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FAQ: Can Depression Be Treated Without Medication?

A fellow caregiver asked...

Can depression be treated without medication?

Expert Answer

Kenneth Robbins, M.D., is a senior medical editor of Caring.com. He is board certified in psychiatry and internal medicine, has a master's in public health from the University of Michigan, and is a clinical professor of psychiatry at the University of Wisconsin-Madison. His current clinical practice focuses primarily on geriatrics. He has written and contributed to many articles and is frequently invited to speak on psychiatric topics, such as psychiatry and the law, depression, anxiety, dementia, and suicide risk and prevention.

Yes, with mild and moderate depression, studies show that talk therapy alone, if done properly, is probably equivalent to the successes of antidepressants, and maybe even better. However, with severe depression, because of the risks involved, there's better success with antidepressant medication, ideally in combination with talk therapy.

Although there was a lot of news hype over recent findings that talk therapy alone can be as effective as drugs (and sometimes more effective), what was less reported was the key fact that not all talk therapy is alike. It's not enough to talk to an empathic listener. You have to find someone with the right skill set.

Specifically, successful talk therapy requires working with someone who knows how to use one of the main types of psychotherapy beneficial to people with depression: cognitive behavioral therapy (CBT, psychotherapy that focuses on the role of thinking in what people feel or do) or interpersonal therapy (which focuses on interpersonal relationships).

Other research that shows that, done incorrectly, talk therapy alone can make a case of depression worse. In general, when someone is depressed, therapies that help someone manage the present are more effective than those that spend a lot of time replaying a painful past.