Ep. 13: Dr. Rob DeRubeis — Latest Research from the Frontier of Depression Treatment

by Seth Gillihan

There’s a lot of “received wisdom” in the field of depression treatment, such as:

  • Medication is more powerful than talk therapy.
  • Psychotherapy plus medication is the best treatment approach.
  • Depression is caused by a “chemical imbalance” involving low serotonin.
  • Antidepressant medication is better than placebo for most people with depression.

Are these ideas well-supported by research data? To explore these issues I spoke with Dr. Rob DeRubeis, a clinical psychologist and expert in depression research. Rob’s work has challenged many of the established beliefs in this field, and has sharpened my own thinking in these areas.

Our discussion spanned multiple decades of Rob’s work as his and others’ research refined our understanding of depression and the best ways to treat it. In this episode we explored:

  • The different types of depression
  • Potential negative side effects of medication and psychotherapy
  • The likelihood that depression will return after the first episode
  • Patient preference for psychotherapy versus medication
  • Possible downsides of combining medication and therapy for depression
  • The difficulty in following through on a therapy referral
  • How to make the best cognitive behavioral treatments more readily available
  • Applying precision medicine to the treatment of depression
  • How Rob applies to principles of CBT in his own life

As you’ll find from our discussion, Rob thinks very carefully and clearly about these ideas, and is skilled at explaining important nuances that shouldn’t be ignored. You’ll also learn about the history of the depression treatment field, and the evolution in our understanding of depression and how to treat it.

If you’d like to learn more about the topics Rob and I discuss, check out these videos:

The Treatment of Depression: What Works, When, and and Why

Medication of Sadness

Moderation in All Things: A Call to Focus on Individual Differences in Mental Health Treatment Research

Here are links to some of the relevant articles we discussed so you can see the data yourself:

Robert J. DeRubeis, PhD, is the Samuel H. Preston Term Professor in the psychology department at the University of Pennsylvania where he also serves as the Director of Clinical Training. His work has shaped the field of modern depression treatment research, and has been supported by multiple major grants from the National Institute of Mental Health.

Rob has authored over 125 peer-reviewed publications, as well as countless book chapters and conference presentations. He has received numerous awards for his work, including the Aaron T. Beck Award from the Academy of Cognitive Therapy for significant and enduring contributions to cognitive therapy; the Distinguished Career Award from the Society for Psychotherapy Research; the Provost’s Award for Distinguished PhD Teaching and Mentoring at the University of Pennsylvania; as well as the James McKean Cattell Fellow Award from the Association for Psychological Science for a lifetime of outstanding contributions to the area of applied psychological research.

To learn more about Rob’s work, check out his Lab Page.

“The best time to act is when it seems to me I don’t want to act.”