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Severe depression usually responds to a combination treatment of medication and therapy. Medication helps to remove some of the more physical symptoms of depression (fatigue, trouble sleeping, appetite problems, etc) so that the patient has the energy and the will to work hard in therapy. However, if the patient makes no effort to change his/her thought processes or behavior, it's very difficult to ever get out of depression. Antidepressants alone cannot fully treat depression - they're just one part of the treatment.
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