Depression treatment: Drugs or psychotherapy?

Depression treatment: Drugs or psychotherapy?

Colloquially depression is understood as a state of sadness, negative thoughts, lack of desire, motivation and interest in the activities of daily life, stably in a considerable period of time.

The diagnostic systems in Psychology and Psychiatry more common, like the DSM-V or ICD-10 They use similar criteria to conclude if a person is going through a depression. There are a number of symptoms associated with it, and depending on how many the person meets, how often and intensity, it is concluded that the person has depression or not.


  • 1 Examples of depressive symptoms
  • 2 Biomedical model of depression
  • 3 Contextual Vision of depression

Examples of depressive symptoms

  • Feelings of hopelessness and emptiness, desire to cry.
  • Tendency to anger and feeling easily irritable
  • Loss of interest in things and difficulty in enjoying them
  • Tiredness and lack of energy
  • Cognitive slowness and difficulty concentrating
  • Tendency to compare with other, apparently better people

It is important to keep in mind that all these symptoms, diagnostic criteria, are thoughts, emotions, physical sensations and behaviors that virtually all people, at one time or another can experience, and enter fully within normality.

However, we observe how these thoughts, emotions ... "normal", can become problematized and pathologize the person who has them. The underlying assumption is that if you are having this kind of internal sensations, there is something that is failing. And certainly, it is very likely that something will fail. The question is where to look.

Biomedical Model of Depression

If a child spends much of his free time sitting on television and eating candy, goodies, pastries ... We will probably observe how there are chemical and physiological variations in his body; High sugar, etc. Imagine that there comes a day when the child warns that he is wrong. If the child is analyzed at this physiological level, we could conclude that he is ill due to irregularities in the body that cause it to contain large amounts of sugar, which are giving rise to problematic alterations and hence the discomfort. If one considers that the origin is there, in a failure of the organism, instead of in the child's habits, it seems unlikely that a positive and lasting solution will be found.

The predominant biomedical model in psychiatry and some psychological schools puts the focus in a similar way. Suppose there must be something in the brain that is failing, and as a consequence the person thinks, feels, acts depressively. And certainly, if the appropriate analyzes are made, deficits or excesses of certain neurotransmitters, compared to the population average.

But is that really the cause of depression? The problem of the child, is his excess sugar in the body, or the habits he has in his spare time of uncontrolled intake of sweets?

Returning to depression, medication can help correct those neurological differences, but are they going to get the person to change that lifestyle, that "eating sugar" that is behind in the form of different unhealthy behavior patterns?

Contextual Vision of Depression

From the Contextual Psychology, among other currents, it would be convenient to emphasize what is happening in the person's life: In the child, it would be to see what leads him to eat sweets in this way, and promote healthy changes. In that of a person with depressive patterns, what is leading him to act this way in a stable manner over time. What is this discomfort made of, and how does the person relate With the thoughts and emotions he doesn't like.

At the same time, what does this person expect from life? How would you like it to be, and how is it? What dreams did he have? How long have you not walked in that direction?

We usually find that people who act (do not have or are) in a depressive way, feel that certain thoughts, emotions, sensations ... they are caught, and they are insurmountable barriers to go towards that desired direction. So they consider that the first and most important thing at this moment is to fight and overcome these symptoms, make them disappear. However, it often turns out that to overcome this battle, people feel that they are increasingly sunk and trapped by all these symptoms.

Medication can alleviate that suffering, but what about that life, those projects, in stand-by? Consider the person as "sick" that requires psychoactive drugsDoes it empower her? Does it make it easier for you to get to work in the life you want? Isn't that, after all, making the child continue with these harmful habits, now more bearable and painless?

Concluding ...

The role of medication in depression can be summed up as a "numbness" of the nervous system, which prevents psychological pain from going through painful circumstances. But this same "numbness" can also hinder a person's ability to enjoy those things that could provide positive experiences.

Its use can be useful to reduce the discomfort of the moment, but to achieve stable and lasting changes it will be necessary for the person to take advantage of this “push” that the drugs provide to initiate changes in their life, something in which the psychotherapy It plays an essential role.