Depression has become so ubiquitous that debate rages as to whether
medication or psychotherapy is the superior solution. One study to
compare the two yields some surprising results: The question shouldn't be
which treatment is better, but how two wildly different approaches can
yield such a uniformly beneficial outcome.
Arthur Brody, M.D., assistant professor of psychiatry at the
University of California at Los Angeles, used positron emission
tomography (PET) scans to monitor changes in the brain activity of
patients who had either taken the antidepressant Paxil or engaged in
interpersonal talk therapy with a psychologist for 12 weeks.
Both groups experienced a similar lift in spirits. But PET scans
revealed stark contrasts in their brain functioning. The talk therapy
contingent displayed high activity in the anterior insula, a region
associated with language and sensory integration, while the drug therapy
group showed low activity in the middle frontal gyrus, which facilitates
higher order abilities like reasoning. "Depression has many aspects and
the two treatments together cover more of the symptoms," Brody believes.
Psychotherapy seems to ease physical symptoms, like lack of appetite,
while antidepressants alleviate psychosocial problems like suicidal
thoughts. "Medication is easier and cheaper than psychotherapy," notes
Brody. "But for patients with the time and money, I think the combination
of drugs and psychotherapy works best."
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