

of view to the elders point of view and the period of time they grew up in (Suma 2013).

When finding a good treatment, patients usually avoid treatments with too many

side effects. This is another factor that puts therapy above medications in the race of

the best treatment. Antidepressant medications, like mentioned before, have many bad

side effects. Some of these side effects can even be dangerous, especially with younger
 Rice 7

children. The common side effects aren’t life threatening, but they do cause

inconvenience and can be dangerous. There are severe side effects that result in

dangerous and possibly life threatening actions (Smith 2020).

When taking antidepressants like Lexapro, the pills come with a long list of side

effects. Some of which can be life threatening. Children from the age 7-11 can take this

medication, but it is not recommended by doctors. This is because the possible side

effects are much more likely to occur. Children may experience throwing up or feeling

like throwing up, stomach pains and diarrhea, and many more. There are chances that

children and young adults taking Lexapro will have suicidal thoughts. Adults may have

problems with your head, sleep, strength, eating, and much more. Other possible

serious side effects to consider are serotonin syndrome, abnormal bleeding, severe

allergies, and more. Cognitive-behavioral therapy and Interpersonal therapy however,

has no direct side effects. This makes it safer to use psychotherapy than Lexapro and

other antidepressant medications.

Success rates are extremely important when choosing the best treatment for

depression. The treatment isn’t “the best'' if it doesn’t work well. In a report titled

“Efficacy of Vitamin D in the Treatment of Depression: A Systematic Review and

Meta-analysis”, the writer describes a test performed on the effectiveness of Vitamin D

for depression. After many tests were done, the results that came back were pretty

insignificant. Vitamin D didn’t show any significant help or benefits to improving patients'

depression, therefore, making it an invalid treatment.

In an interview with Peter Jaret called “Do Antidepressants Work?”, he proved

that antidepressants are not much better than placebo pills. After research was
 Rice 8

performed, antidepressants and placebo pills had similar results in helping with

depression. Jaret said that placebos and antidepressants are around 80% effective. So,

antidepressants do help depression, but they aren’t much more effective than thinking

you’re getting better.

The results from a test to see how effective antidepressants are to placebos. The results are surprisingly

similar.

Like said before, Interpersonal therapy is effective, but is only useful for a select

group of patients and isn’t guaranteed to work. Interpersonal therapy helps with

relationships and past events, but Cognitive-behavioral therapy helps the patients with

overall thoughts. It can tackle more obstacles than just a select thought. A study on

Interpersonal and Cognitive therapy performed a test to see which psychotherapy is the

most effective. A large group of adults with depression were separated into sections

with the treatment plan for Interpersonal and Cognitive therapy. They had tests run for
 Rice 9

each member in both sections over about a year of time. The results came back to

show similar outcomes. Both psychotherapies have similar effectiveness, the outcome

is mostly dependent on the circumstances of the patient (Lemmens 2020).

The results from a test seeing whether interpersonal or cognitive therapy is more effective.

Cognitive-behavioral therapy seems to be the most effective throughout the tests, although the results are

very similar.

The tests throughout the essay show that medication and Cognitive-behavioral

therapy have very similar results of success. So the decision of the best treatment is

mostly based on other factors like it’s effectiveness on every age and the side effects it

gives.
 Rice 10

The results from a study on the effectiveness of different depression treatments. Antidepressants and

Cognitive therapy show similar results.

Cognitive-behavioral therapy is a great treatment option for depression, but it

does have downsides. This type of therapy requires your devotion. If patients don’t

actively try to improve themselves, it won't work well. This can be said for all treatment

options, but Cognitive-behavioral therapy needs more work. This can be a struggle, but

patients can ask their therapists for help as well as any peers they know.

Some might argue by saying that cognitive-behavioral therapy has similar

success rates compared to every other treatment option. This is true, but this treatment

option, compared to all other options, has the most benefits for the most amount of

patients. It can reach a wide variety of ages, it has no direct side effects, it helps with

overall mood and way of thinking, it is set with social interaction (people are there to

help you get better and hold you accountable to some extent), and many more benefits.
 Rice 11

After reviewing the previous information, escitalopram, interpersonal therapy, and

cognitive-behavioral therapy are proven to be the best treatment options for many

people with depression. These treatments have very similar levels of effectiveness, but

medication didn’t reach as many people as Cognitive-behavioral therapy did. Not to

mention, antidepressant medication has many possible dangerous side effects on

patients. Given that Cognitive-behavioral therapy reaches all ages, doesn’t have any

direct side effects, and is one of the most effective treatments, it is the best treatment for

most patients with depression.

 Rice 12

Work Cited*

Behera, Sareeta. “Cognitive Behavior Therapy: Introduction, Methodology, and Benefits

of CBT” Online-Therapy.com, 9 Janruary 2014,

https://www.online-therapy.com/blog/cognitive-behavior-therapy-introduction-met

hodology-benefits-cbt/, ACS 11 April 2021.

Chand, Suma, et al. “How to Adapt Cognitive-Behavioral Therapy for Older Adults”

Current Psychiatry, March 2013,

https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/1203CP_C

hand.pdf, ACS 11 April 2021.

“Depression Statistics” Depression and Bipolar Support Alliance,

https://www.dbsalliance.org/education/depression/statistics/, ACS 11 April

DeRubeis, Robert, et al. “Cognitive therapy vs. medications for depression: Treatment

outcomes and neural mechanisms” NCBI, 1 October 2009,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748674/ , ACS 11 April 2021.

Greene, Paul. “Treatment and Management” ADAA, October 2020,

https://adaa.org/understanding-anxiety/depression/treatment-management, ACS

11 April 2021.
 Rice 13

Greenlaw, Ellen. “How your Depression Medicine can Affect your Life” WebMD, 9 July

2010, https://www.webmd.com/depression/features/antidepressant-effects, ACS

11 April 2021.

Holland, Kimberly. “Interpersonal Therapy” Healthline, 4 February 2021,

https://www.healthline.com/health/depression/interpersonal-therapy, ACS 11 April

2021.

Jaret, Peter. “Do Antidepressants work?” AARP, 7 May 2010,

https://www.aarp.org/health/drugs-supplements/info-05-2010/do_antidepressants

work.htm, ACS 11 April 2021.

Lemmens, Lotte, et al. “Interpersonal Psychotherapy Versus Cognitive Therapy for

Depression: How They Work, How Long, and for Whom—Key Findings From an

RCT” The American Journal of Psychotherapy, 3 Match 2020,

https://psychotherapy.psychiatryonline.org/doi/10.1176/appi.psychotherapy.20190

030, ACS 11 April 2021.

Markowitz, John. “Interpersonal Psychotherapy: Principles and Applications” World

Psychiatry, October 2004,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414693/, ACS 11 April 2021.

Penckofer, Sue. “Vitamin D and Depression: Where is all the Sunshine” US National
 Rice 14

Library of Medicine National Institutes of Health, 1 June 2011,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908269/, ACS 11 April 2021.

Rutherford, Bret, et al. “A Model of Placebo Response in Antidepressant Clinical Trials”

The American Journal of Psychiatry, 1 July 2013,

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2012.12040474, ACS 11

April 2021.

Schimelpfening, Nancy. “The History of Depression” Verywell Mind, 25 February 2020,

https://www.verywellmind.com/who-discovered-depression-1066770, ACS 11

April 2021.

Smith, Anna. “What Side Effects can Lexapro Cause?” Medical News Today, 5 October

2020,

https://www.medicalnewstoday.com/articles/lexapro-side-effects#boxed-warning,

ACS 11 April 2021.

Tome, Ana Larazo, et al. “Efficacy of vitamin D in the treatment of depression: a

systematic review and meta-analysis” MedicLatina, vol. 49, no. 1, pp. 12-23.