Depression

Previously depressed people are an untapped resource for fighting depression

By Jonathan Rottenberg, Ph.D.
Created Feb 28 2011 – 2:24am

When you think of treatments for depression, the first things to jump to mind are medications like Prozac prescribed by a doctor, or talk therapies like cognitive-behavioral therapy, administered by a clinical psychologist. While these treatments help many depressed people, they are relatively expensive to administer and they do not reach a huge segment of the one-fifth of the population that suffers from this problem.

By Jonathan Rottenberg, Ph.D.
Created Feb 28 2011 – 2:24am

When you think of treatments for depression, the first things to jump to mind are medications like Prozac prescribed by a doctor, or talk therapies like cognitive-behavioral therapy, administered by a clinical psychologist. While these treatments help many depressed people, they are relatively expensive to administer and they do not reach a huge segment of the one-fifth of the population that suffers from this problem.

If we are ever to reverse what’s become a losing battle against depression, it’s likely that the usual paradigm of care will need to rely much less on therapies that are delivered one-on-one by a highly trained expert.

We need alternatives that might be less costly, more easily administred to large numbers of people, and not as reliant on highly trained experts.

In this connection, the results of a recently published quantitative review of peer support interventions for depression are big news. Peer support interventions rely on the support of a previously depressed person (the peer) to provide support and guidance to a currently depressed person. The peer support could take a variety of forms; it could be one-on-one or in a group setting, in person or over the telephone.

Paul Pfieffer and his colleagues reviewed 14 studies, involving 1,170 participants. They compared how much depressive symptoms went down with peer support when peer support was compared either to usual care alone (seven studies, 869 participants), or to cognitive behavioral therapy delivered in a group format (seven studies, 301 participants).

As shown in the figure below, peer support interventions decreased symptoms of depression more than usual care alone, and depressed depression as much as group cognitive behavioral therapy (CBT).

The review leaves open why peer support is so helpful in reducing depression. Several reasons may be in play. One that makes good sense is that the support or advice of people who’ve been through the torment of depression themselves has unique credibility to a person who’s currently suffering from depression.

The obvious headline here is the tremendous potential for peer support to make a big difference. Given how many millions of people have survived and sometimes thrived after depression, the previously depressed are a huge resource, mostly untapped, for turning the tide against depression. Although the focus in these studies was on the benefits of the peer to the person seeking support, I suspect that a previously depressed person who supports a currently depressed person also benefits. If this is true, it’s hard to imagine a clearer win-win scenario for depressed people. If you’ve suffered from depression and are now doing well, there’s something you can do: I’d encourage you to seek out resources in your community concerning possible opportunities for peer support for depression.

Reference

Paul N. Pfeiffer, Michele Heisler, John D. Piette, Mary A.M. Rogers, Marcia Valenstein (2011). Efficacy of peer support interventions for depression: a meta-analysis, General Hospital Psychiatry, 33, 29-36.

Link to study

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