Depression

Depression

Depression is a mental health condition that can cause persistent feelings of emptiness, hopelessness, and sadness. People may have a loss of interest in activities that they once enjoyed, and they might have low energy levels. Some individuals with depression could experience sleep disturbances, and unexplained headaches and back pain may also develop.

In 2017, approximately 17.3 million American adults had major depression. The condition is generally more common in females.

While depression can be a serious condition, it is treatable, and many people are able to make a successful recovery. Treatment options depend on the type of depression that the person has. This guide will help you understand the available treatment options that your doctor may recommend.

Treatments for Mild Depression

1. Self-Help Books

Individuals who have been diagnosed with mild depression may wish to start their treatments with self-help books. These texts offer information about coping strategies that are routinely taught in psychotherapy sessions. Stress-management techniques and methods for identifying and altering negative thinking patterns are some of the strategies that may be introduced.

A study about the effectiveness of self-help books for depression found that the books “Feeling Good” and “Managing Anxiety and Depression” are particularly beneficial for people. Patients may wish to ask a doctor or a mental health professional about the most appropriate self-help books for their needs. While self-help books are often a useful aid in alleviating symptoms, they are not a cure for this condition.

2. Support Groups

Support groups offer individuals an opportunity to share their feelings and experiences with others who are coping with depression. Research shows that support groups can help reduce the symptoms of depression, and they help reassure people that those struggling individuals are not alone in their struggles. Support groups can also give patients new ideas for managing their symptoms in a healthy way, and the social interaction they provide may help reduce feelings of isolation.

People can find support groups in their areas by reaching out to local mental health organizations or by scanning area websites for mental health that often publish lists of meeting times. Online support groups provide an alternative for those who cannot attend in-person meetings.

3. Online Resources

Individuals who have mild depression might wish to consider using online resources in their treatments. Many websites provide online counseling services with a licensed therapist, psychologist, or psychiatrist. Patients can chat with their therapists via text, and some websites offer live video sessions and online group therapy sessions as well.

Online therapy is often cheaper than in-person therapy, and it may be particularly helpful for those who are uninsured and who cannot access in-person treatment. In addition to online therapy, patients might also want to read credible blog entries and the websites of mental health associations for reliable advice about self-help strategies for depression.

Are These Treatments Right for You?

Those who use self-help books, support groups, and online resources to manage mild depression should always remember to monitor how they are feeling. If symptoms don’t improve after a few weeks, they should contact their doctors or a mental health professional to be properly assessed.

Psychotherapy for Depression

Psychotherapy, sometimes called “talk therapy,” is useful for people with all types of depression. Mental health professionals may recommend a combination of group therapy, individual therapy, and family therapy that is tailored to the patient’s diagnosis and support needs.

The types of psychotherapy outlined below are commonly used for depression treatment. Studies have shown that all of these types are equally effective for the treatment of this condition.

1. Cognitive Behavioral Therapy

Cognitive behavioral therapy is based on the idea that negative actions and emotions are produced by distorted thoughts and beliefs. People are taught to recognize specific types of negative thoughts and behaviors, and therapists teach them ways to replace these actions with thoughts and behaviors that are healthier and more positive.

Unlike other types of therapy, cognitive behavioral therapy is often used on a short-term basis. Many patients see improvements in their symptoms in as little as 10 sessions, and most cognitive behavioral programs can be completed with a maximum of 20 sessions.

2. Interpersonal Therapy

Interpersonal therapy was originally developed to treat major depression, and it is another form of short-term therapy. Most interpersonal therapy can be completed in 12 to 16 weeks. The goals of this type of therapy are to treat relationship difficulties that might worsen the patient’s symptoms and to improve the patient’s relationship patterns.

This type of therapy is highly structured, and patients are given homework to complete between sessions. While interpersonal therapy acknowledges internal conflicts that the person may have, it focuses primarily on current relationships that are causing issues for the individual.

3. Psychodynamic Therapy

This form of therapy assists patients in processing unhealed emotional wounds from their pasts. In addition, the therapist guides the person in uncovering and healing from unconscious emotional trauma. Sessions are typically 50 minutes in length, and they are based on a process of free association.

While some patients may complete psychodynamic therapy after a short time, others choose to continue sessions for several years. Psychodynamic therapists help the individual confront painful emotions, learning to cope with them in healthy ways so that those feelings don’t interfere so much with daily life.

4. Behavioral Activation Therapy

Behavioral activation therapy aims to increase the amount of positive reinforcement that the patient receives so that they will gradually replace negative behaviors with positive ones. Behavioral activation therapists give the patient positive reinforcement and help him or her identify and implement positive changes.

Other Psychotherapy Techniques

Social skills therapy, problem-solving therapy, and supportive counseling are some of the additional psychotherapy approaches that may be used in the treatment of depression. Individuals may want to try several types of psychotherapy to find a combination that is effective for their specific needs.

Medications That Treat Depression

Doctors often recommend that patients use medications as part of their depression treatments, especially if they have moderate or severe depression. Medications should normally be used in combination with psychotherapy, and patients should have regular follow-up appointments with their clinicians. It may be necessary to take several medications for effective symptom management.

The medications listed below are some of those that may be considered during treatment.

1. Selective Serotonin Reuptake Inhibitors

These antidepressants are currently the most frequently prescribed medicines for the treatment of depression. They work by increasing serotonin levels in the brain, and they have fewer side effects than some older antidepressants. Examples of selective serotonin reuptake inhibitors (SSRIs) include fluoxetine, sertraline, citalopram, and paroxetine.

Nausea, vomiting, diarrhea, and drowsiness may develop in some patients who take these medications. Dizziness and weight changes have been reported. Patients should let their doctors know about any side effects that they experience. It may be possible to switch to another SSRI to reduce side effects.

2. Serotonin and Norepinephrine Reuptake Inhibitors

These medicines (SNRIs) are a newer type of antidepressant. Like SSRIs, they increase serotonin, and they also increase levels of norepinephrine. Duloxetine, venlafaxine, desvenlafaxine, milnacipran, and levomilnacipran are examples of this class of antidepressants.

Those who use serotonin and norepinephrine reuptake inhibitors could notice tremors, muscle weakness, headaches, and increases in heart rate and blood pressure. Patients should let their health care providers know about any history of heart problems before taking this medicine, and they should inform their doctors if side effects worsen or persist.

3. Tricyclic Antidepressants

Tricyclic antidepressants are one of the older types of antidepressants. Like SNRIs, tricyclic antidepressants work by increasing serotonin and norepinephrine. Amitriptyline, desipramine, nortriptyline, and imipramine are a few of the tricyclic antidepressants that are available.

People with seizure disorders, heart conditions, hyperthyroidism, or glaucoma may not be able to use tricyclic antidepressants safely. The most commonly reported side effects associated with this type of antidepressant include constipation, excessive sweating, dry mouth, sexual dysfunction, urine retention, and weight changes.

4. Monoamine Oxidase Inhibitors

Monoamine oxidase inhibitors were the very first antidepressants to be developed. They work by increasing levels of dopamine, serotonin, and norepinephrine in the brain, and they also affect levels of other neurotransmitters in the brain and digestive system. Examples of monoamine oxidase inhibitors include phenelzine, isocarboxazid, selegiline, and tranylcypromine.

Today, doctors usually consider monoamine oxidase inhibitors for patients who have not responded to newer antidepressants. Monoamine oxidase inhibitors may cause headaches, dry mouth, insomnia, dizziness, and drowsiness. Some people might develop more serious side effects, including low blood pressure, involuntary muscle jerks, muscle cramps, and difficulty with urination.

Monoamine oxidase inhibitors should not be prescribed with SSRIs, and patients who are discontinuing monoamine oxidase inhibitors will need to gradually taper their doses to avoid withdrawal symptoms. During treatment with monoamine oxidase inhibitors, patients will need to avoid foods and drinks with high levels of tyramine, including fermented soy products, aged cheeses, cured meats, and sauerkraut.

5. Norepinephrine and Dopamine Reuptake Inhibitors

Norepinephrine and dopamine reuptake inhibitors increase the levels of norepinephrine and dopamine in the brain. Bupropion is the only drug in this class that is currently used for the treatment of depression.

Some of the most frequently reported side effects of this medicine include weight loss, pharyngitis, nausea, constipation, and dry mouth. Some individuals have experienced abdominal pain, skin rashes, migraines, and unusual dreams during treatment. Some people may notice irregular heartbeats, hyperventilation, and irritability as well.

Bupropion may not be safe for individuals with seizures or eating disorders, and patients who have liver or kidney disease may need to have their dosages adjusted. Since bupropion can increase blood pressure, patients will need to have their blood pressure checked before and during treatment. Individuals who take monoamine oxidase inhibitors should not use bupropion.

6. Esketamine

Esketamine is a new antidepressant that was approved in 2019. It is intended for use in individuals with treatment-resistant depression. Administered as a nasal spray, the medicine is typically considered for those who have failed to respond to at least two other types of antidepressants. It is taken in combination with another antidepressant.

Esketamine cannot be taken by people at home. Instead, patients who use the medicine must receive each dose at a certified treatment center, and it is usually given once or twice a week. Esketamine could cause sedation and difficulties with judgment, attention, and thinking in some patients.

While other antidepressants take weeks or months to reduce symptoms, esketamine can reduce depressive symptoms in just a few hours. Patients are monitored at their treatment centers for several hours after each dose, and they should let their treatment teams know immediately if they experience any side effects.

Hospitalization for Depression

Most people with depression can be safely treated on an outpatient basis, taking medication at home and checking in regularly with their mental health professionals. However, some individuals with this condition may need to be hospitalized for a period of time.

Hospitalization is typically considered for those with severe depression who are experiencing suicidal thoughts. People who have become a danger to themselves or to others could require hospital treatment as well.

At the hospital, the patient will receive intensive individual therapy, and group therapy may be offered. Doctors will likely recommend and start treatment with antidepressants. The length of the person’s hospitalization may vary based on their symptoms, their health insurance coverage, and the type of hospital that is providing the treatment.

Some patients may only be hospitalized for a few days. Others may need an extended stay of around one month or more in a psychiatric unit. If the depressed patient is not suicidal, a partial hospitalization may be considered. Partial hospitalizations are intensive outpatient programs that provide therapy on a daily basis for several hours at a time. Unlike inpatient hospitalizations, partial hospitalizations do not become part of the patient’s permanent medical records.

How Can You Find the Most Effective Treatment?

First, you should discuss all available treatment options with your doctor or psychiatrist. He or she will be able to recommend the treatments that are most likely to be beneficial for you based on your health history. You may need to use several treatments in combination, and it may be necessary to switch medications or types of psychotherapy as you heal.