A Special Caution: Many physicians prescribe antidepressants, especially Prozac,
without recommending psychotherapy.
It is becoming common to prescribe Prozac (over 1 million
prescriptions per month, mostly by non-psychiatrists). Because of the
hype and few side effects, Prozac is considered a miracle cure for
many things: eating disorders, obsessions, compulsions, shyness,
unassertiveness, poor thinking, low productivity, weak personality, low
zest, lack of confidence, lack of poise, etc. None of these "treatments"
have been proven. Be careful when you take drugs. Prozac may be
helpful with depression but its help with these other problems is
The effects of Prozac are enhanced by its popularity, i.e. a powerful
placebo effect. In addition, Prozac seems to act as a stimulant,
something like a mild amphetamine of the 1960's. These two factors
lead many depressed patients to be convinced that their Prozac
prescriptions are very beneficial, say the Breggins (1994). However,
when drugs become a well advertised fad (like Valium a decade ago
and Prozac recently), we "medicalize" our problems, i.e., we see our
feelings as caused by uncontrollable biochemical factors permitting us
to deny our history, our conflicts, losses, and stresses, and our morals
or personal failings. Feeling better becomes the doctor's responsibility;
we don't have to try to help ourselves.
Don't overlook the effectiveness of psychological treatment.
Several extensive investigations conclude that psychological
treatment, such as improving social skills, increasing pleasant
activities, and correcting maladaptive negative thoughts, yields better
long-term outcomes than drugs (Antonuccio, Danton, & DeNelsky,
1994). Both cognitive-behavioral and psychodynamic-interpersonal
therapies work with depression (Gallagher-Thompson & Steffen, 1994;
Shapiro, et al., 1994). So, don't think that psychology is just a cheap,
second-rate source of help for depression; objective research says
psychotherapy is the best treatment you can find but, like drugs,
psychotherapy doesn't work for everybody.
Psychological methods aren't just for reducing depression; there is
evidence that psychoeducational sessions can prevent depression.
Gillham, Reivich, Jaycox & Seligman (1995) gave 5th and 6th graders
12 sessions covering some of the cognitive and social problem-solving
skills mentioned above. Among those getting training, only about half
as many (compared to an untreated control group) got depressed
during a two year follow-up.
Don't forget there are many sources of self-help with
depression, especially books. Some are excellent, especially both of