Research has shown that cognitive behavioral therapy is as effective as maintenance antidepressant medication for preventing depression recurrence or relapse in individuals who have had successful depression treatment. According to the study authors, recurrence and relapse following recovery from major depression are typical outcomes that come with tremendous familial, personal and societal costs.
The existing standard for the prevention of depression relapse is maintenance therapy using a single antidepressant. This strategy is usually effective if individuals take their meds, but as much as 40% do not. Alternate options to long-term antidepressant usage, particularly those which deal with mood outcomes in a broader context of wellbeing, could appeal to individuals cautious of continued antidepressant treatment.
Researchers examined 160 individuals who met requirements for major depression and had suffered at least 2 depression episodes. After being treated for 8 months, 52.5% experienced remission. Individuals in remission were allocated randomly to 1 of 3 groups of treatment: 28 continued to take their meds; 30 gradually had their replaced meds with placebo; and 26 had their meds tapered and then received cognitive behavioral therapy.
Individuals learn in this therapy to keep tabs on their thought patterns when they feel sad, modifying depression associated reactions into opportunities. This is achieved through daily homework exercises featuring:
- Guided/recorded awareness exercises directed at increasing nonjudgmental awareness of bodily sensations, feelings and thoughts
- Taking on problems with a position of self-compassion
- Establishing an ‘action plan’ made up of strategies for dealing with early warning signs of relapse/recurrence.
For the duration of the 18-month follow-up, depression relapse occurred in 38% of individuals in the group who had cognitive behavioral therapy, 46% of those in the group who had maintenance meds and 60% of those in the group who had placebo, making both cognitive behavioral therapy and medication effective in the prevention of depression relapse.
For individuals unable or unwilling to tolerate treatment with maintenance antidepressants, cognitive behavioral therapy offers effective protection from depression relapse during 18 months.
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