THE MODERN TREATMENT OF DEPRESSIVE DISORDERS

The pharmacological treatment of depressions offers this immense psychological advantage: the patient maintains his experiential continuity. The amnestic syndrome associated with ECT, to which many attributed therapeutic significance, proves to be quite superfluous as is seen in successful pharmacotherapy. The preservation of experiential continuity has vast implications for psychotherapy. Until now, psychotherapy either followed ECT or had to be limited to patients who seemed capable of affective contact and of self-control over suicidal impulses. With ECT, the patient remains physically and emotionally passive. His recovery comes, as it were, from without. Pharmacotherapy makes him a participating partner. This offers psychotherapy entirely new opportunities to involve the patient in the therapeutic process until recovery is seen as coming from within.

The treatment of depression is once again in transition. If psychiatric history is not to repeat itself, we must realize that the measure of success will depend on our capacity to abandon static positions, to integrate new knowledge and to create comprehensive therapeutic methods.