<p>Your assumption that antidepressants works by "suppressing the thoughts" is not supported. Arguably it's quite the opposite. But let us not comment any further.</p>

<p>Now onto your question</p>

<h2>Do anti depressant provide permanent solution for depression and anxiety?</h2>

<p>At least for Major Depressive Disorder (MDD), they normally do.</p>

<ul>
<li><p>According to a brochure from the Boynton Health Service of the University of Minnesota:</p>

<blockquote>
  <p>Once you respond to an antidepressant, we recommend that you
  continue to take the medication for at least six months. If you stop
  taking the antidepressant before six months have passed there is an
  increased chance that your depression will return. For depressions
  that have lasted a long time (a year or longer), or for a recurrent
  depression, longer periods of treatment should be considered. If you
  wish to discontinue your medication, we recommend that you do this
  during times of decreased demands, such as during breaks or during the
  summer months.</p>
  
  <p>Source: <a href="http://www.mentalhealth.umn.edu/medication/pdfs/antidep_bro.pdf" rel="nofollow noreferrer">"Common Questions About Antidepressants"</a> (2005) - page 2</p>
</blockquote></li>
<li><p>According to an article available from the Massachusetts Institute of Technology healthcare service MIT Medical:</p>

<blockquote>
  <p>Clinicians usually recommend that people continue taking
  antidepressants for about six months after they begin feeling better.
  Although it is tempting to stop taking the medication as soon as you
  feel better, abruptly stopping will greatly increase your risk of
  relapse.</p>
  
  <p>Source: "FAQ: Antidepressants" <a href="https://medical.mit.edu/faqs/antidepressants#faq-7" rel="nofollow noreferrer">question #7: "How long should I continue to take antidepressants?"</a></p>
</blockquote></li>
</ul>

<hr>

<ul>
<li><p>From an article published by the Journal of Clinical Psychiatry, doctor David Louis Dunner has this to say:</p>

<blockquote>
  <p>According to the AHCPR Practice Guidelines(1) for the treatment of
  major depression, acute episodes of depression should be treated for
  almost a year and recurrent episodes should be treated somewhat
  longer.</p>
</blockquote>

<p>However, Dr. John M. Zajecka states:</p>

<blockquote>
  <p>Clinicians should perceive depression as potentially being a lifelong
  illness that may require treatment indefinitely in many patients
  rather than as an illness that can usually be cured with a single,
  short course of treatment like an antibiotic.</p>
</blockquote>

<p>Dr. Michael Edward Thase notes:</p>

<blockquote>
  <p>There is a difference between “forever” and “indefinitely.” In the
  future, treatments that target the altered pathologic mechanisms of
  recurrent depression may be available and may have a more curative
  effect than the present medications, which suppress illness activity.</p>
</blockquote>

<p>While it's debatable whether <em>all</em> "present medications" simply suppress depressive symptoms, consider that this article was published in 2007.</p>

<p>--</p>

<p>Source: "Preventing Recurrent Depression: Long-Term Treatment for Major Depressive Disorder" - PMC <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911177/" rel="nofollow noreferrer">1911177</a>. PMID <a href="https://www.ncbi.nlm.nih.gov/pubmed/17388700" rel="nofollow noreferrer">17388700</a>.</p>

<p>References:</p>

<p>(1) Clinical Practice Guideline. Number 5: Depression in Primary Care, vol 2. Treatment of Major Depression. Rockville, Md: US Dept Health Human Services, Agency for Health Care Policy and Research; 1993. AHCPR Publication 93-0551.</p></li>
</ul>

<hr>

<ul>
<li><p>Last but not least, from Wikipedia:</p>

<blockquote>
  <p>Studies have shown that 80% of those suffering from their first major
  depressive episode will suffer from at least 1 more during their
  life,(1) with a lifetime average of 4 episodes.(2) Other general
  population studies indicate that around half those who have an episode
  recover (whether treated or not) and remain well, while the other half
  will have at least one more, and around 15% of those experience
  chronic recurrence.(3) Studies recruiting from selective inpatient
  sources suggest lower recovery and higher chronicity, while studies of
  mostly outpatients show that nearly all recover, with a median episode
  duration of 11 months. Around 90% of those with severe or psychotic
  depression, most of whom also meet criteria for other mental
  disorders, experience recurrence.(4)(5)</p>
  
  <p>Recurrence is more likely if symptoms have not fully resolved with
  treatment. Current guidelines recommend continuing antidepressants for
  four to six months after remission to prevent relapse. Evidence from
  many randomized controlled trials indicates continuing antidepressant
  medications after recovery can reduce the chance of relapse by 70%
  (41% on placebo vs. 18% on antidepressant). The preventive effect
  probably lasts for at least the first 36 months of use.(6)</p>
  
  <p>Those people experiencing repeated episodes of depression require
  ongoing treatment in order to prevent more severe, long-term
  depression. In some cases, people must take medications for long
  periods of time or for the rest of their lives.(7)</p>
  
  <hr>
  
  <p>References:</p>
  
  <p>(1) Fava GA, Park SK, Sonino N (2006). "Treatment of recurrent
  depression.". Expert Review of Neurotherapeutics. 6 (11): 1735–1740.
  doi:<a href="https://dx.doi.org/10.1586%2F14737175.6.11.1735" rel="nofollow noreferrer">10.1586/14737175.6.11.1735</a>. PMID <a href="https://www.ncbi.nlm.nih.gov/pubmed/17144786" rel="nofollow noreferrer">17144786</a>.</p>
  
  <p>(2) Limosin F, Mekaoui L, Hautecouverture S (2007). "Stratégies
  thérapeutiques prophylactiques dans la dépression unipolaire
  [Prophylactic treatment for recurrent major depression]". La Presse
  Médicale. 36 (11–C2): 1627–1633. doi:<a href="https://dx.doi.org/10.1016%2Fj.lpm.2007.03.032" rel="nofollow noreferrer">10.1016/j.lpm.2007.03.032</a>.
  PMID <a href="https://www.ncbi.nlm.nih.gov/pubmed/17555914" rel="nofollow noreferrer">17555914</a>.</p>
  
  <p>(3) Eaton WW, Shao H, Nestadt G, Lee HB, Lee BH, Bienvenu OJ, Zandi P
  (2008). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761826" rel="nofollow noreferrer">"Population-based study of first onset and chronicity in
  major depressive disorder"</a>. Archives of General Psychiatry. 65
  (5): 513–20. doi:<a href="https://dx.doi.org/10.1001%2Farchpsyc.65.5.513" rel="nofollow noreferrer">10.1001/archpsyc.65.5.513</a>. PMC <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761826" rel="nofollow noreferrer">2761826</a>.
  PMID <a href="https://www.ncbi.nlm.nih.gov/pubmed/18458203" rel="nofollow noreferrer">18458203</a>.</p>
  
  <p>(4) Holma KM, Holma IA, Melartin TK, Rytsälä HJ, Isometsä ET (2008).
  "Long-term outcome of major depressive disorder in psychiatric
  patients is variable". Journal of Clinical Psychiatry. 69 (2):
  196–205. doi:<a href="https://dx.doi.org/10.4088%2FJCP.v69n0205" rel="nofollow noreferrer">10.4088/JCP.v69n0205</a>. PMID <a href="https://www.ncbi.nlm.nih.gov/pubmed/18251627" rel="nofollow noreferrer">18251627</a>.</p>
  
  <p>(5) Kanai T, Takeuchi H, Furukawa TA, Yoshimura R, Imaizumi T,
  Kitamura T, Takahashi K (2003). "Time to recurrence after recovery
  from major depressive episodes and its predictors". Psychological
  Medicine. 33 (5): 839–45. doi:<a href="https://dx.doi.org/10.1017%2FS0033291703007827" rel="nofollow noreferrer">10.1017/S0033291703007827</a>. PMID
  <a href="https://www.ncbi.nlm.nih.gov/pubmed/12877398" rel="nofollow noreferrer">12877398</a>.</p>
  
  <p>(6) Geddes JR, Carney SM, Davies C, Furukawa TA, Kupfer DJ, Frank E,
  Goodwin GM (2003). "Relapse prevention with antidepressant drug
  treatment in depressive disorders: A systematic review". Lancet. 361
  (9358): 653–61. doi:<a href="https://dx.doi.org/10.1016%2FS0140-6736%2803%2912599-8" rel="nofollow noreferrer">10.1016/S0140-6736(03)12599-8</a>. PMID
  <a href="https://www.ncbi.nlm.nih.gov/pubmed/12606176" rel="nofollow noreferrer">12606176</a>.</p>
  
  <p>(7) <a href="https://www.nlm.nih.gov/medlineplus/ency/article/000945.htm" rel="nofollow noreferrer">"Major Depression"</a>. MedlinePlus. 10 March 2014. Retrieved 16
  July 2010.</p>
</blockquote></li>
</ul>

CC BY-SA 3.0
2016-12-31T10:16:38.357Z
Nice and extensive answer. However, it seems to imply that all the medication only have a transient effect. Only when you keep taking the meds, depression will be "surpressed" (by lack of better words). I believe the OP is looking for a pill/shot/other medicine that permanently solves depression, like an antibiotic killing a bacteria.
Robin Kramer-ten Have
CC BY-SA 3.0
2017-01-01T02:24:33.353Z
@RobinKramer That's an interesting observation to be made, considering that I personally believe otherwise. That's why I said "it's debatable whether *all* "present medications" simply suppress depressive symptoms" - because in my opinion, some medication do actually cure depression permanently. Maybe my intention not to convey my personal opinion in my answer worked out a bit too well (:
Marc.2377
CC BY-SA 3.0
2017-01-01T22:39:19.457Z
None of the quotes answer the question of how long an antidepressant is expected to remain effective or useful. Most of the quotes are either (A) usage guidelines, (B) speculation, or (C) correlation, none of which constitutes solid scientific evidence. Based on the given quotes, an antidepressant could become completely ineffective after just three years while allowing the quotes to remain more or less "true". The idea of *long term* seems to be very loose here.
Michael
CC BY-SA 4.0
2016-12-31T09:15:19.450Z
2018-07-15T09:37:28.573Z
2018-07-15T09:37:28.573Z
Marc.2377
<p>Most studies exploring the impact of medication for the treatment of depression track patients in the short term.  Also, these clinical studies are typically not as comparable to the general population as many of exclusion criteria are strict, and rule out individuals who have co-morbid conditions like an anxiety disorder.</p>

<p><a href="http://psych242.class.uic.edu/Articles/Zimmerman,%20Sampling%20in%20depression%20research,%20AmJrPsy,%202002.pdf" rel="nofollow noreferrer">http://psych242.class.uic.edu/Articles/Zimmerman,%20Sampling%20in%20depression%20research,%20AmJrPsy,%202002.pdf</a></p>

<p>Overall, medication without any psychological intervention is largely a short-term fix.  Most studies have shown that the most effective course is to have a combination of antidepressants and therapy, like CBT. In my experience, getting to the core of a psychological issue requires exploration through therapy, while medication is important for managing some symptoms, specifically in the case of severe depression. It is important for a person to be stable before engaging in intensive psychotherapy, hence, medication should be the first course of action, along with more behavioral approaches such as behavioral activation, positive coping skills, etc.</p>

<p>"In any comparison between psychotherapy and medication, it is important to examine whether the sample was responsive to medications and whether pharmacotherapy was adequately implemented. Among more severely depressed participants in this trial,ADM significantly outperformed placebo through 8 weeks of treatment. There were no significant differences in outcome between ADM and placebo for the less severely depressed participants,
consistent with findings from numerous other studies (Hollon et al., 2002). In the absence of a demonstrated drug effect for such patients, there may be little justification for prescribing psychoactive medications when there are comparably effective psychosocial alternatives free of side effects."</p>

<p><a href="http://ww.abnormalwootwoot.com/Cool_Abnormal_Reads_Videos_ETC._files/Dimidjian%202006-Randomized%20Trial%20of%20Behavioral%20Activation_1.pdf" rel="nofollow noreferrer">Among more severely depressed patients, behavioral activation was comparable to antidepressant medication, and both significantly outperformed cognitive therapy.</a></p>

<p>Depression occurs for many reasons.  One route is commonly due to negative and distorted core beliefs (in line with CBT theory).  These beliefs and narratives need to be brought out of automatic processing and explored, and ultimately changed or replaced with beliefs that are not distorted.  Also, depression occurs when automatic thoughts are highly negative, bringing about debilitating emotions.  Often, people attempt to suppress these thoughts by avoiding situations or even resorting to means of distracting themselves by using drugs.  </p>

<p>Depression can also occur when one is no longer living in line with their core and true values, and rather responding to life based upon avoidance of feared outcomes, often irrational and unexplored fears.  This is in line with Acceptance and Commitment (ACT) theory, which proposes that through mindfulness and learning to observe the process of your mind and body rather than getting attached to the content, you will gain freedom from the impact of the thoughts.  Then, you can start to focus on your values, and slowly identify how you interrupt your pursuit of a meaningful life.<br>
If depressive symptoms are severe, and a person is struggling to get out of bed, than medication can help provide reduce these symptoms enough to motivate the person to engage in therapy.</p>

<p>Overall, medication alone is not a long term fix to psychological problems, although it can be highly effective and necessary for certain populations. Medication also communicates that depression and anxiety are things to be fixed; they are not.  All humans, at some point in their lives, will struggle psychologically.  Moreover, we all do our best and have ways of responding that we typically learned as children and that helped us to survive at certain points in our lives.  The issue becomes that when our context changes, some become stuck in old ways of responding to a new context.  Adaptation is key, and to adapt you have to become self-aware in order to have the choice to make a positive change.</p>

CC BY-SA 3.0
2017-01-06T19:58:24.190Z
Could you please provide some references and formatting to your answer? As is it is not readable and not verifiable.
Robin Kramer-ten Have
CC BY-SA 3.0
2017-01-06T20:26:01.313Z
Thank you for your comment, I responded quickly before and have gone back and made some edits to make the post more readable and with some quotes and references. Thank you
Seda Terzyan
CC BY-SA 3.0
2017-01-06T19:02:51.903Z
2017-01-06T20:25:24.593Z
2017-01-06T20:25:24.593Z
Seda Terzyan
<p>Antidepressants works temporarily (as long as you take them), and also affects the cognitive behaviour. Should they be seen as a permanent solution for depression? Shouldn't we find a solution at the psychosocial level, which actually works rather than suppressing the thoughts?</p>

<cognitive-psychology><depression>
Do antidepressants provide a permanent solution for depression and anxiety?
Saurabh Padwekar
# Do antidepressants provide a permanent solution for depression and anxiety?

(Asked by: username_0 on 2016-12-28)

Antidepressants works temporarily (as long as you take them), and also affects the cognitive behaviour. Should they be seen as a permanent solution for depression? Shouldn't we find a solution at the psychosocial level, which actually works rather than suppressing the thoughts?

**Tags:** cognitive-psychology, depression


---

## 2 answers

### Answer by username_1 on 2016-12-31. Score: 2

Your assumption that antidepressants works by "suppressing the thoughts" is not supported. Arguably it's quite the opposite. But let us not comment any further.

Now onto your question

## Do anti depressant provide permanent solution for depression and anxiety?

At least for Major Depressive Disorder (MDD), they normally do.

* According to a brochure from the Boynton Health Service of the University of Minnesota:

  > Once you respond to an antidepressant, we recommend that you
  > continue to take the medication for at least six months. If you stop
  > taking the antidepressant before six months have passed there is an
  > increased chance that your depression will return. For depressions
  > that have lasted a long time (a year or longer), or for a recurrent
  > depression, longer periods of treatment should be considered. If you
  > wish to discontinue your medication, we recommend that you do this
  > during times of decreased demands, such as during breaks or during the
  > summer months.
  >
  > Source: ["Common Questions About Antidepressants"](http://www.mentalhealth.umn.edu/medication/pdfs/antidep_bro.pdf) (2005) - page 2
* According to an article available from the Massachusetts Institute of Technology healthcare service MIT Medical:

  > Clinicians usually recommend that people continue taking
  > antidepressants for about six months after they begin feeling better.
  > Although it is tempting to stop taking the medication as soon as you
  > feel better, abruptly stopping will greatly increase your risk of
  > relapse.
  >
  > Source: "FAQ: Antidepressants" [question #7: "How long should I continue to take antidepressants?"](https://medical.mit.edu/faqs/antidepressants#faq-7)

---

* From an article published by the Journal of Clinical Psychiatry, doctor David Louis Dunner has this to say:

  > According to the AHCPR Practice Guidelines(1) for the treatment of
  > major depression, acute episodes of depression should be treated for
  > almost a year and recurrent episodes should be treated somewhat
  > longer.

  However, Dr. John M. Zajecka states:

  > Clinicians should perceive depression as potentially being a lifelong
  > illness that may require treatment indefinitely in many patients
  > rather than as an illness that can usually be cured with a single,
  > short course of treatment like an antibiotic.

  Dr. username_3 Edward Thase notes:

  > There is a difference between “forever” and “indefinitely.” In the
  > future, treatments that target the altered pathologic mechanisms of
  > recurrent depression may be available and may have a more curative
  > effect than the present medications, which suppress illness activity.

  While it's debatable whether *all* "present medications" simply suppress depressive symptoms, consider that this article was published in 2007.

  --

  Source: "Preventing Recurrent Depression: Long-Term Treatment for Major Depressive Disorder" - PMC [1911177](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911177/). PMID [17388700](https://www.ncbi.nlm.nih.gov/pubmed/17388700).

  References:

  (1) Clinical Practice Guideline. Number 5: Depression in Primary Care, vol 2. Treatment of Major Depression. Rockville, Md: US Dept Health Human Services, Agency for Health Care Policy and Research; 1993. AHCPR Publication 93-0551.

---

* Last but not least, from Wikipedia:

  > Studies have shown that 80% of those suffering from their first major
  > depressive episode will suffer from at least 1 more during their
  > life,(1) with a lifetime average of 4 episodes.(2) Other general
  > population studies indicate that around half those who have an episode
  > recover (whether treated or not) and remain well, while the other half
  > will have at least one more, and around 15% of those experience
  > chronic recurrence.(3) Studies recruiting from selective inpatient
  > sources suggest lower recovery and higher chronicity, while studies of
  > mostly outpatients show that nearly all recover, with a median episode
  > duration of 11 months. Around 90% of those with severe or psychotic
  > depression, most of whom also meet criteria for other mental
  > disorders, experience recurrence.(4)(5)
  >
  > Recurrence is more likely if symptoms have not fully resolved with
  > treatment. Current guidelines recommend continuing antidepressants for
  > four to six months after remission to prevent relapse. Evidence from
  > many randomized controlled trials indicates continuing antidepressant
  > medications after recovery can reduce the chance of relapse by 70%
  > (41% on placebo vs. 18% on antidepressant). The preventive effect
  > probably lasts for at least the first 36 months of use.(6)
  >
  > Those people experiencing repeated episodes of depression require
  > ongoing treatment in order to prevent more severe, long-term
  > depression. In some cases, people must take medications for long
  > periods of time or for the rest of their lives.(7)
  >
  > ---
  >
  > References:
  >
  > (1) Fava GA, Park SK, Sonino N (2006). "Treatment of recurrent
  > depression.". Expert Review of Neurotherapeutics. 6 (11): 1735–1740.
  > doi:[10.1586/14737175.6.11.1735](https://dx.doi.org/10.1586%2F14737175.6.11.1735). PMID [17144786](https://www.ncbi.nlm.nih.gov/pubmed/17144786).
  >
  > (2) Limosin F, Mekaoui L, Hautecouverture S (2007). "Stratégies
  > thérapeutiques prophylactiques dans la dépression unipolaire
  > [Prophylactic treatment for recurrent major depression]". La Presse
  > Médicale. 36 (11–C2): 1627–1633. doi:[10.1016/j.lpm.2007.03.032](https://dx.doi.org/10.1016%2Fj.lpm.2007.03.032).
  > PMID [17555914](https://www.ncbi.nlm.nih.gov/pubmed/17555914).
  >
  > (3) Eaton WW, Shao H, Nestadt G, Lee HB, Lee BH, Bienvenu OJ, Zandi P
  > (2008). ["Population-based study of first onset and chronicity in
  > major depressive disorder"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761826). Archives of General Psychiatry. 65
  > (5): 513–20. doi:[10.1001/archpsyc.65.5.513](https://dx.doi.org/10.1001%2Farchpsyc.65.5.513). PMC [2761826](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761826).
  > PMID [18458203](https://www.ncbi.nlm.nih.gov/pubmed/18458203).
  >
  > (4) Holma KM, Holma IA, Melartin TK, Rytsälä HJ, Isometsä ET (2008).
  > "Long-term outcome of major depressive disorder in psychiatric
  > patients is variable". Journal of Clinical Psychiatry. 69 (2):
  > 196–205. doi:[10.4088/JCP.v69n0205](https://dx.doi.org/10.4088%2FJCP.v69n0205). PMID [18251627](https://www.ncbi.nlm.nih.gov/pubmed/18251627).
  >
  > (5) Kanai T, Takeuchi H, Furukawa TA, Yoshimura R, Imaizumi T,
  > Kitamura T, Takahashi K (2003). "Time to recurrence after recovery
  > from major depressive episodes and its predictors". Psychological
  > Medicine. 33 (5): 839–45. doi:[10.1017/S0033291703007827](https://dx.doi.org/10.1017%2FS0033291703007827). PMID
  > [12877398](https://www.ncbi.nlm.nih.gov/pubmed/12877398).
  >
  > (6) Geddes JR, Carney SM, Davies C, Furukawa TA, Kupfer DJ, Frank E,
  > Goodwin GM (2003). "Relapse prevention with antidepressant drug
  > treatment in depressive disorders: A systematic review". Lancet. 361
  > (9358): 653–61. doi:[10.1016/S0140-6736(03)12599-8](https://dx.doi.org/10.1016%2FS0140-6736%2803%2912599-8). PMID
  > [12606176](https://www.ncbi.nlm.nih.gov/pubmed/12606176).
  >
  > (7) ["Major Depression"](https://www.nlm.nih.gov/medlineplus/ency/article/000945.htm). MedlinePlus. 10 March 2014. Retrieved 16
  > July 2010.

> **Comments:**
> **username_2**: Nice and extensive answer. However, it seems to imply that all the medication only have a transient effect. Only when you keep taking the meds, depression will be "surpressed" (by lack of better words). I believe the OP is looking for a pill/shot/other medicine that permanently solves depression, like an antibiotic killing a bacteria.  
> **username_1**: @RobinKramer That's an interesting observation to be made, considering that I personally believe otherwise. That's why I said "it's debatable whether *all* "present medications" simply suppress depressive symptoms" - because in my opinion, some medication do actually cure depression permanently. Maybe my intention not to convey my personal opinion in my answer worked out a bit too well (:  
> **username_3**: None of the quotes answer the question of how long an antidepressant is expected to remain effective or useful. Most of the quotes are either (A) usage guidelines, (B) speculation, or (C) correlation, none of which constitutes solid scientific evidence. Based on the given quotes, an antidepressant could become completely ineffective after just three years while allowing the quotes to remain more or less "true". The idea of *long term* seems to be very loose here.  

---

### Answer by username_4 on 2017-01-06. Score: 2

Most studies exploring the impact of medication for the treatment of depression track patients in the short term. Also, these clinical studies are typically not as comparable to the general population as many of exclusion criteria are strict, and rule out individuals who have co-morbid conditions like an anxiety disorder.

<http://psych242.class.uic.edu/Articles/Zimmerman,%20Sampling%20in%20depression%20research,%20AmJrPsy,%202002.pdf>

Overall, medication without any psychological intervention is largely a short-term fix. Most studies have shown that the most effective course is to have a combination of antidepressants and therapy, like CBT. In my experience, getting to the core of a psychological issue requires exploration through therapy, while medication is important for managing some symptoms, specifically in the case of severe depression. It is important for a person to be stable before engaging in intensive psychotherapy, hence, medication should be the first course of action, along with more behavioral approaches such as behavioral activation, positive coping skills, etc.

"In any comparison between psychotherapy and medication, it is important to examine whether the sample was responsive to medications and whether pharmacotherapy was adequately implemented. Among more severely depressed participants in this trial,ADM significantly outperformed placebo through 8 weeks of treatment. There were no significant differences in outcome between ADM and placebo for the less severely depressed participants,
consistent with findings from numerous other studies (Hollon et al., 2002). In the absence of a demonstrated drug effect for such patients, there may be little justification for prescribing psychoactive medications when there are comparably effective psychosocial alternatives free of side effects."

[Among more severely depressed patients, behavioral activation was comparable to antidepressant medication, and both significantly outperformed cognitive therapy.](http://ww.abnormalwootwoot.com/Cool_Abnormal_Reads_Videos_ETC._files/Dimidjian%202006-Randomized%20Trial%20of%20Behavioral%20Activation_1.pdf)

Depression occurs for many reasons. One route is commonly due to negative and distorted core beliefs (in line with CBT theory). These beliefs and narratives need to be brought out of automatic processing and explored, and ultimately changed or replaced with beliefs that are not distorted. Also, depression occurs when automatic thoughts are highly negative, bringing about debilitating emotions. Often, people attempt to suppress these thoughts by avoiding situations or even resorting to means of distracting themselves by using drugs.

Depression can also occur when one is no longer living in line with their core and true values, and rather responding to life based upon avoidance of feared outcomes, often irrational and unexplored fears. This is in line with Acceptance and Commitment (ACT) theory, which proposes that through mindfulness and learning to observe the process of your mind and body rather than getting attached to the content, you will gain freedom from the impact of the thoughts. Then, you can start to focus on your values, and slowly identify how you interrupt your pursuit of a meaningful life.  
If depressive symptoms are severe, and a person is struggling to get out of bed, than medication can help provide reduce these symptoms enough to motivate the person to engage in therapy.

Overall, medication alone is not a long term fix to psychological problems, although it can be highly effective and necessary for certain populations. Medication also communicates that depression and anxiety are things to be fixed; they are not. All humans, at some point in their lives, will struggle psychologically. Moreover, we all do our best and have ways of responding that we typically learned as children and that helped us to survive at certain points in our lives. The issue becomes that when our context changes, some become stuck in old ways of responding to a new context. Adaptation is key, and to adapt you have to become self-aware in order to have the choice to make a positive change.

> **Comments:**
> **username_2**: Could you please provide some references and formatting to your answer? As is it is not readable and not verifiable.  
> **username_4**: Thank you for your comment, I responded quickly before and have gone back and made some edits to make the post more readable and with some quotes and references. Thank you  

---

