Depressed? Here's an Idea...

If you think you have major depressive disorder, I would recommend using a cognitive approach to therapy.  Cognitive therapy, heavily influenced by Aaron Beck, seeks to change the patient’s way of thinking about themselves and their situation.  This type of therapy assumes that our thinking impacts our feelings and that by changing our thinking we can change our feelings for the better.  Depressed people often interpret normal or even positive events as being destructive.  For example, if a depressed person gets a date, he/she will most likely rationalize it as a ‘pity date.’  This not only causes an extreme lack of confidence, but also continues the viscous cycle of depression.

            Cognitive therapists use methods to help people to think in more positive ways.  By asking gentle questions a therapist can guide a patient’s thoughts to be more positive and constructive.  Other methods include stress inoculation training, proposed by Donald Meichenbaum.  This method can be used to teach depressed people to relax when thinking negatively about a current or upcoming situation. 

            I believe that cognitive therapy is the best for major depressive disorder as opposed to psychoanalytic, client-centered, behavior, or biomedical therapies.  Psychoanalysis will try to find a root cause of the depression, and not focus on the current problem. It has the tendency to ignore conscious thought, which is very important in depression.  Client-centered therapy is similar to cognitive therapy, but it does little to fix the problem.  In client-centered therapy, the therapist is basically a kind, comforting mirror.  The therapist will do nothing to shape the thoughts of the client, causing therapy to last longer than needed and not go directly to the problem.  Behavior therapists are on the other extreme: they ignore the thoughts of the client and focus solely on the client’s behaviors.  Behavior therapists will try to change the client’s behavior without changing the cause of depression: the thoughts.  Another good thing about cognitive therapy is that it doesn’t rely on medicines and chemical treatments, which can have potentially damaging side effects.  I would save the biomedical approach as a last resort, only if all else fails.  Yes, drugs might help, but if the patient becomes reliant on them and they have bad side effects, it is not worth it.  Anti-depressant drugs don’t change the attitudes or thoughts of the client, only the chemicals in the body.

If you have OCD...

If one of my family members is diagnosed with obsessive compulsive disorder (OCD), I would recommend they seek behavior therapy.  Behavior therapy assumes that the anxiety problems are out of conscious control of the client.  Behaviorists claim that the behaviors are the problem, not the thoughts.  They would explain OCD is caused by a bad case of conditioning out of the client’s control.  Behaviorists would seek to fix the obsessive and damaging behaviors (or thoughts) by counter conditioning, which uses classical conditioning to reverse the bad responses.  Depending on the situation, operant conditioning may be used to shape behaviors more within conscious control.  This can include use of a token economy, which is when the client earns a reward for performing the correct behavior (in this case, NOT showing obsessive actions). 

            Behavior therapy is the best choice because it goes straight to the problem of OCD.  It hopes to break the cycle of reinforcement that occurs when a client performs the obsessive behavior, and anxiety goes away.  This therapy is much more effective than psychoanalysis, because again, psychoanalysis tries to look into the past for the cause, as opposed the current situation.  Psychoanalysis would ignore the preexisting case of conditioning as the problem.  Often times the patient is aware of his/her own OCD, and knows it is a problem.  Talking about it in client-centered therapy will probably have little effect on ending the obsessive behaviors (which is the goal).  Cognitive therapists will try to change the thoughts towards the obsessive behavior, but will not directly affect the obsessive reinforcement cycle currently in place.  Biomedical therapy again could be a last resort, but this again seems contradictory.  If given medicine, the client is simply replacing the obsessive behaviors with drugs.  Behavior therapy can cause lasting change and elimination of obsessive thoughts or actions.