8 wrong beliefs about depression and its treatment
Following a publication in El Mundo (digital version) in the year 2015 in the various misconceptions about depressive disorder . Sanz and García-Vera (2017), from the Complutense University of Madrid, have conducted an exhaustive review on this subject in order to shed some light on the veracity of the information contained in that text (and many others that nowadays can be found in countless websites or blogs of psychology). And it is that in many occasions such data seem not to be based on a contrasted scientific knowledge.
Below is a list of the conclusions supposedly accepted and published by the DMedicina website (2015), the same group of specialists that carries out the edition in El Mundo. These ideas refer both the nature of depressive psychopathology as well as the effectiveness rates of psychological interventions that are applied for your treatment.
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Misconceptions about Depressive Disorder
When it comes to misconceptions about depression itself, we find the following.
1. When everything in life is going well, you can get depressed
Contrary to what was published in the El Mundo article, according to the scientific literature this statement should be considered partially false, since the findings indicate that The relationship between previous life stressors and depression is stronger than expected . In addition, depression is given a connotation of disease, which entails attributing greater biological than environmental causality. Regarding the latter, science states that there is a small number of cases of depression without a prior history of external stressors.
2. Depression is not a chronic disease that never goes away
From the article in El Mundo it is considered that depression is a condition that never goes away completely, although the arguments that sustain it are not completely true.
In the first place, the wording in question affirms that the efficacy rate of the pharmacological intervention is 90%, when in a multitude of meta-analysis studies carried out in the last decade (Magni et al., 2013; Leutch, Huhn and Leutch, 2012; et al., 2010; Cipriani, Santilli et al. 2009) gives an approximate percentage of 50-60% effectiveness to psychiatric treatment , depending on the drug used: SSRIs or tricyclic antidepressants.
On the other hand, the authors of the review article add that in the conclusions of a recent meta-analysis (Johnsen and Friborg, 2015) about 43 researches analyzed reached 57% of patients in total remission after a cognitive-behavioral intervention, so that can be established a similar efficacy index between pharmacological and psychotherapeutic prescription empirically validated.
3. There are no people who feign depression to get sick leave
The wording of the portal states that it is very difficult to deceive the professional by simulating a depression, so there are practically no cases of mock depressions. However, Sanz and García-Vera (2017) expose the data obtained in various investigations in which the percentages of simulation of depression can range between 8 and 30% , this last result in cases where labor indemnities are linked.
Thus, although it can be considered that in a greater proportion the population that visits primary care is not simulating this psychopathology, the assertion that there are no cases in which this case history does not occur can not be considered valid.
4. Optimistic and extraverted people get depressed as much or more than those who are not
The article we are talking about defends the idea that due to the greater affective intensity of optimistic and extraverted people, these are the ones who are more likely to suffer a depression. On the other hand, the list of studies presented by Sanz and García-Vera (2017) in their text affirm precisely the opposite. These authors cite the meta-analysis of Kotov, Gamez, Schmidt and Watson (2010) where it was found lower rates of extraversion in patients with unipolar depression and dysthymia .
On the other hand, it has been indicated that optimism becomes a protective factor against depression, as corroborated by studies such as Giltay, Zitman and Kromhout (2006) or Vickers and Vogeltanz (2000).
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Misconceptions about the treatment of Depressive Disorder
These are other mistakes that can be made when thinking about the psychotherapeutic treatments applied to depressive disorders.
1. Psychotherapy does not cure depression
According to the El Mundo article there is no study that demonstrates that psychological intervention allows depression to subside, although it does assume that it can be effective in the presence of some milder depressive symptoms, such as those that occur in the Adaptive Disorder. Thus, he argues that the only effective treatment is pharmacological.
The data obtained in the Mataulisi of Cuijpers, Berking et al (2013) indicate the opposite to this conclusion, since they found that Behavioral Cognitive Therapy (CBT) was significantly higher than the waiting list or usual treatment (consisting of various psychopharmaceuticals, psychoeducation sessions, etc).
In addition, the data previously provided on the study by Johnsen and Friborg (2015) corroborates the falsity of this initial statement. In the text, the proven efficacy of studies on Behavioral Activation Therapy and Interpersonal Therapy is also discussed.
2. Psychotherapy is less effective than antidepressant medication
In line with the above, there are more than 20 researches collected in the meta-analysis of Cruijpers, Berking et al (2013), which is cited in the article by Sanz and García-Vera (2017) that proves the absence of difference in efficacy between CBT and antidepressant drugs.
It is partially true that it has not been possible to demonstrate greater efficacy in other types of psychotherapeutic interventions other than CBT, for example in the case of Interpersonal Therapy, but no such conclusion can be applied to the TCC . Therefore, this idea should be considered as false.
3. The treatment of depression is long
In El Mundo it is stated that the treatment of severe depression should be at least one year due to frequent recurrences that are associated with the course of this type of disorder. Although scientific knowledge shows agreement in establishing a high rate of recurrence (between 60 and 90% according to Eaton et al., 2008), they also show that there is an approach in brief psychological therapy (based on CBT) that has a significant efficacy index for depression. These interventions range from 16 to 20 weekly sessions.
The aforementioned meta-analyzes indicate a duration of 15 sessions (Johnsen and Friborg) or between 8-16 sessions (Cruijpers et al.). Therefore, this initial hypothesis must be considered false based on the data presented in the reference article.
4. The psychologist is not the professional who treats depression
According to the writing group of El Mundo, it is the psychiatrist who carries out the intervention of patients with depression; the psychologist can take charge of depressive symptoms, of a milder character than the depressive disorder per se. From this statement two conclusions are extracted that have already been refuted previously : 1) depression is a biological disease that can only be addressed by a psychiatrist and 2) psychological intervention can only be effective in cases of mild or moderate depression, but not in cases of severe depression.
In the original text by Sanz and García-Vera (2017), some misconceptions can be consulted more than those presented in this text. This becomes a clear sample of the trend, increasingly common to publish information not sufficiently scientifically contrasted. This can result in a significant risk since nowadays any type of information is available to the general population, causing a biased or not sufficiently validated knowledge. Such a danger is even more disturbing when it comes to health issues.
- Sanz J. and García-Vera, M.P. (2017) Wrong Ideas about Depression and its Treatment (I and II). Papers of the Psychologist, 2017. Vol 38 (3), pp 169-184.
- Drafting of CuidatePlus (2016, October 1). Misconceptions about depression. Recovered from //www.cuidateplus.com/enfermedades/psiquiatricas/2002/04/02/ideas-equivocadas-depresion-7447.html
- Drafting of DMedicina (2015, September 8). Misconceptions about depression. Recovered from //www.dmedicina.com/enfermedades/psiquiatricas/2002/04/02ideas-equivocadas-depresion-7447.html