All my life I’ve worried about the little things. From school to friends to extracurricular activites, there was nothing I didn’t feel stress about. It wasn’t until college that I realized that maybe this wasn’t how life should feel. Since that realization, I’ve been diagnosed with generalized anxiety, along with possibly depression (to keep things interesting, I suppose!). My CAPS counselor suggested I try out a few psychiatrists and medicines as well as a psychologist. For clarifications sake, I’ll define those terms. A psychiatrist, unlike psychologists, are actual medical doctors who evaluate a patient’s symptoms and can prescribe medicine based on those symptoms. A psychologist, on the other hand, is someone who evaluates and studies behaviors. They work more in the therapy and counseling aspect of mental health, and typically have a master’s degree or a doctorate. Although she recommended I check out both avenues, I’m a busy college student. I don’t have the time to spend in multiple appointments a week. I decided to do some research on which form of treatment is more effective, and go from there.
Psychology Today talked about how the average person in America prefers medication to therapy, although this may not be an entirely informed decision on their part. A professor at Cornell, Richard Friedman, believes that many Americans are being over-medicated, despite evidence that suggests it may not be an entirely effective mode of treatment for everyone. Friedman cites a few studies performed that show how effective therapy can be and how it can lead to skipping the drugs altogether. The frequency of medication commercials was something cited for this rise in medication. This connects to what we’ve learned in class that sometimes anecdotal information or media interference can lead to faulty science.
A study performed by Dr. Helen Mayberg found that treatment can depend highly on the person and how their brain functions. Using PET scans, Dr. Mayberg randomized depressed patients into 2 groups: one group on an SSRI (Selective serotonin reuptake inhibitor – a kind of drug used to treat depression and/or anxiety) and another in behavior therapy. The result was that 40% of the participants found their respective treatments to be effective. However, Dr. Mayberg discovered something else in this study that could show how brain differences lead to different responses to treatment. The participants that had low activity in the anterior insula region of their brain responded well to their therapy, while those with higher activity in that region responded more positively to medicine. This difference is attributed to how therapy and medication have been shown to target different parts of the brain. So, while one patient may find therapy very effective, another patient with the same illness may find that it does nothing for them, based simply on where the problem lies in their brain.
My next article, from the Times, also discussed the Mayberg study but detailed how this conclusion could change treatment for mental illness as we know it. Many doctors still stand by the assertion that both forms of therapy can be beneficial for a patient, but are advocating for the use of brain scans in order to determine which treatment would be more effective. The typical remission rate for someone with depression ranges from 40-50% and although those numbers don’t seem necessarily bad, with the amount of people who suffer from mental illness in this country, the actual numbers of people who don’t feel symptom alleviation is enormous.
So as with most of my searches for these blogs, my conclusion is that my question cannot fully be answered. Both forms of treatment can be effective, especially in conjunction, but it depends on the person to determine which is most effective. We can only hope that these brain scans become more readily available in the future to determine which course of action is the right one for people suffering from mental illness.