How Psychotherapy Changes Your Brain

:: The Brain and Therapy ::

For the millions of Americans who are battling mental health disorders, the choice between psychotherapy and psychiatric medications can be a challenging decision. Both methods have merit and track records of success - and certainly both have the same end goal: improving your life. The simple fact is that medication and therapy accomplish these objective by different means - one creates a biochemical change and the other a change in how we think, yet both work on the physical substrate of our brain and result in detectable changes in brain function and structure.

So, if you're considering which route might be best for you, an important question comes to light: Are changes in the brain resulting from psychotherapy the same or different from changes induced by medications?


A recent meta-analysis reveals that talk therapy and medications definitely affect the brain in different ways, but with a complementary effect. Researchers examined results from more than 30 different studies involving patients treated with commonly prescribed SSRIs and 18 studies that focused on individuals who underwent psychotherapy. In comparing brain activity before and after treatment, results revealed some significant differences.

The medication treatments were found to have the most impact on the areas of the brain connected to emotional processing and psychosomatic symptoms like the chest pain and fatigue that are often associated with depression. On the other hand, psychotherapy seemed to reveal changes in frontal and temporal cortex - the parts of our brain that control thoughts and memories. Researchers determined that these two unique effects form a contrasting, but complementary effect.  For example, an individual with fewer physical symptoms might be less likely to sink into a deeper depression, and someone with fewer negative thought patterns might be less likely to develop physical symptoms of depression.

On the whole, a significant body of research supports a combination of psychotherapy and medication. Studies show that medication treatment as an adjunct to psychotherapy leads to longer-lasting remediation of symptoms. The theory is that the combination of medications and talking treatments has the effect of 'revising' parts of the brain to a mode similar to what we would see in individuals who are not depressed.

In particular, Cognitive Behavioral Therapy has been noted as a vital tool in stimulating adaptive brain function patterns. A Kings College London study found that CBT led to heightened brain connectivity and long-term remission of symptoms. Over a period of six months of therapy, researchers found that the connection between key brain regions became stronger in a significant number of study participants. CBT targets anxiety, depression, and other mental illnesses by helping you to identify negative thought patterns and to replace them with healthy ones. 

Specifically, the scans revealed heightened connections in the part of the brain associated with fear, reasoning and thinking rationally, which, in theory, can help a person to more accurately assess social threats and reduce unnecessary anxiety. In essence, rewriting thought patterns can help us to rewrite our brains.

On the surface, psychotherapy may simply seem to be talking about your concerns and symptoms in a supportive environment - but the truth is, the effect is much deeper.  Thoughts become feelings, which, in turn, lead to behaviors.  Identifying and changing thought patterns and beliefs is a powerful way to initiate long-lasting life changes.  If you're dealing with depression or anxiety, medication may be an effective way to increase the benefits of psychotherapy. The good news is therapy in and of itself can help to change brain activity and reverse the imbalances that contribute to a depression.