Psychotherapy for depression should not be long-term


Q. I’ve been depressed for over a year, and I’ve been thinking about seeing a therapist. I hear therapy takes a really long time, and I don’t I have the time or the money for that. Is there such a thing as short-term therapy?

A. In the past, many psychologists saw patients two or three times a week for several years. More recently, most psychologists meet with patients once a week until the presenting problem is resolved. You would probably profit from seeing someone who practices cognitive-behavior therapy (CBT) which is usually short-term.

In CBT, the therapist examines the negative thinking style (cognitions) that has led to your depression. For example, some of the dysfunctional thoughts I hear are: “I thought I’d be happy once I got married/had children/got a better job.” As CBT therapists, we have patients examine these dysfunctional thoughts and conduct a reality check. We attempt to rid them of the “shoulds, have tos, and musts” that often lead to depression and unhappiness.

As a CBT therapist, we also examine behavior. If you are depressed, we encourage you to be more active, to establish a routine, to interact more with others. We also examine alcohol and drug habits. Some people who are depressed attempt to self-medicate through substance use. These band-aid cures never work in the long term. If we think your depression is serious enough or interfering with your functioning, we usually suggest that you meet with your family physician or a psychiatrist to discuss medication.

Depending on the severity of your problem, the psychotherapy need not be long-term. In fact, most psychologists like to see patients get better and move forward in their lives. Our job is to move you along, not to hold you back.

Q. I told my doctor I was depressed about recent deaths in my family and he suggested a drug called Celexa or Citalopram. My husband called it a happy pill. What is it exactly? I haven’t decided to take it yet.

A. Celexa is referred to as an SSRI (Selective Serotonin Reuptake Inhibitor). It is thought to work by increasing the level of serotonin, a natural neurotransmitter, in the brain that is believed to play a role in regulating mood.

Celexa should not change your personality. It is not a “happy pill,” and you will not feel high from taking it. Hopefully, the medication will help you to deal more effectively and efficiently with life’s stressors such as family deaths.

Since the appearance of Prozac, another SSRI, in 1986, these drugs have helped many individuals overcome depression and anxiety disorders. Celexa is simply a newer SSRI which helps in relieving depression in less time. Prozac can bring relief in 4 to 6 weeks, but according to the American Society of Health-System Pharmacists, Celexa works for most people in 1 to 4 weeks. The SSRI medications have proven to be safe and effective for many individuals.

Before beginning any new medication, you and your physician should discuss the side effects and the interaction you may have with other prescription drugs. Be certain to tell your doctor if you use any recreational drugs or products from health food stores or other sources, and be honest about your alcohol consumption. There are sometimes side effect from Celexa, such as nausea, decreased appetite, and fatigue; however, for most people the side effects subside within a few days. If they continue or you have other difficulties, you should contact your physician.

Talk with your doctor should you decide to discontinue the medication. Sudden withdrawal can create unpleasant side effects, so you must taper off Celexa and most SSRI’s gradually.

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Nancy Ryburn holds a doctorate degree in psychology. She teaches psychology at Southeast Arkansas College and maintains a limited private practice in Pine Bluff. If you have questions pertaining to mental health, e-mail them to drnryburn@gmail.com. The questions will not be answered personally, but could appear in a future column. There will be no identifying information and all e-mails remain confidential.