In the United States our mental health care system is dominated by the pharmaceutical companies marketing machine. A surprising and unfortunate ignorance exists in our culture regarding evidence based care. For some, the ethical and evidence-based treatment of common mental health struggles, such as depression, is nothing more than a buzz word. Anti-depressant medication is prescribed at an alarming rate with expectations beyond what the drug has ever been scientifically supported to achieve. The  more our medical community, specifically the American Psychiatric Association, become aligned with the pharmaceutical industry, the greater the likelihood of patient abuse and substandard care. Psychosocial interventions, which should be the first line of treatment for many mild to moderate symptom presentations, are largely being ignored by many in the medical community. Evidence-based psychotherapy is neither adhered to, nor supported, by a large percentage of academics and practitioners, ignoring the tremendous amount of data supporting  established treatment protocols for many common presenting disorders. Included in this blog is a TED talk on publication bias as well as a 2008 article in the New England Journal of Medicine reporting the data on Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy.  In addition, I direct you to the United Kingdom’s National Institute for Clinical Excellence to read their treatment recommendations for Depression. The clinical guidelines for the treatment of depression specifically state:

Do not use antidepressants routinely to treat persistent subthreshold depressive symptoms or mild depression because the risk–benefit ratio is poor, but consider them for people with: a past history of moderate or severe depression or initial presentation of subthreshold depressive symptoms that have been present for a long period (typically at least 2 years) or subthreshold depressive symptoms or mild depression that persist(s) after other interventions. Cognitive Behavioral Therapy continues to represent the established front line treatment for mild to moderate depression and anxiety disorders, the most common symptoms presented to practitioners. Even those presenting with a severe depressive episode medication should be prescribed in conjunction with CBT. Please check out the following resources: