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Compare the Strengths and Weaknesses of Psychological Versus Biological Treatments for Depression

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Compare the strengths and weaknesses of psychological
versus biological treatments for Depression.

The World Health Organization reports depression as “the leading cause of disability worldwide” with over 300 million people suffering from it. With 6% of adults affected each year by depression the search for the most effective treatment is ever so important (The British Psychological Society & The Royal College of Psychiatrists, 2010). There are documented psychological and biological treatments used to cure or lessen the symptoms of depression. Both types of treatments follow different methods using different tools to treat the mood disorder. Many discussions and studies revolve around which type is more effective overall without doing more harm. Many journals state that different individuals respond to the treatments differently and therefore their effectiveness depends on the patient being treated. The use of certain treatments also depends on the severity of depression which is monitored by the stepped-care models. Both treatments have strengths and weaknesses which will be discussed in the following essay.

Presently, there are two major ways to treat depression, psychological or biological treatments. Biological treatments involve the use of pharmacotherapy where drugs are prescribed to restore balance to neurochemicals or electro-convulsive therapy. Three main types of drugs are used, tricyclic drugs, monoamine oxidase inhibitors and selective serotonin reuptake inhibitors such as Prozac. Studies have scientifically proven these treatments to lessen or cure the symptoms of depression. 50-70% cases showed that anti-depressants are highly effective against the disease. The fact that they are biological makes it easier to monitor and measure the effectiveness of treatments. Studies show that ECT improves symptoms of depression in 70-80% of severely depressed patients who have not responded well to medication.

Anti-depressant drugs are also very cheap in comparison to psychological therapy which could be costly to individuals or the NHS depending on the treatment and length of time needed to treat. Highlighted as well is the fact that drug treatments are also more accessible to patients with depression as majority of GPs can prescribe them to patients they believe need them. Where as CBT is a more specialized treatment that only trained therapist can practice, therefore patients would have to be referred to them. However, there are presently easier ways to receive CBT.

Studies in support of biological treatments point towards their benefits however they do have weaknesses as well as strengths. Compared to psychological treatments, biological ones are more prone to causing cognitive harm and side effects then benefits. It has been reported that some patients develop suicidal thoughts due to the use of antidepressants. Other side effects associated with taking antidepressants include tremors, sexual dysfunction, and weight gain. Moreover, drug therapy has been said to only maintain a low relapse rate if the therapy is continued and maintained.

The fact that three thirds of patients relapse when taken off the medication strongly indicates that the drugs are palliative unlike psychological treatments and only help treat symptoms and not depression. When treated again the medication used also becomes less effective on relapsed patients as their brain chemistry is altered by the drugs used in first treatments (Hollon, 2005). While for psychological treatments the effectiveness does not change even after patients used drug therapy before.

Furthermore, biological treatments have been said to have negative impacts on memory. Patients undergoing ECT can suffer from retrograde amnesia or even anterograde amnesia. On top of that, ECT appears to only work temporarily in curing symptoms of depression. Relapse and the recurrence risk after the treatment ceases is substantially high. The therapeutic mechanism is also not clearly understood making it a very unknown and unmeasurable treatment. It also decreases the metabolic activity and blood flow, so it could possibly inhibit some brain activity, affect brain protein synthesis, secretion of endocrine hormones and gene expression. The large list of side effects from the use of biological treatments is one of its clear weaknesses. ECT in particular is also very expensive unlike the use of drugs, this is another downside to the use of this type of treatment.

Results also indicate that patients tend to relapse within 6 months of ceasing ECT. Even when paired with medication relapse is still recorded as high among patients, especially females (Sackeim et al., 2001). Breggin (1997) discovered little evidence to show that the beneficial effects lasted any longer than 4 weeks.  

Depressed patients can also become reliant on anti-depressants due to the easiness of obtaining and consuming them. There is also the downside of the “placebo effect” – are patients only feeling better because they believe ingesting a “happy” pill will make them better.  Another weakness is that severely depressed patients may be tempted to use certain antidepressants to commit suicide if in the wrong state of mind.

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