As a psychologist in private practice, I see a lot of clients who are depressed. They often ask about Cognitive Therapy and Depression. Many are on medications and would like to get off them. Some wonder if medications would help their depression. Since I am not a medical doctor I never make specific recommendations. However, a recent article in The National Psychologist suggests that the vast majority of prescriptions for psychotropic medications are written by primary care physicians and without a thorough diagnostic evaluation. It further states that this prescribing of psychotropic medication is usually the first line treatment in caring for patients with psychiatric symptoms whether they need it or not.
In my experience most patients can be effectively treated for anxiety and depression by working on their underlying causes, which in most cases is psychological and not biological. There is ample empirical evidence as to the success and effectiveness of cognitive-behavioral therapy, rational-emotive behavioral therapy and related approaches.
In cases of extreme depression and/or anxiety, adding medication to the therapy seems to provide increased effectiveness based on research studies. Even in these cases, I have often found clients willing to learn and use the tools of CBT and REBT can get better or get off medications they are currently on.
When clients NEED medication, I prefer they be evaluated and monitored by a psychiatrist rather than the primary care physician and I do my best to talk with that health care provider to coordinate treatment.
So, my take on Cognitive Therapy and Medication is that if a client is already on medication, I give them cognitive therapy and as the depression is alleviated, in conjunction with their medical doctor, gradually wean them off of the medication. For clients who have received 10-20 sessions of cognitive therapy and have not substantially reduced their depression, then we discuss adding medication to the mix. The exception to this is clients who are very depressed and/or having suicidal thoughts. Here, the combination of cognitive therapy and medication makes the most sense.