Drugs vs. talk therapy: 3,079 readers rate their care for depression and anxiety.(CR Investigates Antidepressants)

Where people turn for help to combat depression and anxiety can make a critical difference in the type of care they receive and how completely they recover. That's an important finding of a new survey, one of the largest of its kind, of thousands of CONSUMER REPORTS subscribers who recently sought treatment for those conditions.

The survey results, plus our interviews with patients and experts, offer a compelling snapshot of how people found mental-health care and how they fared given the choices they made. Among our other findings:

* Talk therapy rivaled drug therapy in effectiveness. Respondents who said their therapy was "mostly talk" and lasted at least 13 sessions had better outcomes than those whose therapy was "mostly medication." Therapy delivered by psychologists and clinical social workers was perceived as effective as that given by psychiatrists.

* Drug therapy relieved symptoms faster than talk therapy, and the majority of people who described their therapy as "mostly medication" also had good outcomes, But it can take much trial and error to find the right medication. More than 50 percent of survey respondents who took antidepressants tried two or more drugs; 10 percent tried five or more.

* The rates of adverse drug side effects that our respondents experienced were much higher than those noted on the medications' package inserts. Forty percent said they experienced a loss of sexual interest or performance, and almost 20 percent said they gained weight.

* Health-plan restrictions, such as limits on therapy visits, and costs kept some people from getting the best treatment.

* Consumers who did their own research and monitored their own care reported better results.