Talk therapy key to managing mental health problems

SUMMARY

  • Health specialists should not automatically prescribe anti-depressant medication to all patients, since not all conditions require the drugs.
  • A new study published in the Lancet Psychiatry Journal notes that young people seeking support for depression should be offered psychotherapy as the first line of treatment.

Mental health challenges are increasingly affecting young people due to life pressures such as unemployment, poverty and the pursuit of lavish lifestyles that they cannot afford.

For those diagnosed with depression, there can be a tendency to rely on medication to help deal with the condition.

In as much as they work, researchers note that health specialists should not automatically prescribe anti-depressant medication to all patients, since not all conditions require the drugs.

A new study published in the Lancet Psychiatry Journal notes that young people seeking support for depression should be offered psychotherapy as the first line of treatment.

The research, which was conducted by scientists from the Orygen Youth Mental Health institute in Melbourne, Australia, emphasised the importance of a multi-faceted approach to treating depression in young people. “The results suggest that we should really be focusing on providing good quality psychotherapy, such as cognitive behavioural therapy, to young people and keeping medication as the second line of treatment,” said Christopher Davey, the head of mood disorder research at Orygen.

Psychotherapy— offered by psychologists, counsellors or psychiatrists — is commonly called a “talking|” treatment because it uses talking sessions, rather than medication to tackle mental health problems.

The treatment aims at enabling patients to understand their feelings and what makes them feel positive, anxious, or depressed. This empowers them to cope with difficult situations in a more adaptive way.

The psychotherapy sessions may be conducted on a one-to-one basis, in pairs, or in groups.

A type of psychotherapy known as Cognitive Behavioural Therapy (CBT) is recommended for young people.

It works on the basis that the way people think and interpret life events, affects how they behave and ultimately how they feel.

Consequently, it helps young people to become aware of inaccurate or negative thinking so they can view challenging situations more clearly and respond to them in a more effective way.

The randomised study involved 153 young people aged between 15 and 25 years who had been diagnosed with depression and were being treated at the Youth Mental Health Services in North-West Melbourne, Australia.

All study participants received cognitive behavioural therapy for 12 weeks coupled with either the common antidepressant — known as fluoxetine — or a placebo medication. The results of the study showed that there were no significant differences in symptom improvement between the two groups.

This suggested that the addition of the fluoxetine drug did not affect the participants’ mental health outcomes. “The take-home message from the study is that the first-line treatment for young people with depression should be psychotherapy,” said Dr Davey. He, however, noted that the results do not suggest that antidepressant drugs should not be used in treating depression.

“Antidepressants can be very useful for some people. But anyone considering the role of these drugs in their treatment should first discuss this with their doctor or clinician.”

Susan Njoroge, a Nairobi-based family psychologist, trainer and addiction counsellor notes that despite the significance of psychotherapy on mental illness, awareness about the treatment is still low. This compromises its uptake.

“Most young people going through depression may not know the importance of psychotherapy. So it will not cross their mind as a solution when they have the condition.”

In addition, health experts state that people are accustomed to taking medicine when they are unwell. So when dealing with a mental health condition, there is a tendency to shun psychotherapy.

“For some, it’s peer pressure. They hear that a friend or relative takes medicine to deal with their depression. So, they will rush for the drugs at nearby chemists without a proper diagnosis from doctors to determine whether they should take them or not,” says Ms Njoroge.

According to her, the family can play a significant role in averting stressful situations and helping young people deal with mental health problems.

“In close-knit families, children find it easy to open up and talk about issues bothering them, before the problem escalates and leads to mental illness.”

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