Psychotherapy explained

Over the next few days we will explore the different therapeutic modalities for treating anxiety and depression. In the past depressive and anxiety disorders were considered distinct clinical entities. That is, anxiety and depression were not related conditions. In the last decade however, brain studies and the fact that many drugs work to treat both depression and anxiety have led the field of psychiatry reconsider that position. Today it is considered that depression and anxiety are related medical conditions.

We begin by exploring the oldest type of intervention for the treatment of depression and anxiety: psychotherapy. The essence of psychotherapy (talk therapy as some call it) is to explore a person’s thought and behavior patterns so that a person can make changes that will help him feel better.

There are different types of psychotherapies. Each is practiced according to the philosophy of the person giving treatment. Psychoanalysis explores the experiences of the person, seeking the meanings of these experiences and how they affect the person. The idea is that if a person becomes aware of the effects past events have had on him that person may change their personal patterns of meaning and behavior. And in that way the person can change his life. There are other similar therapies are usually referred to as introspective therapies. They all have in common that the person explores personal symbols and personal meanings. By becoming more aware of them the person can modify the effects of these influences in his life and feel better. The person generally tries to change to a healthier personality.

The other commonly practiced type of psychotherapy is cognitive-behavioral therapy. This type of therapy does not focus much on the meanings of events in the life of the person. It is intended that a person changes his thought patterns and behavior to healthier ones and this will achieve symptom relief. This kind of therapy is considered more focused and tends to be shorter than introspective therapy. Many people with neuropsychiatric conditions have distortions of perceptions and interpretations of their events. These so called cognitive distortions are corrected so that the person can see more clearly the reality and behave in healthier ways.

In recent times there is an emergence of different types of spiritual therapies. The approach is to seek a transcendental element in the person's belief system to help him better manage his personal situations. It focuses on a person’s frame of reference so that events can be put in perspective. This allows a person to better manage his personal reality and manage his situations with greater peace.

Another type of therapy is hypnosis, which I will discuss in the near future.

The ultimate goal of the various psychotherapies is to change the brain of a person so he feels relief from his symptoms. Studies comparing medication alone versus psychotherapy alone in people with mild depression found that both treatments cause similar changes in the brains of people who responded to therapy. This suggests that medication and psychotherapy work similarly in the brain.

For most neuropsychiatric conditions it is recommended to combine psychotherapy and medication. Each of these therapies has its advantages. In general, the medications work more quickly, with relief staring about one or two weeks from the beginning of therapy. But their effect often goes after discontinuing the drug. Psychotherapy usually takes longer to bring relief. Many studies suggest that a person usually needs about eight treatments for relief of symptoms. But the psychotherapies have the advantage that a person learns life skills that may continue to apply long after completing a course of psychotherapy. Hence the current recommendation by most experts is to start medications for prompt symptom relief and combine it with psychotherapy for the person to acquire personal skills for improvement. And of course every psychiatrist and patient has a preference on which method or therapeutic combination is best.

The information in this blog is not a substitute for a medical evaluation. Consult with your physician about any health concerns you have.

For appointments with Dr. Douglas J. Romero call 787-764-5642 or visit www.mimejoramiento.com

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