Medications vs Therapy – which should I go for if I am depressed?

Medications vs Therapy – which should I go for if I am depressed?

In this short Q&A series, we address commonly asked questions about depression treatment, discuss the effectiveness of medications vs therapy for depression, and explore what other treatment options may be helpful.

Q1: Is medication or psychological therapy better?

Medications and therapy are both important in recovery. While medication serve to restore chemical balance in the brain and promote rapid improvement, therapy aims to build lifelong skills and literally re-wire the brain to create more positive thinking and behavioural patterns.
For mild depression, medications and therapy have been found to be equally effective. But if your depression is more severe, medications are recommended first. In fact, medications help relieve the depressive symptoms to promote a state of mind which is more receptive to psychological therapy. When combined, medications and therapy work together synergistically to optimise recovery.

Q2: How long do we have to take medication for depression?

For a first episode of depression, we recommend taking medication for at least 6 months after symptoms improve significantly. This is because medications also play an important role in preventing the symptoms from recurring. As a general rule, the longer the duration of “maintenance” medications, the less likely a second episode will occur in the future.
For recurrent episodes of depression, your doctor may advise you to be on medications for a duration of 2 to 3 years. If the episodes are very severe and medications are found to be helpful, an even longer duration of medications will be recommended to prevent a “relapse”.
Because medications are generally very safe with minimal side effects, most patients are able to complete the full course of treatment.

Q3: What is psychological therapy, and how does it work?

Psychological therapy is also known as “talk therapy”. It aims to help clients build important life skills to regulate their thoughts, emotions and behaviour. Some forms of therapy focus on the “here and now” and are more practical and solutions-focused. Other forms of therapy invite the client to delve into past life events, and explore how past events may have shaped a person’s personality and coping style, which may contribute to current life difficulties.
Psychological therapy is not all talk and no action. Clients have to apply the skills they learnt, and may be assigned tasks in between sessions. This may involve modifying unhelpful behaviours or adopting new behaviours.
Some forms of therapy focus on specific issues such as grief, trauma, or end-of-life issues. In Music and Art therapy, the therapists use music and art as mediums to promote greater understanding, discovery and awareness of oneself and to facilitate psychological recovery.
Therapy is a scientifically proven way to treat psychological conditions and has been found to rewire the brain on a microscopic, cellular level. It is akin to upgrading the “software” (brain cells and neural circuits) within the “hardware” (our brains and body). Each therapy session is 1 hour, usually on a weekly or monthly basis. We recommend 6 to 12 sessions of therapy for full benefit.

Q4: If a patient does not wish to take medications, what other options are there?

Besides medications and psychological therapy, we also treat depression with a combination of lifestyle modifications, dietary supplements, workplace adjustment and family-based interventions.
Physical exercise is a great anti-depressant which is natural, healthy, and free of charge. However, it takes time, effort and discipline to create and stick with an exercise plan. Depression itself can become a barrier to exercise since depressed individuals usually have low energy levels and lack of interest in pleasurable activities.
Therefore, it is best to discuss with your doctor or therapist and tailor a treatment plan according to your symptoms, preferences, life circumstances and goals.
Dr. Tay Kai Hong
Psychiatrist, Medical Doctor
Private Space Medical