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What are the different types of treatment?
The most common treatment for depression includes the
combination of antidepressant medicine and psychotherapy.
Psychotherapy
Psychotherapy is sometimes called
"talking therapy." It is used to treat mild and moderate forms of
depression. A licensed mental health professional helps people with depression
focus on behaviors, emotions, and ideas that contribute to depression. They also
help the depressed person identify and
understand life problems that contribute to their illness in order to
enable them to regain a sense of control. Psychotherapy can be done on an
individual or group basis and can include family members and spouses. It is most
often the first line of treatment for depression.
Medicines
Medicines are commonly used to treat
depression. Your family doctor or a psychiatrist can prescribe the medications,
which are chosen based on your symptoms. The cost of medicines and potential
side effects are important considerations when choosing this type of treatment
for depression.
Electroconvulsive therapy
Electroconvulsive therapy (ECT) is a
procedure in which of an electric current is used to produce a seizure in the
patient. It is believed that ECT results in the release of chemicals in the
brain that aid communication between nerves. It is one of the fastest and most
effective ways to relieve symptoms in severely depressed or suicidal patients
or patients who are suffering from mania. ECT is used when severe depression is
unresponsive to other forms of therapy. It also is used when medication is
considered unsafe. Although it is safe and effective, ECT remains the most
controversial treatment for psychiatric illnesses because of potential risks
from incorrect administration, and because of misconceptions about ECT—from
the media and in movies like One Flew Over The Cuckoo's Nest. ECT is
usually followed by psychotherapy and medication under a psychiatrist's care. On
occasion, ECT is prescribed on a regular basis (monthly to quarterly) to prevent
further episodes of depression.
Alternative treatments
Alternative treatments can sometimes provide
relief that traditional western medicine cannot. While some alternative
treatments have become accepted as part of modern health care practice, others
still have not been proven safe and effective.
Whether they are scientifically effective, alternative
therapies—by providing forms of relaxation and relief from stress—have a
place in healing and general health and well-being. Examples of alternative
therapies include acupuncture, guided imagery, chiropractic treatments, yoga,
hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage, and
many others.
In general, alternative therapies by themselves are effective
for mild, but not more severe forms of depression.
Experimental therapies
Experimental therapies are treatments that are not
regularly used by doctors. Their safety and effectiveness are still being
studied.
Some experimental therapies currently being investigated for
treatment of depression include:
Vagal nerve stimulation (VNS) —
Traditionally used for epilepsy, this treatment uses electrical pulses to
stimulate the vagus nerve, a nerve thought to affect the area of the brain that
controls depression. A tiny pacemaker-like device implanted in the chest sends
electrical impulses to an electrode in the neck to stimulate the nerve and
provide relief. This has only been used for patients who have not responded to
standard treatment methods. Research is underway to prove its safety and
effectiveness.
Transcranial magnetic stimulation (TMS)
— Also called repetitive transcranial magnetic stimulation (rTMS),
this is a technique in which magnets are placed on the head for a short time to
alter the electrical currents in the part of the brain thought to control mood.
Transcranial magnetic stimulation has been shown to help some people with
depression and has few, if any, side effects. It is not, as originally
anticipated, a replacement for ECT. Although these results are promising, more
studies are needed to determine any long-term side effects and benefits.
Hormone replacement therapy (HRT) in women —
Depression is more common in women than in men. Changes in mood with
premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), after
childbirth, and following menopause are all linked with sudden drops in hormone
levels.
Hormone replacement is a treatment currently used to relieve
symptoms of menopause such as night sweats and hot flashes. By using HRT, women
can help prevent osteoporosis and possibly reduce memory loss. There are many
advantages to using HRT for relieving symptoms of menopause; and although they
may, in the future, be found to help depression in some women, these hormones
can actually contribute to depression. Be sure to tell your doctor if you have
had depression before and are considering HRT.
Can depression come back?
Even when treatment is successful, depression can
return. Psychotherapy and/or maintenance antidepressant medication can help
prevent depression from coming back by correcting the beliefs, perceptions, and
behaviors that contribute to your depression. If you do experience recurring
symptoms, don’t hesitate to seek help again.
What is the outlook?
The outlook for depressed people who seek treatment is
very promising. By working with a qualified and experienced mental health care
professional, you can regain control of your life.
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