| What do we mean by "seek help"? Currently, we have two gold standard treatments, SSRI drugs and Cognitive Behavioural Therapy. SSRI drugs probably sort of work a bit, depending on how much weight you place on non-publication bias. The most flattering data suggests that SSRIs beat placebo by about 30%, meaning that over 75% of the effect of SSRIs is accounted for by placebo - the patient's own beliefs about the efficacy of the treatment. Cognitive Behavioural Therapy is based upon the idea that a patient can learn to think differently about daily events and their emotional responses to them, and in doing so improve their overall mood and reduce specific symptoms of psychological distress. The entire basis for CBT is the idea that people control their own moods through cognition, with the goal of making the patient self-sufficient in managing their mood. The notion that only clinical intervention can improve depressive symptoms directly contradicts the most effective treatment for depression. In the best case, either of these treatments is only marginally more efficacious than arbitrary interventions that generally improve wellbeing - exercise, better diet, mindfulness practice etc. There is simply no scientific basis for arguing that depression can only be alleviated through clinical intervention. Study after study has shown (though rarely highlighted in the abstract) that placebo is an incredibly powerful treatment for depression, to the extent that basically anything is a good treatment so log as the patient believes in it. The belief that clinical intervention is the only way to improve depressive symptoms is at best inaccurate and baseless, at worst actively harmful. It is an irrational and essentially depressive belief and propagating it runs counter to all our interests. http://ccdan.cochrane.org/ |
Starting someone on a course of CBT (whether applied by a skilled practitioner, or self guided[1]) and then pushing them to exercise and to social life improvement, with meds if needed, is an excellent treatment.