Antidepressants,Psychotherapy or their Combination: Weighing Options for Depression Treatments

Psychotherapy and antidepressant medications are the two preeminent treatment choices for depression. This article puts each of these treatments into perspective by presenting an overview of what is currently known about their effectiveness either singly or in combination. Discussion of placebos, common factors among therapies, relapse rates, depression severity, patient treatment preferences and exaggerations in pharmaceutical advertising provide guidance for clinicians in deciding on the best course of treatment. Overall, research reveals the importance of psychosocial factors, no matter what the mode of treatment, and the need for fostering a collaborative bond between clinicians and their patients. We argue that empirical evidence points to making psychotherapy the initial treatment choice for most cases of depression.     

Blind or deaf? A matter of aesthetics

Blind or deaf? Surprisingly, a small but noticeable minority, 17%, opted for blindness. Another 6% were indifferent. For these individuals (23% of the sample), the loss of the aesthetic experience--music--was given relatively greater weight than the loss of the practical--conversation. This was not a symmetric effect in that those who opted for being deaf did not place greater value on the aesthetic aspects of vision compared to those who opted for being blind. What predicts the preference for being blind was not the amount of time spent listening to music but the extent to which one formally studied, created, and played music and experienced intense emotions when engaged by music.     

The Case Against Objective Values

While objective values need not be intrinsically motivating, need not actually motivate us, they would determine what we ought to pursue and protect. They would provide reasons for actions. Objective values would come in degrees, and more objective value would provide stronger reasons. It follows that, if objective value exists, we ought to maximize it in the world. But virtually no one acts with that goal in mind. Furthermore, objective value would exist independently of our subjective valuings. But we have no way of measuring amounts of such values independently of the ways we value objects. While a subjectivist can account for mistaken values, a fully impersonal viewpoint, from which objective values would appear, seems instead to cause all values to disappear. Nor does the moral point of view, which requires more impartiality than agents usually exhibit, reveal fully objective values. The paper closes with an examination of the most widely endorsed candidates for states having positive and negative objective values: pleasures and pains. It concludes again that, once we adjust for worthiness of the object and desert of the subject for such states, there is no way to measure their supposed objective value.