Cognitive-behavioral psychotherapy by a well-trained therapist (e.g., doctoral psychologist, clinical social worker) is the most effective and cost effective treatment of depression. It has a substantially lower relapse rate than drugs alone, it is about twice as effective as drugs alone, relief typically begins after the first session, total number of sessions vary from a total of 3 to 25 sessions (depending on severity) and, even for major depression, adding drugs to psychotherapy adds little or no benefit to the benefits of psychotherapy alone.

Depression is a combination of biological, personality, and environmental factors, and to call it a disease or chemical imbalance (depression does cause brain changes, and these brain changes are altered by psychotherapy) is naïve and is playing havoc with the truth. As an example of the major impact that even the cultural climate has on depression, China has by far the world's highest suicide rate among women.

Giving drugs alone for depression (also giving drugs to depressed cancer patients, stroke patients, etc.) cannot be justified nor are general physicians competent to treat this complex disorder that can be life threatening.