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Is Therapy Better than Medication for Treating Depression?

by Dr. Patrick Arbore, Elder Abuse & Depression Expert
November 30, 2012

Question: Is therapy more beneficial to seniors with depression than medication?

Answer: In a 2011 article  in the Journal of the American Geriatrics Society Akincigil and associates  examined  trends from the Medicare Current Beneficiary Survey, a nationally representative survey of Medicare enrollees, from 1992 to 2005.  The researchers analyzed the numbers of older adults with depression diagnoses who utilized  psychotherapy as well as antidepressant use. Results indicated an increase in depression diagnoses between the years 1992 and 2005 as well as an increased use of antidepressant medication for older adults.  Older adults who received psychotherapy, however, declined by almost half from 1992 to 2005. Although study participants relied more on medication only treatment, the authors suggested that the added support of psychotherapy was being underused.  

Most of the literature I have read strongly suggests that the combination of antidepressant medications plus psychotherapy results in fewer relapses than either treatment alone. What makes sense to me is to provide an opportunity for older depressed adults to understand what has triggered the depression. If the older adult relies only on medications, they may be unaware of the cause of the depression.  This would be a disadvantage should they decrease and/or stop taking their antidepressants. The medications may increase the serotonin levels in the brain, which is a positive outcome; psychotherapy, however, can affect the behavior, thinking or feelings of the depressed older person, which can have long lasting positive effects.       

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Dr. Patrick Arbore is the Founder and Director of the Center for Elderly Suicide Prevention and Grief Related Services (CESP), a program offered by the Institute on Aging in San Francisco. Dr. Arbore conducts workshops and lectures locally and nationally on aging-related subjects. He is the author of numerous articles and book chapters on suicide prevention, bereavement, suffering, etc., including a chapter he co-authored in the book, “When Professionals Weep".

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