Treatment Methods

Treatment Methods

Over 350 million people suffer from depression worldwide. 10% of Americans are prescribed antidepressants every year. There are a large percentage of Americans in therapy and utilizing holistic and modern treatments in an effort to combat their depression.

What is Depression?

Symptoms of depression can come in many forms. Bouts of depression can be spurred from any number of different things, from positive interactions to negative ones. Being with a loved one, a friend, or colleague that suffers from depression can be difficult at times, patience and understanding are key to their recovery. There are numerous telltale signs to watch out for when encountering someone with depression and should be kept in mind when trying to assist someone through their hardship.

The most common symptoms of depression are:

  • Anhedonia (loss of pleasure and interest)
  • Fatigue
  • Sleeping too much or too little, insomnia or restlessness
  • Changes in appetite
  • Weight gain or loss
  • Unexplained feelings of guilt or shame
  • Excessive crying or irritability
  • Hopelessness
  • Rumination
  • Social isolation
  • Problems concentrating
  • Slowed activity
  • Thoughts of suicide
  • Emotional numbness

At its worst, depression can lead to suicidal thoughts, behavior, and attempts. Suicide is the tenth leading cause of death in the United States, making suicide more deadly than car accidents.

How is depression treated?

Depression is a complex mental health issue with numerous variables and types, each one requiring a unique treatment plan. The leading treatments for depression are therapeutic, pharmacological, and brain stimulation therapies.

Therapeutic Treatments

Behavior Therapy

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.

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.

Talk Therapy

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.

Pharmacological Treatment Methods

There are dozens of medications that can be prescribed for depression. Depending on which type of depression the patient has, and the severity of it, any one of these medications may ease the symptoms of depression and help the patient make a life-long recovery.

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.

Examples of MAOIs:

  • Marplan
  • Nardil
  • Emsam

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.

FDA approved SSRIs:

  • Lexapro
  • Celexa
  • Prozac
  • Paxil
  • Zoloft
  • Viibryd

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.

FDA approved SNRIs:

  • Pristiq
  • Effexor
  • Cymbalta

When Therapy and Medication Are Not Enough

Sometimes depression is so severe and the patient’s biological make-up resists classic methods. In these cases, more invasive methods may be needed.

Electric Shock Therapy (ECT)

Despite the stigma, ECT is a highly effective and safe 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.

Transcranial Magnetic Stimulation (TMS)

TMS uses magnetic waves to activate certain areas of the brain. 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.