Depression therapies and treatments
Treatments for depression: Medication and therapy
If you or someone close to you might be experiencing depression (see symptoms ), the most important thing is diagnosis and treatment. Depression can make one feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up or not seeking help. It is important to realize that these negative views are part of the depression and typically don't accurately reflect the actual circumstances. Negative thinking and thoughts fade as treatment begins to help.
Most suffering from depression do best with combined treatment:
medication to gain relatively quick symptom relief and
psychotherapy to learn more effective ways to respond to
situations, reactions and problems, including the depression itself. There are a variety of
antidepressant medications and psychological therapies that
can be used to treat depression. Some with milder forms may do well with psychological therapy
alone.
People with moderate to severe depression most often benefit from antidepressants. Depending on the patient's diagnosis and severity of symptoms, the doctor may prescribe medication and/or one of the several forms of therapy that have proven effective for depression.
Therapy
Many forms of psychological therapy, including some short-term (10-20 week) therapies, can help
depressed individuals. Some therapies help patients gain insight into and resolve their problems.
Behavioral therapists, for example, help patients learn how to obtain more satisfaction and
rewards through their own actions and how to unlearn the behavioral patterns that contribute to or
result from their depression.
Two of the short-term psychological therapies that research has shown effective for some
forms of depression are interpersonal and cognitive/behavioral therapies. Interpersonal therapies
focus on the patient's personal relationships that both contribute to or worsen the depression.
Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving
that often complicates, contributes or increases the depression.
Medication
There are a variety of anitdepressent medication now available for depression. These include the newer (SSRIs) selective serotonin reuptake inhibitors, as well as tricyclics, and monoamine oxidase inhibitors (MAOIs). Some of the more common SSRIs approved by the FDA for depression include Prozac (fluoxetine); Paxil (paroxetine); Celexa (citalopram); Lexapro (escitalopram); Effexor (venlafaxine); and Zoloft (sertraline). Wellbutrin (bupropion) is also popular antidepressant, though not an SSRI. The SSRIs and other newer medications help affect neurotransmitters such as dopamine or norepinephrine, and generally have fewer side effects than tricyclics.
Antianxiety drugs or sedatives are not antidepressants. They are sometimes prescribed along with antidepressants; however, they are not effective when taken by themselves for depression.
Sometimes the doctor will try a variety of antidepressants before finding the most effective medication or combination of medications. Sometimes the dosage must be increased to be effective. Although some improvements may be seen in the first few weeks, antidepressant medications must be taken regularly for 3 to 4 weeks (in some cases, as many as 8 weeks) before the full effect occurs.
With depression, patients are often tempted to stop medication too soon. Sometimes they start to feel better and think they no longer need the medication. Or they may think the medication isn't helping because they haven't allowed enough time for the treatment to begin taking affect. It is important to keep taking medication until it has a chance to work, though side effects may appear before antidepressant activity does. Once the individual is feeling better, it is often recommended to continue the medication for at least 4 to 9 months to prevent a recurrence of the depression.
Medication in the body
Some medications must be stopped gradually to give the body time to adjust. This facet is often overlooked but very, very important—too often, someone will decide to stop treatment without consulting their doctor because they feel better. Never stop taking an antidepressant without consulting the doctor for instructions on how to safely discontinue the medication. Antidepressant drugs are not habit-forming. But like any medication prescribed for more than a few days, antidepressants have to be carefully monitored for correct dosage. And different specific medications require specific dosages and timetables to safely adjust out of one's system.
Also, for the small number of people for whom MAOIs are the best treatment, it is necessary to avoid certain foods that contain high levels of tyramine, such as many cheeses, wines, and pickles, as well as medications such as decongestants. The interaction of tyramine with MAOIs can bring on a hypertensive crisis, a sharp increase in blood pressure that can lead to a stroke. The doctor should furnish a complete list of prohibited foods that the patient should carry at all times. Other forms of antidepressants do not have food restrictions.