Women and Depression

Depression is a Treatable Illness:
Types of Treatment

Even severe depression can be highly responsive to treatment. Indeed, believing one's condition is "incurable" is often part of the hopelessness that accompanies serious depression. Such patients should be provided with the information about the effectiveness of modern treatments for depression. As with many illnesses, the earlier treatment begins, the more effective and the greater the likelihood of preventing serious recurrences. Of course, treatment will not eliminate life's inevitable stresses and ups and downs. But it can greatly enhance the ability to manage such challenges and lead to greater enjoyment of life.

As a first step, a thorough physical examination may be recommended to rule out any physical illnesses that may cause depressive symptoms.

Types of treatment for depression

The most commonly used treatments for depression are antidepressant medication, psychotherapy, or a combination of the two. Which of these is the right treatment for an individual case and depends on the nature and severity of the depression and, to some extent, on individual preference. In mild or moderate depression, one or both of these treatments may be useful, while in severe or incapacitating depression, medication is generally recommended as a first step in the treatment. In combined treatment, medication can relieve physical symptoms quickly, while psychotherapy allows the opportunity to learn more effective ways of handling problems.

Medications

The medications used to treat depression include tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), serotonin reuptake inhibitors (SRIs), and bupropion. Each acts on different chemical pathways of the human brain related to moods. Antidepressant medications are not habit-forming. To be effective, medications must be taken for about 4-6 months (in a first episode), carefully following the doctor's instructions. Medications must be monitored to ensure the most effective dosage and to minimize side effects.

The prescribing doctor will provide information about possible side-effects and dietary restrictions.

In addition, other medically prescribed medications being used should be reviewed because some can interact negatively with antidepressant medication. There may be restrictions during pregnancy.

Psychotherapy

In mild to moderate cases, psychotherapy is also a treatment option. Some short-term (10-20 week) therapies have been very effective in several types of depression. "Talking" therapies help patients gain insight into and resolve their problems through verbal give-and-take with the therapist. "Behavioral" therapies help patients learn new behaviors that lead to more satisfaction in life, and "unlearn" counter-productive behaviors.

Research has shown that two short-term psychotherapies, Interpersonal and Cognitive/Behavioral, are helpful for some forms of depression. Interpersonal therapy works to change interpersonal relationships that cause or exacerbate depression. Cognitive/Behavioral therapy helps change negative styles of thinking and behaving that may contribute to the depression.

Other treatments

Despite the unfavorable publicity electroconvulsive therapy (ECT) has received, research has shown that there are circumstances in which its use is medically justified and can even save lives. This is particularly true for those with extreme suicide risk, psychotic agitation, severe weight loss or physical debilitation due to other physical illness. ECT may also be recommended for persons who cannot take or do not respond to medication.

Some people experience depressive illness during the winter (seasonal depression), and are helped by a new form of therapy using lights, called phototherapy.

Treating recurrent depression

Even when treatment is successful, depression may recur. Studies indicate that certain treatment strategies are very useful in this instance. Continuation of antidepressant medication at the same dose that successfully treated the acute episode can often prevent recurrence. Monthly interpersonal psychotherapy can lengthen the time between episodes in patients not taking medication.

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