Medication or therapy for depression? Or both?

No single treatment—whether it's an antidepressant drug or a style of talk therapy—can ease depression in every case. However, research suggests you will improve your chances of getting relief if you combine drugs and therapy. One report that pooled findings from 25 studies found that adding psychotherapy to drug treatment was more helpful than medication alone in treating major depression. Earlier research suggested that one reason therapy and medication may complement each other is that they have different effects on the brain.

In addition to relieving depression, combination therapy may help ward off recurrences. A classic three-year study reported in JAMA tracked recurrences of major depression in about 200 people ages 60 or older. Of those who received monthly interpersonal therapy and who also took an antidepressant medication, 80% avoided a recurrence. In contrast, the same could be said for only 57% of those who received the drug alone, 36% of those given just interpersonal therapy, and a mere 10% in the placebo group.

If your symptoms are mild or moderate, it is often reasonable to start with either medication or psycho-therapy. If your depression is mild, there is an excellent chance that you will respond well to psychotherapy alone. Generally, as symptoms become more severe, it is more important to consider medication earlier in your treatment.

Of course, consider all your options carefully, and discuss them with the professionals you are consult-ing. If one type of treatment alone isn't helping you— and especially if your depression is getting worse— don't hesitate to do both, medication and psychotherapy.

For more on diagnosing and finding the right treatment for depression, read Understanding Depression, a Special Health Report from Harvard Medical School.

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