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Talk-talk is better than pill-pill

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For some reason, anxiety has become one of the most common medical problems of our age. It seems to have overtaken depression. One explanation is that people are less judgmental if you admit anxiety. There is considerable prejudice and some discrimination against people suffering with a depressive disorder. It's considered only one step away from madness and insanity which justifies locking up those affected in a hospital or institution - the public safety argument is that these people are a danger to themselves and others. The reaction of family, friends and employers is the unsympathetic view that depression is a sign of weakness, that with a little effort, people can snap out of their despair and turn their lives around. But we have all experienced some anxiety at some point in our lives and so are more accepting. It's strange that a change of label can make such a big difference. In many cases, there is nothing to choose between anxiety and depression, i.e. the depressed are often anxious and the anxious get depressed. But society feels less threatened by anxiety and is prepared to be more caring and supportive.


The results of a clinical trial in the north of England have just been published. It involved almost 4,000 patients with anxiety and depression. They were referred to a stepped program of psychological counseling. The majority received low level cognitive behavioral therapy (CBT) delivered over the telephone. Their progress was carefully monitored and those who did not respond well were referred to higher levels of CBT on a face-to-face basis. Over a twelve month period, the participants each received counseling lasting an average of 2 hours 45 minutes. The results show that 75% were either in remission or recovery. This is yet another piece of scientific research confirming psychological therapy to be the most effective way to treat anxiety disorders and depression. What is particularly interesting about this latest English study is that about two-thirds of those who improved only received therapy by telephone. Even a disembodied voice offering comfort and advice delivers effective treatment. As a result of this latest research, some 75,000 patients have now been enrolled in a national program of telephone therapy. The initial results are promising.


Now is the moment when we all put our prejudices aside. Yes, the British have socialized medicine and are treated by Stalinist-trained doctors, but this research is not unique to Britain. There is a rising tide a evidence to show talk-talk is better than a drug-based approach. The reason is not hard to find. People can self-medicate. They go online to buy xanax, the most advertized and so most popular of all the drugs used to treat anxiety. There is no need to produce a prescription. This cuts down the cost to a minimum. No hassles with the health insurance company in arguing whether psychological therapy is accepted, no co-payments and hospital bills. Just a few minutes online brings welcome relief a few days later. But there are just as many clinical trials showing xanax and the other drugs work best over the short term. People must either talk themselves better or get help. Therapy brings lasting cures. If the British are correct in finding telephone delivery just as effective as expensive face-to-face sessions for the majority suffering with anxiety disorders, we should be looking for this service in the US.

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