This review examines the complex relationship between depression, medication, and cognitive processes, revealing implicit cognitive frameworks that affect depression. It examines how automatic thinking and cognitive schemas affect depression-related emotions and behaviors using the Dysfunctional Attitude Scale. We examine how antidepressants affect cognition and emotion, including automatic thinking, cognitive schemas, and emotional well-being. It stresses evidence-based depression treatment and the placebo effect. The study compares cognitive therapy's long-term benefits on patients' pessimism, self-view, and mood versus medication's, focusing on cognitive schema modification. The study examines pharmaceutical users' cognitive reactivity and relapse triggers using mood induction to understand depression relapse vulnerability better. Neuroimaging is also used to examine metabolic activity and brain areas after cognitive treatment and medication to determine how each treatment affects memory consolidation and cognitive functioning. This thorough study explains the complicated interaction between depression, pharmacological therapy, and cognitive processes, enhancing depression understanding and empirically supported mental health approaches.