Mary Renard wrote: Whatever happened to psychotherapy?  According to *my*
>psychiatrist/therapist who is NOT a pill-pusher, there are numerous studies
>showing that psychotherapy is every bit as effective as antidepressants -
>and IMHO antidepressant medication should be the adjunct to therapy, NOT the
>other way around.  It may take longer but it is more respectful of the
>person and ultimately more effective because it is making changes at a
>deeper level.


I have to jump in here and disagree.  Some people are depressed (or have
other mental health problems) because of difficult situations in their life,
or in their past, that they are not coping well with.  For them, fixing the
stressful/depressing situations makes more sense than either psychotherapy
or drugs.  For situations that can't be helped -- like coping with the death
of a loved one, or a chronic illness or handicap in a loved one, etc., then
psychotherapy (or even a support group of people facing the same situation)
may be the best solution.  But there are plenty of people out there who are
"mentally ill" according to current understanding/definitions because of
abnormal brain chemistry, which may be traced to genes, early illness, or
any number of things.

All the psychotherapy in the world will not help my sister with bipolar
disorder as long as her brain chemicals are screwed up.  Bipolar disorder
(manic-depression) has been linked to genetic predispositions, and once
finally diagnosed when she was in her 30s, it was clear she'd been showing
symptoms since high school.  After many years of ineffective psychotherapy,
she showed amazing improvement on Lithium.

The discovery that many mental illnesses are the result of abnormal brain
chemistry, and that many of these can be dramatically helped (though
obviously not permanently *cured*) by medications, is one of the greatest
discoveries of 20th century medicine, IMHO.  By no means should people be
given medication if what they really need is psychotherapy (or a support
group).  On the other hand, people who need medication to restore normal
levels of brain chemicals should not be sent instead to a psychotherapist
who "doesn't believe in drugs" and who charges them tons of money to talk
about their childhood, and doesn't ever help them!

Climbing off a soapbox I never before realized I had handy.....

Katherine A. Dettwyler, Ph.D.
Associate Professor
Department of Anthropology
Texas A&M University