In recent years, the dichotomy between psychotherapy and pharmacotherapy vis-à-vis the treatment of mood disorders has begun to be resolved as the benefits of integrating the two modalities are increasingly recognized. This new understanding has expanded the scope of successful treatment, but it has also complicated the process of making decisions about appropriate treatment. The author reviews the literature, illustrates some of the complex issues with case examples, and suggest guidelines for the mental health clinicians who must make such treatment decisions.