Clinical Depression Treatments
Depression is often treated with medication and psychotherapy (talk therapy). The use of medication can help alleviate many symptoms, but it's not an effective treatment.
Talk therapy incorporates cognitive behavior therapy, which focuses on identifying and changing your negative thoughts. Interpersonal psychotherapy is focused on relationships and issues that could cause depression. Other treatments can be utilized in addition, such as ECT and vagus nerve stimulation.
Medication
Psychotherapy (talk therapy), along with medication, is commonly used to treat depression in clinical cases. Antidepressants are the most popular medications prescribed for patients suffering from clinical depression and can also be antipsychotics or mood stabilizers. It is crucial to understand that these medications can take some time to work so don't lose hope if you aren't feeling better right away. It could take several months or even longer for you to start feeling better, particularly if your symptoms are serious.
Certain people don't respond well to antidepressants, or may experience negative side effects, including dry mouth, weight gain, dizziness, or shakiness. It is important to inform your doctor about any adverse effects and discuss the possibility of altering your medication or your dosage. Finding the right medication can be an exercise in trial and error.
To start treatment, make an appointment to see your doctor or mental healthcare professional. They'll ask about your symptoms and the time they started. They'll also inquire about any other factors that could be affecting your mood such as stress and alcohol abuse. They'll probably want to perform an exam on your body to rule out any medical issues.
A doctor can diagnose a clinical depressive disorder by examining your symptoms and medical records. They can help you to understand what is happening and offer advice and support. They may also refer you to mental health professionals if they feel you need them.
Psychological treatments can reduce the symptoms of depression, and even prevent the recurrence of depression. Cognitive behavioral therapy (CBT), and interpersonal therapy have both been proved to be effective in treating depression. Both therapies require one-on-one sessions with a trained therapist. You can receive them in person or via telehealth.
Other clinical depression treatments include electroconvulsive treatment (ECT) and vagus nerve stimulator. ECT involves the passing of electrical currents through your brain, which alter the functioning and effects of neurotransmitters in order to ease your depression. Esketamine is a second option. It is FDA-approved, and is recommended for people who aren't improving with other medications or at the risk of suicide.
Psychotherapy (talk therapy)
Psychotherapy is one type of talk therapy that can be used to treat depression. Studies show that it is often more effective than medication on its own. It involves talking to an expert in mental health such as psychologist or a social worker. It helps people understand how to deal with negative emotions, thoughts and behaviors. Psychotherapy can be found in a variety of forms. The most popular types of psychotherapy are cognitive behavioral therapy (CBT) as well as interpersonal therapy.
Talk therapy can be conducted in a one-on-one meeting with the therapist, or it can be performed in groups. Group therapy is generally cheaper than individual sessions. It is also less intimidating for some people. It may take longer for the results to be seen.
If you are suffering from depression, it is crucial to seek treatment immediately. Early treatment can stop the symptoms from becoming worse. Treatment can also prevent the condition from recurring. Talk to your doctor about the best treatment for you.
Before diagnosing depression, it's important to rule other medical illnesses out. A physical examination and blood tests could be beneficial. The doctor will also inquire about your symptoms and how they affect your life. The mental health professional employs the same set of criteria called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to determine whether depression is present.
Prescription antidepressants may help by altering the brain's chemical chemistry. They can be used to treat mild, moderate, or severe depression. It can take a bit of time and trial-and-error to find the appropriate dosage and medication for you. Antidepressants' side effects can be uncomfortable, but they generally improve over time.
Some people suffer from severe, life-threatening depression that isn't able to be treated with medication. In those instances electroconvulsive therapy or ECT, can be very beneficial. During ECT the mild electric current flows through your brain, causing an instant seizure. It is highly effective, however, it is not recommended as the first treatment. It is generally reserved for patients who have tried other treatments but have not seen any improvement.
Light therapy
A light therapy device emits bright light to compensate for the absence of sunlight which may cause seasonal affective disorders (SAD). This is often used in conjunction with antidepressant medications. Research suggests that light therapy is effective for both SAD and nonseasonal depression, however, it is to be most effective when it is initiated in the fall or in the early winter before symptoms appear and then continued through spring. Treatment lasts about 30 minutes every morning but you can modify the duration to suit your needs.
Some people may experience more pain while others may experience rapid improvements. If you are feeling suicidal or if your symptoms worsen you should dial 911. Clinical depression is characterised by extreme sadness or hopelessness. Other symptoms include sleeplessness (insomnia) as well as fatigue and low energy levels, trouble talking and thinking and weight loss or gain or loss of weight, and occasionally psychomotor agitation. Bipolar disorder sufferers should not engage in light therapy without consulting a psychiatrist, because it may trigger the symptoms of mania.
Psychological treatments, known as talking therapies, have been found to be effective in treating depression. Cognitive behavioral therapy is one of many types of psychotherapy. It helps you to change unhelpful thinking patterns and improve your coping capabilities. Other psychotherapies, like psychodynamic psychotherapy, assist you to look back at your past experiences and explore how they might be impacting you in the present.
The therapy of brain stimulation isn't frequently utilized as a treatment for depression, but it can be an option if other treatments fail. It involves sending mild electric currents through the brain to trigger brief seizures which restore the balance of chemical and ease your symptoms. This type of treatment is typically used after the patient has tried psychotherapy and medication, but it is sometimes employed earlier in the case of severe life-threatening depression that do not respond to medicine. Psychologists can also suggest lifestyle changes, like increasing physical activity or changing sleeping patterns, to alleviate symptoms. They may also suggest social and family support. Some people find it beneficial to share their feelings with family members and trusted friends, while others prefer seeking for support from peers.
Vagus nerve stimulation
The FDA has approved vagus nerve stimulation as a depression treatment for patients with unipolar or bipolar depression that is refractory. It is a surgically-implanted device that sends electrical impulses through the vagus to the locus ceruleus nuclei and dorsal Raphe nuclei of the brain stem. It is a viable alternative to antidepressants and psychotherapy. The FDA recommends that it is used in conjunction with other treatment options.
The device has shown to help reduce depression by stimulating the cereruleus locus. This is a brain region that regulates the ability to impulsively. It also increases the release of norepinephrine, dopamine, and other neurotransmitters that are believed to be involved in depression improvement. It is important to note that the device must be prescribed by psychiatrists who have been trained in its use.
Multiple studies have shown that VNS can increase the effectiveness of antidepressants and could enhance the effectiveness of psychotherapy in treatment-resistant depression. A recent registry study showed that the use of adjunctive VNS significantly improved depression outcome when compared to pharmacotherapy on its own in a group of patients who were resistant to treatment. The registry is the most comprehensive naturalistic study to date, and provides further evidence that VNS can be an effective treatment for this difficult-to-treat disorder.
VNS is believed to act directly on the limbic system of the brain. Furthermore, studies have demonstrated that it influences monoamine activity in the forebrain. VNS, for example, is associated with increased the gamma aminobutryric (GABA) activity, as well as LC and reduced noradrenergic activity in the cingulate retrosplenial cortex. Moreover, cerebral spinal fluid (CSF) studies in epilepsy patients treated with VNS show increases of homovanillic acid (HVA) and decreases of 5-hydroxyindoleacetic acid (5-HIAA), the major metabolites of dopamine and serotonin, respectively (Ben-Menachem et al, 1995; Naritoku et al, 1995).
In one study, participants receiving VNS were found to have a correlation between deactivation in the medial prefrontal cortex, left superior temporal gyrus and right insula. The insula also displayed an active response to depression severity, with VNS-induced activation increasing over the course of time as reflected by reduced depressive symptoms. The authors of the study suggest that this response is consistent with the function that the insula plays in vicero-autonomic functions and pain modulation.