Should I seek therapy or medication for OCD treatment?
Did you know that good OCD treatment is just as likely to include cognitive-behavioral therapy as medication?
The National Institute for Health and Clinical Excellence in the UK recommends that adults with mild to moderate symptoms of OCD be offered either cognitive-behavioral therapy or an antidepressant medication (SSRI). The recommendation for adults with severe symptoms is that they undertake both treatments.
This is because both options are safe and effective, and perform similarly to in research studies. Some people prefer to not use medication in their OCD treatment, and some prefer to use it; both options are realistic for most people.
National Institute for Health and Clinical Excellence. (2006). Obsessive-compulsive disorder. London: British Psychological Society and the Royal College of Psychiatrists.
A stem cell transplant (SCT) or bone marrow transplant (BMT) is a procedure oncologists use in the treatment of lymphoma, leukemia, and some other cancers and disorders of the blood. These procedures are also referred to as hematopoietic stem cell transplants (HSCT). While this procedure has existed for decades, it came into more common use in the early 1990’s. The effectiveness of transplant varies according to the diagnosis, age, and health of the recipient. The present article aims to give general information about the experience of transplant and the emotional challenges during recovery after bone marrow transplant.
A recent study in the Archives of General Psychiatry examined the relationship between our thoughts and our mood. In the July 2006 issue, Zindel Segal and colleagues from the University of Toronto and the Centre for Addiction and Mental Health in Toronto write about a study they conducted on people with a history of recurrent depression. Their results showed that for those with recurrent depression but who are currently not depressed, the more a sad mood influences their thought patterns, the more vulnerable they will be to further depression.
An Impact of Cognitive-Behavioral Therapy
Participants in this research study were randomly assigned to receive either antidepressive medication or cognitive-behavioral therapy. One interesting result the study’s authors found was that those participants receiving the cognitive-behavioral therapy had less “cognitive reactivity” to sad mood than those participants who received medication. This means that for those people receiving the cognitive-behavioral therapy, their thoughts were less influenced by a sad mood than was the case for those who received the antidepressant treatment.
CBT vs Antidepressant Medication
It is generally accepted that cognitive-behavioral therapy or antidepressant medication, or both, are effective treatments for depression. However, the choice between these two treatment options can be difficult for many people. Often it comes down to personal preference. Some people are reluctant to go on medications for various reasons. Others are reluctant to enter psychotherapy. Research has shown both types of treatment to be effective for depression, and can help people struggling with depression to create some positive changes in their lives.
The above-mentioned study found an interesting difference between these two treatments: people who received antidepressant medication experienced greater changes in their depressive thoughts than those who had received the cognitive-behavioral therapy.
Thoughts Affect Mood
This is a relevant finding because we know that depressive thought content is very relevant to depressed mood. Thoughts can make depression worse. For example, if someone is often having thoughts like “I’m a bad person” or “I’m no good at anything” or “Something is bound to go wrong today,” these thoughts will quite likely have an eventual effect on the person’s mood. This effect can be greater or lesser depending on the exact content of the thoughts, and other factors.
One of these “other factors” involves the beliefs or self-image that underlie the negative thoughts. In CBT, a therapist will sometimes explore these beliefs using various techniques such as the downward arrow technique. The goal of such techniques is to make the relevant aspects of self-image apparent to both therapist and client, so they can be discussed directly.
Mood can also affect thinking
If a brief sad mood effects your thought patterns significantly, you may be more likely to experience a relapse of depression. This is especially true if you have a history of depression.
An Insight Into How CBT Works
This study suggests that those participants who received the cognitive-behavioral therapy were more resistant to negative changes in their thought patterns. While the study did not investigate why people in cognitive-behavioral therapy fared better in this way, it does make some intuitive sense. Cognitive-behavioral therapy teaches how to recognize and rationally evaluate thoughts that may be contributing to depression (or anxiety). It may be that the people who received cognitive-behavioral therapy were better able to recognize early changes in thought patterns, and prevented those changes from becoming more pronounced by taking a more balanced perspective on the depressive thoughts.
A study conducted by my former lab at Massachusetts General Hospital recently examined the effects of regular meditation practice on the structure of the brain.
The study showed that, among other results, the thickness of particular areas of the cerebral cortex was different for regular meditators than it was for an age-matched comparison group. Additionally, the study showed that this effect was more pronounced in the older meditators studied than it was in the young ones. This may be interpreted as suggesting meditation slows natural aging processes in certain parts of the brain. While more research is certainly needed to corroborate these findings, they are very intriguing. This study was led by Dr. Sara Lazar, and investigated a type of meditation called Insight meditation, a form of Buddhist spiritual practice that is practiced in Myanmar and Thailand. Mindfulness meditation is derived from this tradition.