What is Depression?
Types of Disorders Considered for Depression Treatment
What are Depression Treatment options?
Depression is a complex mental health issue and there are several types, each one requiring a customized treatment plan. Treatments for depression range from therapeutic, pharmacological, electric shock therapy, and Transcranial Magnetic Stimulation.
With behavior therapy, patients are encouraged to examine their negative, harmful behavioral patterns associated with psychological distress. Patients are encouraged to explore and develop better coping mechanisms and to modify their behavior when experiencing depressive symptoms or other negative emotions.
The least efficacious of the three, talk therapy is focused on current thoughts and feelings. While talk therapy is beneficial, it does not explore the harmful beliefs and negative behavior patterns associated with depression, and therefore, does not give patients the chance to challenge them and modify their feelings and reactions to them for the better.
Cognitive Behavioral Therapy (CBT)
CBT is an evidenced-based therapy method which focuses on solutions and requires the patient to take an active role in their recovery.
CBT explores the harmful thoughts and emotions a patient may have that exacerbate their depressive symptoms. CBT encourages the patient to challenge their assumptions, change their thinking patterns, and improve their behavior with positive changes and outlooks.
Patients who undergo CBT sessions with a trained therapist have the lowest rates of relapse amongst depression patients who do not utilize CBT in their treatment plan.
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs are one of the oldest classes of antidepressant medications on the market, first emerging in the 1950s. They are not prescribed very often anymore because they can cause dangerous interactions with other medications and certain foods, such as fermented cheeses and alcohol.
MAOIs, if abruptly ceased, can cause unpleasant and sometimes dangerous withdrawal symptoms, including psychosis. Coming off the drug must be done under the care and supervision of trained medical professionals to prevent these withdrawal symptoms and the risk of experiencing a rebound depressive episode in the form of dysphoria and mood disturbances.
But despite their side-effects, MAOIs are still highly effective in treating depression, especially depression that is accompanied with anxiety and panic disorders and has been found to be resistant to the newer classes of antidepressant drugs.
Examples of MAOIs:
MAOIs, though effective treatment methods, fell out of favor with most United States physicians in the 1980s, when newer classes of antidepressant medications emerged.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are the most prescribed treatment option for moderate to severe depression. These drugs have high efficacy rates and have low side-effects and are safer to use than older MAOI treatments.
SSRIs work by increasing naturally-occurring serotonin in the brain. Serotonin is a neurotransmitter and a mood stabilizer. A lack of it is a major contributor to developing depression and other mood disorders.
An SSRI will block serotonin from being processed and reabsorbed back into the brain. Since the brain will naturally produce more serotonin, the SSRI will keep it in the brain for longer, increasing the amount of it, and improving the patient’s mood. SSRIs only affect the reuptake of serotonin and are also used to successfully treat anxiety and panic disorders.
FDA approved SSRIs:
Within two to six weeks of taking an SSRI, over half of patients experience a reduction in depressive symptoms. Taking an SSRI will also greatly reduce the risk of relapse.
Serotonin Norepinephrine Reuptake Inhibitor (SNRI)
These are some of the newest classes of antidepressant drugs on the market. They are very similar to SSRIs, except they target the reuptake of serotonin and norepinephrine.
Norepinephrine is responsible for feelings of motivation, energy, and alertness, which are lacking in people suffering from depression. If these symptoms are particularly severe, an SNRI may be prescribed.
When Therapy and Medication Are Not Enough
Sometimes depression is so severe and the patient’s biological make-up resistance to pharmacological methods. In these cases, more invasive methods may be needed.
Electric Shock Therapy (ECT)
Pop culture would have many mistakenly believe that ECT is a torture mechanism and not a legitimate treatment method for severe mental health disorders. Despite the stigma, ECT is a commonly used treatment for severe, treatment resistant depression, bipolar mania, aggressive dementia, and catatonia.
Electric shocks are used to induce a mild seizure. The seizure causes changes in brain chemistry, and improvements in mood and mental health functioning can be seen immediately after an ECT session.
ECT is administered under general anesthesia, and most people who undergo ECT notice an improvement after six sessions.
Transcranial Magnetic Stimulation (TMS)
TMS uses magnetic waves to activate certain areas of the brain. While ECT is not targeted to certain areas, TMS is. TMS works in the same way that ECT does, in that it changes the chemical structure of the brain, but without any of the harmful side effects.
During a TMS session, patients do not require anesthesia. An electromagnetic coil is placed against the patient’s forehead, and small, electromagnetic pulses are generated through the coil. The pulses pass through the skull and stimulate the area of the brain thought to regulate mood.
Because the electromagnetic pulses and the coil through which they pass can be placed in specific locations, scientists and doctors can move the coil around to certain parts of the brain, making the entire method much more targeted and precise than ECT.
In a large clinical study of patients undergoing TMS treatment for the first time, 14% of patients experienced a remission of symptoms after one session. After the second session, that number rose to 30%.
Despite its commonality, severity, and economic and societal consequences, depression can be treated and cured. After a bout of depression, many go on to make a full and life-long recovery. Although some may experience a relapse even with treatment, most do not. Only about twenty percent of people who experience depression and take preventative measures will experience a relapse in symptoms.
With the help of a trained therapist, caring and knowledgeable doctors, and by taking an active role in managing their illness, sufferers can live a life free from the black moods of depression.
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