English: Leonard Cohen (Photo credit: Wikipedia)

“I speak of a clinical depression that is the background of your entire life, a background of anguish and anxiety, a sense that nothing goes well, that pleasure is unavailable and all your strategies collapse.” …Leonard Cohen

Holidays and depression

This is the time of year when many people feel sad or depressed. They look around and see other family members, neighbors, co-workers, and classmates who all seem to be getting into the holiday spirit…, but for those who feel depressed during the holiday season their memories of holidays past may just add to their sadness.

We all have different life experiences and we view the holidays through our own lens. Recently a friend mentioned that her parents always kept Christmas simple; no more than one or two gifts per child and a Christmas tree that usually resembled something out of A Charlie Brown’s Christmas. At the same time this friend had a close neighbor whose home sparkled like a window display at Macy’s, with a perfect tree and the gifts spilling from under the tree covering a large section of living room floor. Each celebrated Christmas and the truth is both experienced some joy and some family heartache through their own personal lens.

Whether you celebrate Christmas, Hanukkah, Kwanzaa or not, this season can be very difficult for people diagnosed with clinical depression.

New study compares depression treatment…

Typically if a person feels they are suffering from depression or their primary care physician determines a diagnosis of depression a first option is to seek or offer a prescription for an antidepressant. But what occurs if the antidepressant does not help the patient?

This week a new study was published on-line in The Lancet: Cognitive behavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment resistant depression: results of the CoBalT randomised controlled trial. 

This study is considered the first large-scale trial to examine cognitive behavioral therapy (CBT) effectiveness when used with patients who were already taking antidepressants. Here is an overview of how the study proceeded:

• 469 people were recruited who experienced treatment-resistant depression
• Age ranges were 18 – 75
• Half of the people received CBT while continuing taking their antidepressants, the other half continued their usual care
• Each participant’s progress was reviewed again at six months and 12 months

The researchers report the following findings:

•  46% who received CBT in addition to their antidepressants improved
• 50% of this group reported a reduction of their depression symptoms at the six month point
• Only 22% of those who continued their usual care showed benefits, with these benefits lasting for 12 months

These findings are important as the World Health Organization estimates that 300 million people worldwide are affected by depression. In a press release, the study’s lead author Dr. Nicola Wiles (Senior Lecturer in the University of Bristol’s School of Social and Community Medicine) states: “In many countries, access to psychological treatments such as CBT is limited to people who can afford to pay, or those with health insurance. These findings emphasise the importance of increasing the availability of psychological therapy. While there have been initiatives to increase access to such treatments in both the UK and Australia, worldwide initiatives are rare, and even in the UK many people who have not responded to antidepressants do not get psychological treatment. Our study suggests that by investing in psychological services it is possible to reduce the significant burden to patients and healthcare systems that is associated with non-response to antidepressant medication.” 

Cottonwood Tucson offers CBT

Here at Cottonwood Tucson our staff cares for many patients and offers cognitive behavioral therapy (CBT) when treating anxiety disorders, trauma and post-traumatic stress disorder (PTSD), and depression. We consider CBT to be an important component of our comprehensive holistic behavioral health care.

Sharing Leonard Cohen’s “Hallelujah”

We opened today’s post with a quote from the singer-songwriter Leonard Cohen. If you are familiar with Mr. Cohen’s music, then undoubtedly you have heard his masterpiece “Hallelujah.” You might also know that Cohen admits to suffering most of his life from depression and many of his songs reference depression and suicide. “Hallelujah” was originally released in 1984 and it is reported that he wrote 80 draft verses while composing this beautiful song. Last week Alan Light published his book The Holy or the Broken: Leonard Cohen, Jeff Buckley & The Unlikely Ascent of “Hallelujah”.  People of all faiths and cultures love this song, using it at weddings and funerals, in movies and television shows, and in religious services.

In keeping with the holiday spirit and thinking of those who may be suffering from sadness and depression, we would like to share a video of Leonard Cohen performing “Hallelujah.”

If you are having trouble viewing the video, you can watch it here.

As always, we welcome your comments.

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