Do You Need Talk Therapy, Medication, or Both?

The widespread use of safe, effective antidepressants like Prozac has put advocates of traditional psychotherapy on the defensive. Who wants to lie on a couch recounting their dreams at $160 an hour when they can pop a pill and hear birds chirping?

Fortunately the stereotype of talk therapy as a bastion of self-indulgent, unscientific chatter is changing as insurance companies and mental health experts press for more evidence-based treatment. The result, say patients and researchers, is growing proof that all types of talk therapy can be effective, even for patients whose problems are biochemical.

"Drugs and therapy are essential"
Joseph, 55, has been dealing with severe depression for 25 years. In psychotherapy he has learned to predict the chemical shifts in his brain that precipitated his debilitating depressions. Meanwhile, antidepressants have kept him functioning at an even keel between episodes. "For me, drugs and therapy turned out to be essential," he says.

"No compelling data suggests that everyone with depression must have both drug therapy and talk therapy," says William C. Sanderson, PhD, a psychology professor at Hofstra University in Hempstead, N.Y.