Depression Treatment

A number of treatment options offer relief from depression.

Psychotherapy

Which Psychotherapies Work Best?

Several have research to prove effectiveness:

Cognitive Therapy

Depression is often caused or maintained by attitude and thought patterns. Cognitive therapy helps clients find and replace depressive thought patterns and attitudes. Research demonstrates that cognitive therapy is one of the most effective therapies for depression.

EMDR

Eye Movement Desensitization and Reprocessing therapy is a well-researched approach to dealing with some types of depression. It won't help biologically based depression. But it can be very effective with depression caused by early environment and present life circumstances.

The principle behind EMDR is the use of rapid eye movement to adaptively reprocess previously unprocessed depressing memories. Reprocessing usually occurs much more rapidly than with the talk therapies. Learn more about EMDR.

Group Therapy

Group therapy has proven effective in helping people move beyond depressive patterns. It is usually used after individual therapy, to reinforce gains made in individual work.

Client-Therapist Relationship

Not only is it important to use a therapy that will get results, the therapist is also an important factor.

Medication

Drugs called antidepressants are used to treat depression and other mood disorders that include depression. They do not cure depression, but can sometimes produce reduction of symptoms.

Types of Antidepressants

There are four major families of antidepressants on the market. All of them affect brain chemicals called neurotransmitters.

Five types of antidepressants include:

SSRIs

Some of the newest antidepressants are called selective serotonin re uptake inhibitors, or SSRIs. SSRIs alter the levels of the neurotransmitter serotonin in the brain, which, like other neurotransmitters, helps brain cells communicate with one another.

Fluoxetine (Prozac®), sertraline (Zoloft®), escitalopram (Lexapro®), paroxetine (Paxil®), and citalopram (Celexa®) are some of the SSRIs commonly prescribed for panic disorder, OCD, PTSD, and social phobia.

SSRIs are also used to treat panic disorder when it occurs in combination with OCD, social phobia, or depression. Venlafaxine (Effexor®), a drug closely related to the SSRIs, is used to treat GAD.

These medications are started at low doses and gradually increased until they have a beneficial effect.

SSRIs have fewer side effects than older antidepressants, but they sometimes produce slight nausea or jitters when people first start to take them. These symptoms fade with time. Some people also experience sexual dysfunction with SSRIs, which may be helped by adjusting the dosage or switching to another SSRI.
Tricyclics

Tricyclics are older than SSRIs and work as well as SSRIs for anxiety disorders other than OCD. They are also started at low doses that are gradually increased.

They sometimes cause dizziness, drowsiness, dry mouth, and weight gain, which can usually be corrected by changing the dosage or switching to another tricyclic medication.

Tricyclics include imipramine (Tofranil®), which is prescribed for panic disorder and GAD, and clomipramine (Anafranil®), which is the only tricyclic antidepressant useful for treating OCD.
MAOIs

Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressant medications.

The MAOIs most commonly prescribed for anxiety disorders are phenelzine (Nardil®), followed by tranylcypromine (Parnate®), and isocarboxazid (Marplan®), which are useful in treating panic disorder and social phobia.

People who take MAOIs cannot eat a variety of foods and beverages (including cheese and red wine) that contain tyramine or take certain medications, including some types of birth control pills, pain relievers (such as Advil®, Motrin®, or Tylenol®), cold and allergy medications, and herbal supplements.

These substances can interact with MAOIs to cause dangerous increases in blood pressure. The development of a new MAOI skin patch may help lessen these risks.

MAOIs can also react with SSRIs to produce a serious condition called “serotonin syndrome,” which can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm, and other potentially life-threatening conditions.

Please note:

Alcohol inhibits the positive effects of anti-depressants.
Antidepressants sometimes can cause children and adolescents to become suicidal.

Light Therapy

Light therapy is used with seasonal depression, since the lack of light has been suspected of causing this type of depression. For more information see Seasonal Depression on our Bill Jacobs LPCC web site

Electro Convulsive Therapy (ECT)

Before drug therapy was available this form of treatment was used more frequently.

ECT was targeted by the media as a negative form of treatment. Consequently many people have an extremely negative view of it.

However, the present day use of this therapy is not nearly as stressful to the body as it used to be. Some people who suffer severe depression find significant relief from ECT.

This form of therapy is usually reserved for people who's symptoms are so sever as to be hospitalized.

Hospitalization

In some cases depression is so sever that patients are placed in in-patient treatment centers. In such cases the ability to function has seriously deteriorated and suicidal thinking is usually a factor.

Additional Resources

More on treatment from the Psychology Information Online...