Furthermore, Brent and his colleagues (as cited in Bender 2007) evaluated a number of pediatric clinical trials for depression from 1998 to 2006 testing the effects of anti depressants and suggested that although the benefits of taking medication for mood disorders outweighs any associated risks, responding to medication is not the same as remission so in order for patients to recover on a long term basis a combination of drugs and psychotherapy is needed. The study also emphasizes the fact that youth suicide rates increased by 18% between 2003 and 2004 which correlates with the steep decline in antidepressants prescribed during this period because of the fears surrounding the links between antidepressants and increased suicidal tendencies. This evidence supports the use of antidepressants and fails to support the idea of a link between antidepressants and an increase in suicide rates.
In support of psychological therapies as a way of treating mood disorders, Layard et al (2007) suggested that the majority of patients who visit their GPs with depression would prefer psychological therapies over pharmaceuticals but as the latter is not usually offered as an initial treatment, many patients will go untreated rather than take the medication offered even if this predicts negative consequences. Layard et al (2007) also suggests that previous research has shown that psychological interventions, especially cognitive behavior therapy (CBT), has been shown to relieve symptoms of mood disorders equally effectively as pharmaceuticals in the short term and unless drugs are taken continuously throughout the patients life, CBT is more effective in the long term at preventing relapses. Layard et al (2007) emphasizes that the reason CBT is not initially offered to patients with mood disorders is because of the costs involved which is estimated to be around seven hundred and fifty pounds for a standard course. Because of this, CBT on the NHS is limited so patients are usually offered a pharmaceutical option instead. Although the problem with psychological therapies appears to be due to the economy, if mood disorder patients were treated in a way which would provide them more benefits in the long term, less people would be on unemployment benefits due to mental illness, which would benefit the economy anyway.
Sometimes when psychological therapies are not immediately available, stepped care models can be applied as a way to bridge the gap between treatment and no treatment in people, especially those who do not want to take pharmaceuticals for mood disorders and are waiting to receive some form of psychological therapy (Bower & Gilbody 2005). These models involve the patient to make the most of methods to overcome mood disorders such as self help groups, books, counseling and other more gentle resources before opting for intensive therapy. This idea aims to keep the costs of therapy down without the need for pharmaceuticals so more costly therapies such as CBT can be reserved for patients who need it the most and for whom all other methods of help have failed.
Although CBT has inferred lots of support from previous research other psychological therapies have not been shown to be so successful. Whitfield and Williams (2003) suggested that eclectic, counseling and psychodynamic therapies have very little supportive evidence so have not found scientific support to provide any benefits for patients with mood disorders. Although this is the case, these types of therapies are still frequently offered to patients on the NHS. Whitefield & Williams (2003) also suggested that the usual amount of CBT sessions offered to patients is twelve to sixteen one hour sessions although no great improvements are normally seen after the first eight weeks of therapy. If CBT were to be cut down to eight sessions average per patient then double the amount of patients would be able to benefit from the amount of CBT already available without the need to employ or train more therapists.
Barlow (2008) suggested that patients are more likely to comply with psychological therapies and emphasized the fact that in some situations, the drop out rate for antidepressants is up to sixty percent. Barlow (2008) also acknowledged that psychological therapies may have negative side effects associated with their use but little is known about the effects of these therapies yet. Finally, Barlow (2008) concluded that even though CBT and other psychological therapies can prove costly, when combined with other treatments such as pharmaceuticals, costs can actually be reduced as relapse rates lower therefore lessening the need for future interventions for patients.
To conclude, the purpose of this essay was to decide whether psychological therapies are equally effective in treating mood disorders than drug treatments. Pharmaceuticals do appear to provide a short term fix for mood disorders but relapse rates will be high unless medication is continued indefinitely. For people that are reluctant to take this type of medication, another intervention is needed. Psychological therapies appear to provide some benefits, especially in the long-term, although the only therapy which has been shown to produce significant improvements in patient’s moods is CBT. CBT appears to be equally as effective as pharmaceuticals at treating mood disorders although side effects of drugs, suggested by previous studies are quite contradictory whereas the side effects of CBT, if there are any, are unknown at present.
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