Watching: TAKE ONE STEP: Caring for Depression, with Jane Pauley
Chapter 3: Drugs, Therapy, and Giving Support [7:21]
What are the risks of going off drugs? Does talk therapy alone work? Helping others can help lighten the load of depression.
Transcript: Chapter 3 - Drugs, Therapy, and Giving Support
JANE PAULEY: What about the efficacy of talk therapy alone? And it does, you can see that it's having an effect in this young man's life. But talk therapy alone, without medication, is there any way to differentiate between the success rates?
DR. DENNIS CHARNEY: There is evidence for sure that certain forms of talk therapy, like cognitive behavioral therapy and interpersonal psychotherapy, and a couple of others, definitely work, without medicine. So there are lots of patients who are gonna respond very well to talk therapy and will not need medicine.
JANE PAULEY: When you say 'work' we're not just talking about, you know, subjective, "Oh look - he looks like he's-- he's doing great now. It must be working." But you can-- Science now can see that at the brain level, change was accomplished in the course of this cognitive [simultaneous conversation]--
DR. DENNIS CHARNEY: That's true. Because we can now image the brain. There have been studies that have shown that if you compare the brain before talk therapy and after talk therapy, there have been changes in the areas of the brain that seem to involve depression. What's also interesting, though, is that medicine affects the brain too, but in certain other areas. So it may be that for patients with a particularly difficult form of depression, that the combination of talk therapy and medicine is gonna work particularly well. And, you know, that's a common treatment that those of us who see a lot of depressed patients recommend.
JANE PAULEY: Someone told me once that it's the person who is in flaming crisis, you know, whose life is such a mess that it's an emergency, clear to one and all, this person is gonna get help. This is the lucky one because he will get help. In contrast, the person who is suffering a low grade depression, dysthymia, which is what Terrie Williams suffered. Which is just lasts so long, it becomes--- you think it's just you.
DR. ANNELLE PRIMM: Yes. It has many of the same symptoms as depression, but perhaps on a lower level. But it lasts for a long period of time. And you don't see the same sort of episodes that you might see in depression. But still, very much debilitating, having a huge impact on the person's life and their motivation. And I think Terrie really illustrates the fact that getting a diagnosis really relieved her, that, you know, this wasn't something wrong with her, but really an illness that could help explain all that she was going through.
JANE PAULEY: And she has a relationship with Jiwe-- It's a two-way thing that deserves to be isolated and examined. The young man reached out. He reached out for help to a woman he had heard about.
DR. ANNELLE PRIMM: Correct.
JANE PAULEY: He recognized that a stranger could give him important support. And she reached back and helped him. Altruism, which is helping others, is referred to over and over in this documentary. But just on that example, her helping him makes her better. Is that possible?
DR. ANNELLE PRIMM: Yes, that's possible. And we find that very commonly that it really helps to sort of feed and nurture resilience. When you're able to help others, it makes you feel better. And there were other instances in the documentary. I think Philip described the same sort of thing. He started helping others. But that's really akin... I think really all of the people in this documentary, by speaking out publicly about this, are helping others, too, in reaching millions.
JANE PAULEY: But a point I think is worth making is that, you don't need to come out, you know? You don't need to walk into your office one day and say, "I'm in treatment for depression." That's not necessary. But telling one person is more than just kind of liberating. It gets your brain in a new place that says, "I know I have something and I'm working on it." And that is therapeutic?
DR. DENNIS CHARNEY: Well, sure. And also, when you're in, say, a support group, which I find very important for my patients, you're gonna learn things from the other people in the support group. You're gonna not necessarily do everything one individual does, but you'll pick up a clue from one person, then another clue from another individual. They'll tell you how they got out of a particular episode by doing something. So that information is going to help you in the long-run as you face challenges down the road.