Irving Kirsch
Irving Kirsch
Irving Kirschis Associate Director of the Program in Placebo Studies and a lecturer in medicine at the Harvard Medical School and Beth Israel Deaconess Medical Center. He is also professor emeritus of psychology at the Universities of Hull and Plymouth in the United Kingdom, and the University of Connecticut in the United States. Kirsch is noted for his research on placebo effects, antidepressants, expectancy, and hypnosis. He is the originator of response expectancy theory, and his analyses of clinical trials...
NationalityAmerican
ProfessionEducator
Date of Birth7 March 1943
CountryUnited States of America
Depression is a serious problem, but drugs are not the answer. In the long run, psychotherapy is both cheaper and more effective, even for very serious levels of depression. Physical exercise and self-help books based on CBT can also be useful, either alone or in combination with therapy. Reducing social and economic inequality would also reduce the incidence of depression.
Antidepressants can have troubling side effects and are addictive for some people.
Depression comes back over time in about 90 percent of people on antidepressants. Studies show that relapses are far less common when people are treated with psychotherapy.
I do a lot of research on the placebo effect, not just in depression but in irritable bowel syndrome, pain, arthritis of the knee, migraine, asthma.
There are a variety of techniques to help people change the kind of thinking that leads them to become depressed. These techniques are called cognitive behavioral therapy.
The doctor-patient relationship is critical to the placebo effect.
Anything that instills a sense of hope will at least temporarily help treat depression.
Psychotherapy works, and some types of therapy have been shown to be much more effective than antidepressants over the long run.
Depression is not caused by a chemical imbalance in the brain, and it is not cured by medication. Depression may not even be an illness at all. Often, it can be a normal reaction to abnormal situations. Poverty, unemployment, and the loss of loved ones can make people depressed, and these social and situational causes of depression cannot be changed by drugs.
Perhaps anti-depressants should be best reserved for the very extreme cases and, more importantly, for those who do not respond to alternative forms of interventions.
There seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients.
One problem I have with drug companies is that they don't make all their data public.
If doctors just spent more time with their patients so they felt more reassured, that might help.
If you're taking an antidepressant, it's working, and you're not experiencing side effects, go on taking it. But if it's not working, or not working well enough, or if you have side effects you don't like, talk to your doctor about an alternative approach.