to explain aggression away by saying you were only joking. There is no
such thing as only joking.
Joking aside, cognitive therapy is a more exhaustive attempt to cate-
gorize, explain, and offer arguments against distorted thinking in depression.
Depressed people engage in typical and recognizable patterns of self-
defeating thought. Based on very little evidence, they quickly conclude
that situations are hopeless, that they are helpless to change them and
therefore worthless.
Cognitive therapists ask depressed people to go back and take a closer
look at the evidence on which they base these negative conclusions. Like
the behaviorists, cognitive therapists often have clients chart the relation-
ship between their thoughts, actions, and mood. The two approaches are
usually combined, and turn out to be extremely effective at helping
depressed people get better and stay better.
INTERPERSONAL THERAPY. Another approach widely used in the treat-
ment of depression is interpersonal therapy. It involves teaching depressed
people more effective strategies for dealing with human problems, like dis-
putes, role transitions, and social skill deficits using standard procedures,
manuals, and lesson plans. The approaches for dealing with loss described
earlier are similar to what an interpersonal therapist might do.
Recent studies show that both cognitive-behavioral therapy and
interpersonal therapy can change the brain scans of depressed people in
a manner quite similar to that achieved by antidepressant medication.
Other studies have shown that these approaches are more effective than
medication in preventing relapses into depression over time.
This is all well and good, but before you tell the depressed people in
your life to throw away their Prozac and get in to see cognitive or inter-
personal therapists, wait. The research is valuable, but the results are not
as simple as they seem.
Most research on the treatment of mental illness involves pitting one
treatment against another and against a control group that gets no treat-
ment at all to see which one works best. But what isbest?
Considering all you’ve learned about the idiosyncracies of the great gray
beast, think of the difficulty of devising a study to measure the effective-
ness of a treatment for depression. First you have to define the disorder,
The Psychology of Depression ❧ 191