Depression: Psychodynamic Psychotherapy

This is an interesting form of therapy, which has undergone a lot of changes in recent decades, as some schools of thought within the field have moved away from Freud’s legacy. This type of therapy is longer-term and often multiple times per week. The aim of psychoanalysis is to help a person understand their unconscious processes and beliefs, so that, once brought to the surface, they can be addressed and ultimately released. The idea is that psychoanalysis can help treat depression in a getting-to-the-roots sort of way, since for many people, depression is caused by long-held and often unconscious ideas we have about ourselves and others, and about workings of the world in general. Often these are formed through bad family dynamics and traumas early on.

“For people who may have more historical, unresolved trauma in their lives that cause depression, psychoanalysis improves insight and reduces conflicts,” says Serani. “A way to think about psychoanalysis is, bringing insight and understanding to your life story reduces depression. When I work with patients, part of my assessment at the consultation is to understand the origin of depressive symptoms. I’m trained in both CBT and Psychoanalysis, so I offer these treatments based on the unique needs of a patient.”

Though historically studies addressing the efficacy of psychoanalysis have been sparser than the behavioral methods, several studies have supported its use in mental health disorders including depression, particularly over the long term. One study a couple of years ago found that although it didn’t have much benefit over “usual care” (cognitive-behavioral therapies) in the short term (that is, at the end of the 18-month period over which treatments were given), it sure did in the long-term. As time passed, psychoanalysis became much more effective than usual care, whose efficacy fell off relatively rapidly.

At least one brain study has supported the use of psychodynamic therapy in treating depression, finding changes in brain regions that are known to be affected in depression (like the mPFC mentioned earlier, and others). Again, the form of therapy that works best for you may not be clear right away, and many people are not aware that there are many forms. Below are some additional methods that are worth researching.