Skype Therapy and Yoga for Depression? Choose Carefully

Search online for yoga and depression and you will turn up article after article claiming yoga lowers depression. I think yoga is a reasonably safe way to cope with the condition. Curing it is another matter, and I doubt yoga does that. It might not even be the right coping tool for you. Part of the problem is that some researchers lean on inflated conclusions to sell a theory or prop up a section of a paper, which also happens to prop up their own reputation.

The way we reach information has shifted. People in this generation are so wired into their devices that pushing an idea out to a wide audience takes almost no effort, and the idea does not have to survive any real scientific scrutiny first. That audience includes plenty of readers with no background in the subject, depression and other mental illnesses among them. I am not out to discredit professionals and their theories. I am saying that a few of them exploit an uninformed population, and the people least protected are the ones already carrying a disorder like depression.

To me, the worst move a person with a mental illness can make is to self-medicate with no supervision. A lot of what sits online will skip right past the parts that matter: the role of professional help, the role of medication, the value of ordinary cognitive behavioral treatment. To the writers who do press the importance of medication and behavioral management, thank you for not working your readers for an angle. Depression is a serious disorder affecting millions of people, and the strongest option remains seeking out a licensed professional. The better information tends to live on sites built specifically around depression. If your employer provides health insurance, check whether it covers sessions with a psychologist.

I would urge you, firmly, not to settle for sessions with a licensed professional conducted over the phone.

Tele-therapy keeps gaining ground, web-based therapy in particular. Rick Nauert's article Tele-Therapy Helps with Depression reports that 77 percent of participants said they felt better, for lack of a cleaner phrase, after trying it (2007). Notice the verb: said. Pulling data from clients or test subjects is a common research method, and that poll becomes the evidence some researchers point to when defending a theory. People are fickle, though. A fast survey can miss whatever is actually driving those positive answers.

My own view has always been that face-to-face therapy is the right place to begin climbing out of depression. Tele-therapy can work, and it can also hand someone a false sense of hope. Depression does not clear up the way a case of crabs clears up, fast and done. Yet psychologists will take this kind of survey evidence and present tele-therapy as if it works for everybody. Technology runs through daily life, mine included. It still cannot cure depression. Not yet. Bipolar disorder and schizophrenia, which falls under major depressive disorders, call for specialized care and genuine case management. Tele-therapy may help some people, but it risks being treated like fast-food therapy. Therapy is not a joke, and it should not be handled casually.

If you do read articles offering advice on getting through depression, do not read them hunting for the single fix to your situation.

Once this post goes up, I expect some psychologists to ask what I could possibly know about treatment without a Ph.D. They may ask how I can speak so harshly about licensed professionals who write about advanced, technology-driven care. I am not a licensed professional. I have, however, spent enough time working with people from every kind of background to see how simple it is for a small cluster of operators to take advantage of others. Honesty has always struck me as the better policy, and compassion is essential when the people in front of you are living with a mental disorder.

Consider the gap this way. Many articles float coping mechanisms for individuals. Almost none of them speak to people from low socio-economic backgrounds, people whose medication comes from a doctor at a free clinic. As someone with an education, I feel a responsibility to point others toward the best way to cope with depression as I understand it. Technology is a fine thing, and people can abuse what it makes possible. If anything, licensed professionals ought to use technology to teach the public more about coping well and about where to find affordable treatment.

Psychology is a profession worth respecting. It should not be cheapened by people chasing a quick dollar, whether they get there by twisting research data and jumping to conclusions or by leaning on weaker formats like Skype sessions. Give people the real thing: a one-on-one session grounded in evidence-based practice.

- Heather Browning, MBA, BA

Reference: Nauert, R. (22 March 2007). Tele-Therapy Helps with Depression. PsychCentral. Retrieved January 27, 2015.