8 Mistaken Beliefs About Depression And Its Treatment
Following a publication in El Mundo (digital version) in 2015 in which various misconceptions about depressive disorder Sanz and García-Vera (2017), from the Complutense University of Madrid, have carried out an exhaustive review on this topic in order to shed some light on the veracity of the information contained in that text (and many others that today They can be found on countless psychology websites or blogs). And on many occasions such data seem not to be based on proven scientific knowledge.
Below is the list of the conclusions supposedly accepted and published by the Editorial Team of the DMedicina portal (2015), the same group of specialists that carries out the edition in El Mundo. These ideas refer both to the nature of depressive psychopathology as well as to the efficacy rates of psychological interventions that are applied for their treatment.
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 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 Furthermore, depression is given the connotation of a disease, which leads to attributing greater biological rather than environmental causality. Regarding the latter, science affirms that there are a small number of cases of depression without a prior history of external stressors.
2. Depression is not a chronic illness that never goes away
From the El Mundo article, it is considered that depression is a condition that never completely goes away, despite the fact that the arguments that support it are not completely true.
Firstly, the wording in question states that the efficacy rate of pharmacological intervention is 90%, when in many meta-analysis studies carried out in the last decade (Magni et al. 2013; Leutch, Huhn and Leutch 2012; Omari et al. 2010; Cipriani, Santilli et al 2009) an approximate percentage of the 50-60% effectiveness of 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) on 43 analyzed investigations, 57% of patients were in total remission after a cognitive-behavioral intervention, so can be established a similar efficacy rate between pharmacological and psychotherapeutic prescription empirically validated.
3. There are no people who fake depression to get sick leave
The editorial staff of the portal states that it is very difficult to deceive the professional by simulating depression, which is why there are practically no cases of fake depression. However, Sanz and García-Vera (2017) present the data obtained in various investigations in which Depression simulation percentages can range between 8 and 30% the latter result in cases where labor compensation is linked.
Thus, although it can be considered that a greater proportion of the population visited in primary care is not simulating said psychopathology, the statement that there are no cases in which this casuistry does not occur cannot be considered valid.
4. Optimistic and extroverted people become depressed as much or more than those who are not.
The article we are talking about defends the idea that due to the greater emotional intensity of optimistic and extraverted people, these are the ones who are most likely to suffer from 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 by Kotov, Gamez, Schmidt and Watson (2010) where it was found lower extraversion indices 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 those by Giltay, Zitman and Kromhout (2006) or Vickers and Vogeltanz (2000).
Misconceptions about the treatment of Depressive Disorder
These are other errors that can be made when thinking about 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 Adaptive Disorder. Thus, he defends that the only effective treatment is pharmacological.
The data obtained in the study by Cuijpers, Berking et al (2013) indicate the opposite of this conclusion, since they found that Cognitive Behavioral Therapy (CBT) was significantly superior to wait list or treatment as usual (consisting of various psychotropic drugs, psychoeducation sessions, etc.).
Furthermore, the data provided previously about the study by Johnsen and Friborg (2015) corroborates the falsehood of such initial statement. The text also presents the proven effectiveness in studies on Behavioral Activation Therapy and Interpersonal Therapy.
2. Psychotherapy is less effective than antidepressant medication
In line with what was stated above, there are more than 20 investigations collected in the meta-analysis by Cruijpers, Berking et al (2013), which is cited in the article by Sanz and García-Vera (2017) that proves the absence of difference in effectiveness between CBT and antidepressant drugs.
Yes, it is partially true that greater effectiveness has not been demonstrated in other types of psychotherapeutic interventions other than CBT, for example in the case of Interpersonal Therapy, but such a conclusion cannot be applied to CBT Therefore, this idea must be considered false.
3. Depression treatment is long
In El Mundo it is stated that the treatment of severe depression should be for at least one year due to the frequent relapses that are associated with the course of this type of disorder. Although scientific knowledge agrees on establishing a high rate of recurrence (between 60 and 90% according to Eaton et al., 2008), it also shows that There is an approach in brief psychological therapy (based on CBT) which has a significant rate of effectiveness for depression. These interventions range between 16 and 20 weekly sessions.
The aforementioned meta-analyses indicate a duration of 15 sessions (Johnsen and Friborg) or between 8-16 sessions (Cruijpers et al.). Therefore, such 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 El Mundo editorial group, it is the psychiatrist who carries out the intervention for patients with depression; The psychologist can take care of depressive symptoms, which are milder than the depressive disorder per se. Two conclusions are drawn from this statement 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) you can consult some more misconceptions than those presented in this text. This becomes a clear example of the increasingly common tendency to publish information that is not sufficiently scientifically verified. This can lead to a significant risk since today any type of information is available to the general population, causing knowledge that is biased or not sufficiently validated. This danger is even more worrying when it comes to health issues.
