Treating depression one step at a time

(Medical Xpress) -- One in six people worldwide will experience depression over the course of a lifetime. This alarming fact has led to recent research by Dr. Paul Biegler from the Center for Human Bioethics at Monash University. Dr. Biegler argues that the under use of psychotherapy, and the over-prescription of antidepressants, is cause for serious ethical concern.

Most people seeking relief for through the healthcare system will receive . In the United States alone, nearly 170 million prescriptions for antidepressants were written in 2005, resulting in more than $12 billion in sales.

In his new book, "The Ethical Treatment of Depression," Dr. Biegler takes aim at the fact that antidepressants can lift mood independent of a person’s understanding of symptoms or stressors. Yet, he points out, nearly 70 per cent of depressive episodes are triggered directly by stressful life events. Moreover, depressed mood causes biased information processing that leads to unrealistic pessimism.

“Despite the dominance of antidepressants in the marketplace and the consulting room, another treatment for depression has proven equally effective – psychotherapy, in particular, cognitive behavior therapy (CBT). CBT teaches patients skills for dealing with distressing feelings, negative thoughts, and causal stressors, and in so doing promotes personal ,” said Dr Biegler.

Dr. Biegler’s research shows that depression is a disorder in which autonomy is routinely and extensively undermined. He argues that physicians have a moral obligation to promote the autonomy of depressed patients.

“The insights that patients gain from the therapeutic process promote autonomy and so medical practitioners have an ethical imperative to prescribe psychotherapy – CBT in particular – for depression,” said Dr. Biegler.

“Doctors who treat depressed people with medication alone, and make no attempt to explore the causes, or tackle them through evidence-based , engage in unethical practice.

More information: The Ethical Treatment of Depression: Autonomy through Psychotherapy by Dr Paul Biegler is published by The MIT Press.

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Jul 06, 2011
I truly belief that antidepressants are not the answer to severe depression. I believe that the science community has not explored the benefits of a healthy lifestyle, in particular exercise, in relation to depression. And before anyone says that exercise just isn't for everyone, I am clinically obese (if you believe the stupid BMI ) and I run 16km a week, dance for 3 hours a week and gym up to 3 hours a week. I don't want to come across as some kind of "alternative" nut, but when I exercise my ability to cope with stress and depression increases exponentially. I also believe that fresh air is vital in the treatment of depression, cities are the worst place to be for your physical, mental and emotional health.

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