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| In May 2000, The New England Journal of Medicine published the results of a study underscoring the importance of combining psychotropic medication with psychotherapy. In this study, 681 adults with chronic major depressive disorder were randomly divided into 3 groups and treated for 12 weeks with either (a) medication (b) psychotherapy or (c) both. Among the 519 subjects who completed the study, the rates of positive outcome (remission or satisfactory response) were 55% in the medicated group, 52% in the psychotherapy group, and 73% in the combined treatment group. These impressive statistics indicate that a combination of medication and psychotherapy is far more effective than medication alone in treating chronic major depressive disorder (N Engl J Med 2000;342:1462-70.). Although medications promise rapid relief and provide a "floor," preventing what can feel like a frightening emotional free-fall for distressed individuals, psychotropic drugs can only relieve symptoms. The self is unchanged, and the underlying conditions and psychological processes that led to the emotional distress are still part of the personality structure. If it were simply a matter of correcting chemical imbalances, we would expect the results of the May 2000 study to show no significant difference between Group A (the group receiving medication only) and Group C (the group receiving both medication and psychotherapy). Instead, the addition of psychotherapy produced significantly better results. The current stream of scientific research goes even further than the results published in the New England Journal of Medicine. We now know that the human brain contains mechanisms that allow our neuronal connections to shift and change. This "rewirability," basic to all learning - including learning in psychotherapy - allows us to unlearn maladaptive thought/behavior patterns and develop new associations and connections that lead to emotional well-being, ultimately eliminating the need for medication. If you are currently on anti-depressant or anti-anxiety medication, you might want to reflect on your characteristic defenses: withdrawal and isolation, persistent irritability, helplessness (feeling victimized by life), hopelessness (resignation), intellectualization (philosophizing to avoid feelings), rationalization, avoidance, denial, procrastination, or projection - to name a few. These defenses, most of which operate out of conscious awareness, become the problem. They create a wall around our ingrained maladaptive patterns and so prevent in-depth examination and resolution. Without a psychotherapist's challenge to the wall of defense and resistance, one may be left with debilitating anxiety or depression that is only masked - not resolved - by medication. |
| To learn more about Dr. Shulman and her practice, click "Bio" below |
| Anxiety/Depression Managing Anger Medication? For Lawyers Bio Sessions Contact Home |
| Los Angeles psychotherapist, Diana W. Shulman, J.D., Ph.D. |