Is Cognitive Behavioral Therapy (CBT) More Effective than Medications for Depression? A Psychiatrist’s Perspective.

I guess it should not take me very long to give you my answer-No; CBT alone is not as effective as Medication Management (antidepressants) plus CBT.

First off, let’s quickly review what CBT is to the patient. This type of therapy is the process whereby a skilled therapist (licensed and properly trained) seeks to help the patient recognize and extinguish his or her “automatic negative thoughts.” You may ask, “Dr.O just what is an automatic negative thought” Let me give you a couple of examples;

  1. 1.       I am ugly!”
  2. 2.       “I hate my job!’
  3. 3.       “Today is the worst day of my life.”
  4. 4.       “She/he really doesn’t like me.”
  5. 5.       “The world is in a recession.”
  6. 6.       “I will never find anybody.’

After a person, continuously feeds their mind with negative propaganda and untruths, that most time are not based in fact; they will began to believe them.  Over time a person will develop the mantra, “I am bad, the world is no good and the future is hopeless.” This can certainly lead into one of the most difficult forms of depression to treat. Therefore “negative thoughts” as well as “negative persons”        must be dealt with immediately. It some of the more extreme cases, patients’ can develop what is called “catastrophic thinking.” This is very bad. This is the thought process where one begins to think that one negative things lead to another, and another, and another.(old fashioned mushrooming)

A skilled therapist will employ various techniques to help the patient extinguish this pattern of behavior. However the most important of these is “Homework.” The therapist has to allow the patient to journal or write down all of his or her automatic negative thoughts. I am an avid believer of this process of therapy and I often have my patients participate in this technique

Now, let’s get back to the basic of medication management. I don’t work for any particular company so I will refrain from suggesting a particular name-brand of medication.  However, I will share with you that most SSRI’s and SNRI’s really work. They medication, based on clinical trials, usually take about 4-6 weeks to work,  However, I have seen many patients improve in about 2-3 weeks.

Finally, the combination of medication management and CBT are certainly effective for the treatment of depression.

There are a couple of medications that I use oftentimes that are effective;  Lexapro, Prozac, Zoloft, Celexa, Wellbutrin, and Pristiq.


Now if the source of your depression, is a bad relationship, why not read my book at for help and education.


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