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Depression, ADHD, Psychotherapy and Medication

Allan Schwartz, LCSW, Ph.D.

Depression, ADHD, Psychotherapy and MedicationDepression, ADHD, Psychotherapy and Medication

It is a fact that I receive E. Mail questions from people around the world about issues of mental health and mental illness. Some of them are from students who are working on various types of research papers that are related to psychology, social work and social psychology.

I recently received an interesting question from a forty year old man from the UK who stated the he is suffering from depression. He wanted to know what types of medication would help him feel better. He asserted that he had neither the time nor the money to invest in psychotherapy. Besides, he stated, he has a chemical imbalance in his brain and  knows that medication will solve his problem. He also happened to state that he has suffered from many stresses over the years.

I thought it curious that a man of his age and from the UK would still believe that medication can cure psychological problems.

I answered his E. Mail by telling him that he would have to consult a psychiatrist who would do an evaluation and, based on the diagnosis from the evaluation, prescribe the necessary medicine treatment. I also pointed out that he could start by seeing his family doctor with whom he could discuss his symptoms and get a prescription for the same purpose.

However, I was quick to point out, very emphatically, that there is no cure in medication. Citing recent research, I reported that it is the combination of medication and psychotherapy that works best. In addition, I underlined the fact that, for many people, cognitive behavioral therapy can produce the same or better results than medication alone...I never heard back and, that's OK, I rarely do.

Another person wrote to me stating that they know they have ADD. They wanted to know what type of medical doctor they should see for this condition. This person added that they did not want psychotherapy as they are "hard wired" for this problem and that only medication would work.

In this case of ADD I also encouraged the person to be evaluated by a psychologist in order to get a correct diagnosis followed by a recommendation for treatment. I repeated, in this case, as the last, that medication is not the only way to go. The individual thanked me but said they did not have the money for therapy, only for medication.

Discussion:

I believe that we, in the Western World rely heavily upon medications to cure all of our problems. I am convinced that this is particularly true, here, in the United States, where we both demand and expect instant solutions to all problems. Of course, this is unrealistic.

We know that the treatment of depression with psychotherapy helps relieve depression. Cognitive Behavioral Psychotherapy seems to work most rapidly. However, psychodynamic and psychoanalytic therapies, that take much longer, also work quite well in helping people to recover terrible feelings of being emotionally down and upset."

With regard to ADD, whether with children or adults, the proper therapy teaches the behaviors necessary to compensate for the problems created by the disorder. Many times, the correct training works as well or better than medication alone.

It is true that years of stress, combined with certain genetic vulnerabilities, can result alterations in the brain that affect the chemical balances of the neurotransmitters, resulting in feelings of hopelessness.

At the very same time, our brains are incredible machines, plastic and flexible in nature, and that means that the brain can recover from or repair lots of things that can go wrong. Our ability to learn throughout our lives is what helps the brain learn to correct chemical imbalances and repair all types of mood disorders. This is also the reason why children and adults can learn to compensate for the deficits created by ADHD.

"Where there is a will there is a way:"

I am very sympathetic to the pressures that the world wide economic crisis has placed on people around the globe. There are more people now, in the United States, the UK and elsewhere, who lost their jobs or are earning far less than before. Yet, doesn't health come first? How can a person function to find a new job, keep up with the old job, maintain family and social relationships if they feel too depressed to get out of bed?

Money spent on mental health is an excellent investment that a person makes for the well being of their mind and body. This means that, in terms of dealing with depression, anxiety or any other psychological conditions, treatment needs to be obtained and followed through.

In fact, we now know, more than ever, that mental health translates into physical health because there is no distinction between mind and body.

Remember, we are more than just chemical balances and imbalances. As the Gestalt psychologists said long ago, "The whole is greater than the sum of its parts."

If you are depressed, anxious or troubled in any way, seek help.

Your comments and questions are welcome and encouraged.

Allan N. Schwartz, PhD