Depression has become so ubiquitous that debate rages as to whether medication or psychotherapy is the superior solution. One study to compare the two yields some surprising results: The question shouldn't be which treatment is better, but how two wildly different approaches can yield such a uniformly beneficial outcome.
Arthur Brody, M.D., assistant professor of psychiatry at the University of California at Los Angeles, used positron emission tomography (PET) scans to monitor changes in the brain activity of patients who had either taken the antidepressant Paxil or engaged in interpersonal talk therapy with a psychologist for 12 weeks.
Both groups experienced a similar lift in spirits. But PET scans revealed stark contrasts in their brain functioning. The talk therapy contingent displayed high activity in the anterior insula, a region associated with language and sensory integration, while the drug therapy group showed low activity in the middle frontal gyrus, which facilitates higher order abilities like reasoning. "Depression has many aspects and the two treatments together cover more of the symptoms," Brody believes. Psychotherapy seems to ease physical symptoms, like lack of appetite, while antidepressants alleviate psychosocial problems like suicidal thoughts. "Medication is easier and cheaper than psychotherapy," notes Brody. "But for patients with the time and money, I think the combination of drugs and psychotherapy works best."
