The Treatment of Depression
Depression treatment is a very complex and difficult process. It entails the therapeutic management of depression by medical doctors, psychologists, therapists or psychiatrists. The first step in the treatment process of depression includes a thorough examination of the patient’s mental and physical health.
Depression treatment begins with a thorough diagnostic process to determine what type of depression is being experienced as well as its severity. The next step in treatment is the development of a plan for treatment. In order to effectively treat depression, it must be determined why and how it started as well as what treatments will work best for each individual patient.
What is Depression Treatment?
Depression treatment is the process of stopping as well as or reducing depression. Depression is not considered a curable disease, but it can be treated successfully with medication or psychotherapy, or talk therapy.
Depression treatment can be done in one of two ways. The first is by using medication, which may include anti-depressants coupled with other psychiatric medications. Secondly, psychotherapy or talk therapy is used to help people cope with depression.
Both medication and psychotherapy can be effective in treating the symptoms of depression, but only one or the other may work for a given individual. Psychotherapy is often considered the best option for people affected with mild depression.
Talk therapy is the first-line treatment for mild depression. If this proves ineffective, medication may be necessary to treat moderate or severe symptoms of depression. Psychotherapy can also help people with more severe depression.
A depression treatment centre like PROMIS can help you find the best treatment options to treat your situation of depression.
Types of Depression Treatment
There are a variety of different treatments for depression. They include psychotherapy, medication, and electroconvulsive therapy (ECT). Psychotherapy is a form of treatment that helps people to understand their thoughts and feelings which will, in turn, help them feel better.
Medication is a treatment that involves taking prescribed drugs to lessen the symptoms of depression which includes sadness or loss of interest in regular daily activities. Electroconvulsive therapy (ECT) is another form of treatment that uses brief electric currents to trigger mild shocks to treat depression.
It is important for people with depression to be treated as soon as possible because, without treatment, the symptoms of depression can become more severe.
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy, or CBT, is a type of psychotherapy that has been scientifically proven to be effective in the treatment of depression. It focuses on changing thought patterns and behaviours through “the examination and then restructuring of negative thoughts, beliefs or behaviours.”
CBT is used to treat a range of mental health conditions including depression. Treatment usually consists of 14-26 sessions with a therapist, with each session lasting 45 to 60 minutes. CBT can be delivered in a range of settings, including individual and group therapy sessions. It is often used to complement medication treatment for depression.
Computerised CBT (CCBT)
Computerised CBT (CCBT) is also known as “internet-based” or “online” CBT. It can be accessed through the internet and doesn’t require any special equipment.
CCBT is the most recent type of internet-based therapy that has been shown to be as effective as face-to-face CBT. The idea behind CCBT is that you can get help for your depression from the comfort of your own home.
The therapist will give you feedback through email or on a website. You can also chat with other people who are experiencing the same situation and share experiences.
Interpersonal Therapy (IPT)
IPT is one of the more common types of depression treatment. It focuses on teaching patients skills for improving their interactions with others and themselves, as well as understanding and managing their problems.
IPT is time-limited problem-focused psychotherapy. The clinician’s goal in IPT is to help the patient learn healthier ways of coping with the internal and external stresses that trigger depressive symptoms. This treatment form is designed for patients with mild to moderate depression or dysthymia (chronic, low-grade depression).
BRAIN STIMULATION THERAPIES
Electroconvulsive therapy
ECT started to be used in the 40s and 50s. Despite a bad public image, it is effective to treat severe depression and is one of the least harmful to a fetus for pregnant mothers to receive. It has a similar risk and impact as brief general anaesthesia, but this isn’t one of the treatments we offer at PROMIS.
Repetitive transcranial magnetic stimulation
Nearly as effective as electroconvulsive therapy is repetitive transcranial magnetic stimulation. This involves putting a magnetic coil in specific locations on the scalp and developing a magnetic field in the brain.
It doesn’t go very deep, and the locations on the scalp associated with depression and anxiety treatment are both at the front of the brain ( the prefrontal cortex ) on either side of the centre.
One type of pulse is used to ‘dampen down’ activity in the area associated with anxiety, and another is used to ‘excite’ the area associated with depressive disorders.
As Anxiety and Depression very often go hand in glove, it is common to use this treatment on both sites in the same treatment. This is a treatment we sometimes provide at PROMIS Hay Farm.
Transcranial direct current stimulation (tDCS)
tDCS is slightly less effective than TMS but it is even less invasive. The device has a small headset with foam pads which are placed on the temple and produce a very mild electrical current.
One of the early devices we used was powered only by a 9v battery so you can see that the stimulation involved is minor, however, it still has a demonstrable effect on treatment resistant depression symptoms. This is a treatment we can offer at PROMIS Hay Farm and at PROMIS London.
The British Medical Journal has produced this visual representation of the relative effectiveness of these different electrical stimulation treatments for depression.
If someone is suffering from a persistent depressive disorder, then it is very helpful to explore a wide variety of treatment options.
Alternative Therapies
Alternative therapies are treatments that fall outside of traditional Western medicine. A few examples of alternative treatments for depression include acupuncture, yoga, massage therapy, and aromatherapy.
Yoga is based on the idea that good health depends on the balance of mind, body, and spirit. Many who practice yoga believe it offers a way to relieve stress and bring about relaxation.
Massage therapy is therapeutic handwork that can be self-administered or performed by a qualified practitioner. Massage therapists believe that the combination of touch and deep manipulation helps to release tension, promote circulation, and ease the movement of muscles.
Types of Depression
Symptoms of depression can be both psychological and physical which is why it’s important to seek help for this condition.
The symptoms of physical depression can vary from person to person and may be caused by a number of factors such as stress, illness, or injury. Symptoms could include weight gain (or loss), fatigue, restlessness, and agitation. Psychological depression symptoms may include feelings of hopelessness, guilt, or worthlessness.
Major Depressive Disorder
Major Depressive Disorder (MDD) is a medical condition that can affect people of any age, but it usually begins in late adolescence or early adulthood. MDD can be difficult to diagnose because it may mimic other illnesses, such as anxiety disorder or bipolar disorder.
Antidepressants are the most commonly prescribed medications to treat MDD because they have and effect on improving mood and reducing symptoms, but therapy can also help a person learn psychological skills to manage them.
Major Depressive Disorder is the most common form of depression. It involves an extended period of low mood and loss of interest in pleasurable activities.
Depression is the most common mental health illness in the United Kingdom, affecting about one out of every ten adults. Studies show that major depressive disorder (MDD) accounts for up to 80% of these cases. Yet despite its prevalence, MDD is still not well understood.
Treatment for depression may include medication, therapy, exercise, or other lifestyle changes. Antidepressants are the most commonly prescribed medications to treat major depressive disorder because they are effective in improving mood and reducing symptoms.
Therapy can also help a person learn practical skills to manage their symptoms, as well as explore the underlying causes of the disorder.
Persistent Depressive Disorder
Persistent depressive disorder is a type of depression that lasts for at least two years. The symptoms include depressed mood, low self-esteem, and lack of interest in pleasurable activities. There are two types of persistent depressive disorder: major and minor.
Major depression is diagnosed when there are three or more symptoms that last at least two weeks, while minor depression typically only has one symptom for a period of two years.
Bipolar Disorder
Bipolar disorder is a mood disorder that causes shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. The swings between mania (highs) and depression (lows) can last for days, weeks, or even months.
The manic phase of bipolar disorder may involve excessive activity and productivity, distractibility, little sleep needed, racing thoughts with jumping from one idea to another, reduced need for sleep, and talking very fast. A depressive phase may involve feelings of sadness, hopelessness, or guilt; loss of interest in activities that were once enjoyed; little energy; and problems with sleep.
A depressive phase may involve feelings of sadness, hopelessness, or guilt; loss of interest in activities that were once enjoyed; little energy, and problems with sleep.
Postpartum Depression
Postpartum depression is the most severe form of depression that a woman can experience after pregnancy. It may begin during pregnancy or any time in the first 12 months following childbirth. Postpartum depression can last for a few days or more than one year.
It is important to know the symptoms of postpartum depression, which are similar to those of other types of depression but may vary in severity. Some symptoms include feeling sad; having trouble sleeping; not enjoying activities that used to be pleasurable, like eating or sex; and lacking energy.
It is possible for a woman with postpartum depression to feel better without treatment. But for many women, the symptoms are so severe that they need professional help to get relief.
Major Depressive Disorder with Seasonal Patterns
Major depressive disorder with seasonal patterns is a type of major depressive disorder that occurs in conjunction with milder depression during the winter. The rate of this form is higher than most other types and it is often accompanied by a higher rate of suicidal ideation.
Medication for Depression
Medication is the most commonly used treatment for major depressive disorder. This type of depression is often accompanied by higher rates of suicidal ideation. Medication, like Prozac or Zoloft, is commonly used in the treatment of major depressive disorder.
Serotonin and Norepinephrine Reuptake Inhibitors
Serotonin and Norepinephrine Reuptake Inhibitors are drugs that increase the levels of serotonin and norepinephrine, which help regulate mood. The first-line treatment for depression is usually one of these.
Some people can’t tolerate SSRIs, so they take SNRI instead. These drugs start to work after two weeks and are most effective when taken every day for at least six months.
These medications have many side effects, including nausea and headaches. They can also cause sexual dysfunction or weight gain in some people and they may be addictive for some individuals, especially when taken for a long period of time.
The first line of treatment for depression is usually either an SSRI or SNRI. These drugs work after two weeks and are most effective when taken every day for at least six months. These medications have many side effects, including nausea and headaches which can be common with any drugs taken for depression treatment.
Norepinephrine and Dopamine Reuptake Inhibitors
Norepinephrine and dopamine reuptake inhibitors are the most frequently prescribed medications for depression. They have been found to be equally effective in treating depression, but each medication has its own side effects.
Norepinephrine and dopamine reuptake inhibitors are primarily prescribed for depression that is caused by a chemical imbalance in the brain. When serotonin, norepinephrine, and dopamine levels become imbalanced, they can lead to depression.
These reuptake inhibitors help regulate serotonin and norepinephrine levels in the brain, which can alleviate symptoms of depression.
Dopamine reuptake inhibitors are not the only type of treatment for depression, but they may be appropriate in certain cases when other treatments have proven ineffective or caused intolerable side effects.
Monoamine Oxidase Inhibitors
Monoamine Oxidase Inhibitors (MAOIs) was the first class of antidepressant medication and is sometimes still used in conjunction with other medications.
MAOIs work by inhibiting the enzyme monoamine oxidase, which breaks down neurotransmitters. Neurotransmitters are chemicals that transmit signals between neurons in the brain; MAOIs inhibit their destruction and increase the number of neurotransmitters in the brain.
Newer Medication Options
Newer medication options include antidepressants, antipsychotics, and mood stabilizers. These medications are used to treat the symptoms of depression such as low energy, sleep disturbances, and changes in appetite.
Antidepressants are used to treat depression by increasing the levels of serotonin, dopamine, and norepinephrine in the brain which can help relieve symptoms. Antipsychotics target positive or negative thoughts that may be causing depression and mood stabilizers help to balance out high or low emotions.
Depression Signs and Symptoms
· Low energy
· Lack of interest in activities previously enjoyed. (such as hobbies, work, school)
· Sleep disturbances (insomnia, trouble falling asleep)
· Changes in appetite (not eating/overeating)
· Feeling tired or sluggish despite rest. (including mental fatigue)
· No interest in sex, or sexual difficulties. (difficulty getting aroused)
· Loss of feeling pleasure from activities that were once enjoyable
