Talk Therapy

Question: How many therapists does it take to change a light bulb?

Answer: One, but the light bulb has to really want to change. 

A criticism that can easily be made about Pros of Prozac is that I do not place enough emphasis on psychotherapy, or talk therapy, as a tool for dealing with and overcoming depression or anxiety.

Although I do touch on many resources that can help in the journey to healing from depression and anxiety in the book, including talk therapy, my aim in Pros of Prozac is to address the specific stigma taking psychotropic medication carries. Because I have intentionally written a succinct book, I have left it to countless other authors to write books about the benefits of talk therapy.

I would like to add my thoughts on talk therapy here.

Scientific research clearly shows that combined treatment of medication and psychotherapy results in faster remission of chronic depression.

Source: Manber, R., Kraemer, H. C., Arnow, B. A., Trivedi, M. H., Rush, A. J., Thase, M. E., . . . Keller, M. E. (2008). Faster remission of chronic depression with combined psychotherapy and medication than with each therapy alone. Journal of Consulting and Clinical Psychology, 76(3), 459-467.

I definitely agree. Working with someone outside of yourself, such as a counselor, therapist, life coach, or even a twelve-steps sponsor, is often necessary in the process of change.

Involving another person in the journey to overcome a mental illness often establishes accountability and provides an invaluable outside, more objective view.

For those unfamiliar with psychotherapy, the two most common types are:

1. Cognitive-behavioral therapy (CBT), where therapists guide patients in restructuring negative thought patterns and contributing behaviors.

2. Interpersonal therapy (IPT), where therapists work with patients to resolve contributing troubled relationships.

I can see how it would always be helpful for an individual to restructure negative thought patterns and contributing behaviors and to resolve troubled relationships.

That being said, I suggest that taking the right medication can often open more doors to healing through talk therapy than would be possible without it.

Beth's Story

My friend, Beth (name has been changed), began visiting a therapist and also went on Prozac (fluoxetine) during high school to counter issues she began to have at the time with depression and anxiety.

Years later, she no longer visited the therapist, but still took Prozac. She married and when she decided to have a baby, she decided she didn't want to be on Prozac during her pregnancy.

She worked with her doctor to slowly and calculatedly come off Prozac before she even attempted to get pregnant. Although her doctor instructed her how to safely (i.e., slowly and calculatedly) do so, I still warned her about the risk because I did the same thing and this was a horrific choice for me.

Although there is no scientifically-proven risk to a fetus when taking Prozac, there is risk with every medication. I lovingly explained to Beth how the risk of a medication must always be weighed against the risks of depression left untreated during pregnancy, which can lead to “poor birth outcomes, including low birth weight, preterm delivery, lower Apgar Scores, poor prenatal care, failure to recognize or report signs of labor; and an increased risk of fetal abuse, neonaticide, or maternal suicide.”
Source: O’Keane, V., & Marsh, S. M. (2007). Depression during pregnancy. BMJ, 334, 1003-1005.

Beth still decided to go off Prozac. Like I did, she learned the hard way how beneficial Prozac was to her life. Within a few weeks, she was not doing well. Being on Prozac their whole marriage, her husband had never seen the depressed and anxious Beth that emerged. He was extremely supportive, but didn't know what to do. Beth wisely spoke with her doctor and started taking Prozac again. 

When on the medication, Beth is functional. Without it, Beth isn't. Talk therapy has nothing to do with it.

Luckily, Beth was on Prozac for a significant amount of time before she conceived and is now doing well once again and successfully managing her first pregnancy.

God is great!

The information contained on this blog is intended to be educational and not for diagnosis, prescription, or treatment of any mental illness. The information should not replace consultation with a competent healthcare provider or mental health professional. The content of this blog is intended to be used in adjunct to a rational and responsible healthcare or psychotherapy program. Beca Mark or CTL Press, Inc. is in no way liable for any misuse of the material contained on this website.