An estimated 14 percent of Americans will experience a serious bout of depression during their lifetime, and 20 percent will experience an anxiety disorder. The ubiquitous advertisements for anti-depressant drugs suggest that pills are the only answer—and that they work for everyone. Neither is really true, but you don't have to take our word for it: We surveyed more than 1,500 respondents to Consumer Reports' 2009 Annual Questionnaire who had sought professional help for depression, anxiety, or both.
Our results provide a window onto mental-health treatment as it's practiced in the real world, as opposed to the carefully controlled environment of clinical trials of psychiatric drugs.
Among our key findings:
Respondents to our survey who stuck with talk therapy for just a little while—at least seven sessions—reported as much improvement as those who only took medication (though people who did both fared even better).
People who took medications from the SSRI class of antidepressants—which includes citalopram (Celexa), fluoxetine (Prozac), sertraline (Zoloft), and their generic equivalents—reported lower rates of side effects than those taking SNRIs, a newer, often more expensive class of antidepressants that includes venlafaxine (Effexor and generic) and duloxetine (Cymbalta). Yet patients found SSRI treatment at least as helpful.
Of readers who sought help for a mental-health difficulty, 58 percent had experienced anxiety, up from 41 percent in our previous mental-health survey, in 2004. Most drugs currently used to treat depression also work for anxiety, a boon for the many people who experience the two problems simultaneously.
As in our previous survey, rates of reported side effects among people taking antidepressants were higher than those reported in studies funded by drug companies. But rates for the most common side effect, loss of sexual interest or ability, were substantially lower among people taking the drugs than the last time we surveyed. (We'll get into why that might be later.)
Psychologists (Ph.D.s), social workers (M.S.W.s), and licensed professional counselors (L.P.C.s) received equal helpfulness ratings from those who had talk therapy.
Our survey sample consisted of subscribers to Consumer Reports who had sought help for depression, anxiety, or another mental-health problem between January 2006 and April 2009. This report focuses primarily on the 1,544 respondents who experienced depression only (30 percent of the total), anxiety only (18 percent), or anxiety and depression at the same time (52 percent). They're not necessarily representative of the general U.S. population. Their average age was 58, and 55 percent were male.