Editing Major depressive disorder (section)

===Talking therapies===
{{See also|Behavioral theories of depression}}
[[Talking therapy]] (psychotherapy) can be delivered to individuals, groups, or families by mental health professionals, including psychotherapists, psychiatrists, psychologists, clinical [[social work]]ers, counselors, and psychiatric nurses. A 2012 review found psychotherapy to be better than no treatment but not other treatments.<ref>{{cite journal | vauthors = Khan A, Faucett J, Lichtenberg P, Kirsch I, Brown WA | title = A systematic review of comparative efficacy of treatments and controls for depression | journal = PLOS ONE | volume = 7 | issue = 7 | pages = e41778 | date = 30 July 2012 | pmid = 22860015 | pmc = 3408478 | doi = 10.1371/journal.pone.0041778 | bibcode = 2012PLoSO...741778K | doi-access = free }}</ref> With more complex and chronic forms of depression, a combination of medication and psychotherapy may be used.<ref>{{cite journal | vauthors = Thase ME | title = When are psychotherapy and pharmacotherapy combinations the treatment of choice for major depressive disorder? | journal = The Psychiatric Quarterly | volume = 70 | issue = 4 | pages = 333–46 | year = 1999 | pmid = 10587988 | doi = 10.1023/A:1022042316895 | s2cid = 45091134 }}</ref><ref>{{cite encyclopedia| vauthors = Cordes J |title=Encyclopedia of Sciences and Religions |pages=610–16 |year=2013 |doi=10.1007/978-1-4020-8265-8_301 |chapter=Depression |isbn=978-1-4020-8264-1 }}</ref> There is moderate-quality evidence that psychological therapies are a useful addition to standard antidepressant treatment of [[treatment-resistant depression]] in the short term.<ref>{{cite journal | vauthors = Ijaz S, Davies P, Williams CJ, et al | title = Psychological therapies for treatment-resistant depression in adults | journal = The Cochrane Database of Systematic Reviews | volume = 5 | pages = CD010558 | date = May 2018 | issue = 8 | pmid = 29761488 | pmc = 6494651 | doi = 10.1002/14651858.CD010558.pub2 }}</ref> Psychotherapy has been shown to be effective in older people.<ref>{{cite journal |vauthors=Wilson KC, Mottram PG, Vassilas CA |title=Psychotherapeutic treatments for older depressed people |journal=The Cochrane Database of Systematic Reviews |volume=23 |issue=1 |page=CD004853 |date=January 2008 |pmid=18254062 |doi=10.1002/14651858.CD004853.pub2 }}</ref><ref>{{cite journal |vauthors=Cuijpers P, van Straten A, Smit F |title=Psychological treatment of late-life depression: a meta-analysis of randomized controlled trials |journal=International Journal of Geriatric Psychiatry |volume=21 |issue=12 |pages=1139–49 |date=December 2006 |pmid=16955421 |doi=10.1002/gps.1620 |hdl=1871/16894 |s2cid=14778731 |url=https://research.vu.nl/en/publications/5a654ac9-4dbf-4df9-9d2c-2cbc760d8bc9 }}</ref> Successful psychotherapy appears to reduce the recurrence of depression even after it has been stopped or replaced by occasional booster sessions.

The most-studied form of psychotherapy for depression is CBT, which teaches clients to challenge self-defeating, but enduring ways of thinking (cognitions) and change counter-productive behaviors. CBT can perform as well as antidepressants in people with major depression.<ref>{{cite journal | vauthors = Gartlehner G, Wagner G, Matyas N, et al | title = Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews | journal = BMJ Open | volume = 7 | issue = 6 | pages = e014912 | date = June 2017 | pmid = 28615268 | pmc = 5623437 | doi = 10.1136/bmjopen-2016-014912 }}</ref> CBT has the most research evidence for the treatment of depression in children and adolescents, and CBT and interpersonal psychotherapy (IPT) are preferred therapies for adolescent depression.<ref name=abct>[https://web.archive.org/web/20110726055131/http://www.abct.org/sccap/?m=sPublic&fa=pub_Depression Childhood Depression]. abct.org. Last updated: 30 July 2010</ref> In people under 18, according to the [[National Institute for Health and Clinical Excellence]], medication should be offered only in conjunction with a psychological therapy, such as [[Cognitive behavioral therapy|CBT]], [[Interpersonal psychotherapy|interpersonal therapy]], or [[family therapy]].<ref name=NICEkids5>{{cite book |title=NICE guidelines: Depression in children and adolescents |publisher=NICE |location=London |year=2005 |page=5 |isbn=978-1-84629-074-9 |url=http://www.nice.org.uk/Guidance/CG28/QuickRefGuide/pdf/English |access-date=16 August 2008 |url-status=live |archive-url=https://web.archive.org/web/20080924152314/http://www.nice.org.uk/Guidance/CG28/QuickRefGuide/pdf/English |archive-date=24 September 2008 |author-link=National Institute for Health and Clinical Excellence }}</ref> Several variables predict success for cognitive behavioral therapy in adolescents: higher levels of rational thoughts, less hopelessness, fewer negative thoughts, and fewer cognitive distortions.<ref>{{cite journal | vauthors = Becker SJ |title=Cognitive-Behavioral Therapy for Adolescent Depression: Processes of Cognitive Change |journal=Psychiatric Times|volume=25 |issue=14 |year=2008 |url= http://www.psychiatrictimes.com/depression/article/10168/1357884 }}</ref> CBT is particularly beneficial in preventing relapse.<ref>{{cite journal |vauthors=Almeida AM, Lotufo Neto F |title=[Cognitive-behavioral therapy in prevention of depression relapses and recurrences: a review] |journal=Revista Brasileira de Psiquiatria |volume=25 |issue=4 |pages=239–44 |date=October 2003 |pmid=15328551 |doi=10.1590/S1516-44462003000400011|doi-access=free }}</ref><ref>{{cite journal |vauthors=Paykel ES |title=Cognitive therapy in relapse prevention in depression |journal=The International Journal of Neuropsychopharmacology |volume=10 |issue=1 |pages=131–36 |date=February 2007 |pmid=16787553 |doi=10.1017/S1461145706006912 |doi-access=free }}</ref> Cognitive behavioral therapy and occupational programs (including modification of work activities and assistance) have been shown to be effective in reducing sick days taken by workers with depression.<ref name=Nieuwenhuijsen2020/> Several variants of cognitive behavior therapy have been used in those with depression, the most notable being [[rational emotive behavior therapy]],<ref name="h303">{{cite journal | last1=David | first1=Daniel | last2=Cotet | first2=Carmen | last3=Matu | first3=Silviu | last4=Mogoase | first4=Cristina | last5=Stefan | first5=Simona | title=50 years of rational-emotive and cognitive-behavioral therapy: A systematic review and meta-analysis | journal=Journal of Clinical Psychology | volume=74 | issue=3 | date=2018 | issn=0021-9762 | pmid=28898411 | pmc=5836900 | doi=10.1002/jclp.22514 | doi-access=free | pages=304–318 }}</ref> and [[mindfulness-based cognitive therapy]].<ref name="g399">{{cite book | last1=Salmon | first1=Paul | last2=Loo | first2=Jiann Lin | title=Tasman's Psychiatry | chapter=Mindfulness-Based Cognitive Therapy | publisher=Springer International Publishing | publication-place=Cham | date=2024 | isbn=978-3-030-51365-8 | doi=10.1007/978-3-030-51366-5_75 | pages=3717–3735}}</ref> Mindfulness-based stress reduction programs may reduce depression symptoms.<ref>{{cite journal |vauthors=Khoury B, Lecomte T, Fortin G, et al |title=Mindfulness-based therapy: a comprehensive meta-analysis |journal=Clinical Psychology Review |volume=33 |issue=6 |pages=763–71 |date=August 2013 |pmid=23796855 |doi=10.1016/j.cpr.2013.05.005 }}</ref><ref>{{cite journal |vauthors=Jain FA, Walsh RN, Eisendrath SJ, Christensen S, Rael Cahn B |title=Critical analysis of the efficacy of meditation therapies for acute and subacute phase treatment of depressive disorders: a systematic review |journal=Psychosomatics |volume=56 |issue=2 |pages=140–52 |year=2014 |pmid=25591492 |pmc=4383597 |doi=10.1016/j.psym.2014.10.007 |url=http://www.escholarship.org/uc/item/0372c9xp }}</ref> Mindfulness programs also appear to be a promising intervention in youth.<ref>{{cite journal |vauthors=Simkin DR, Black NB |title=Meditation and mindfulness in clinical practice |journal=Child and Adolescent Psychiatric Clinics of North America |volume=23 |issue=3 |pages=487–534 |date=July 2014 |pmid=24975623 |doi=10.1016/j.chc.2014.03.002 }}</ref> [[Problem solving therapy]], cognitive behavioral therapy, and interpersonal therapy are effective interventions in the elderly.<ref name="Alexopoulos2019" />

[[Psychoanalysis]] is a school of thought, founded by [[Sigmund Freud]], which emphasizes the resolution of [[Unconscious mind|unconscious]] mental conflicts.<ref>{{cite book |vauthors=Dworetzky J |title=Psychology |publisher=Brooks/Cole Pub. Co |location=Pacific Grove, CA|year=1997 |page=602 |isbn=978-0-314-20412-7}}</ref> Psychoanalytic techniques are used by some practitioners to treat clients presenting with major depression.<ref name="o365">{{cite book | last=Kay | first=Jerald | title=Tasman's Psychiatry | chapter=Individual Psychodynamic Psychotherapy | publisher=Springer International Publishing | publication-place=Cham | date=2024 | isbn=978-3-030-51365-8 | doi=10.1007/978-3-030-51366-5_11 | pages=3583–3623}}</ref> A more widely practiced therapy, called [[psychodynamic psychotherapy]], is in the tradition of psychoanalysis but less intensive, meeting once or twice a week. It also tends to focus more on the person's immediate problems, and has an additional social and interpersonal focus.<ref name="o365">{{cite book | last=Kay | first=Jerald | title=Tasman's Psychiatry | chapter=Individual Psychodynamic Psychotherapy | publisher=Springer International Publishing | publication-place=Cham | date=2024 | isbn=978-3-030-51365-8 | doi=10.1007/978-3-030-51366-5_11 | pages=3583–3623}}</ref> In a meta-analysis of three controlled trials of Short Psychodynamic Supportive Psychotherapy, this modification was found to be as effective as medication for mild to moderate depression.<ref>{{cite journal |vauthors=de Maat S, Dekker J, Schoevers R, et al |title=Short psychodynamic supportive psychotherapy, antidepressants, and their combination in the treatment of major depression: a mega-analysis based on three randomized clinical trials |journal=Depression and Anxiety |volume=25 |issue=7 |pages=565–74 |year=2007 |pmid=17557313 |doi=10.1002/da.20305 |s2cid=20373635 |doi-access=free }}</ref>