Overview of Treatment Approaches for Clinical Depression

First of you should be aware that depression, even in the most severe forms, is a highly treatable disorder. However, as with many mental illnesses, the earlier that treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.

There are several valid reasons for seeking and obtaining treatment for depression:
  • The treatment can result in health improvements that would not occur otherwise.
  • The treatment is likely to result in quicker recovery.
  • The treatment can result in a more complete recovery, with fewer leftover symptoms.
  • The treatment can help to prevent relapse.
The first step to getting appropriate treatment is to visit a doctor. Certain medications, and some medical conditions such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor can rule out these possibilities by conducting a physical examination, interview and lab tests. If the doctor can eliminate a medical condition as a cause, he or she should conduct a psychological evaluation or refer the patient to a mental health professional.

The doctor or mental health professional will conduct a complete diagnostic evaluation. He or she should discuss any family history of depression, and get a complete history of symptoms, e.g., when they started, how long they have lasted, their severity, and whether they have occurred before and if so, how they were treated. He or she should also ask if the patient is using alcohol or drugs, and whether the patient is thinking about death or suicide.

Once diagnosed, a person with depression can be treated with a number of methods. Although there are claims supporting the effectiveness of many different treatment approaches for depression, there are relatively few of them that have been tested thoroughly and supported through well-controlled research studies. You should know upfront that research does not predict individual responses to the specific depression treatments. In other words, just because it works for some (or even most) people does not mean it will work for you. It’s important to keep this in mind as you or a loved one undergoes treatment for depression, because the first treatment or set of treatments tried may not be effective.

Most clinicians practicing today believe that depression is caused by an equal combination of biological (including genetics), social, and psychological factors. A treatment approach that focuses exclusively on one of these factors is not likely to be as beneficial as a treatment approach that addresses both psychological and biological aspects (through, for example, psychotherapy and medication). Depression remains a complicated, complex disorder and researchers are only beginning to fully grasp the multitude of factors — personal, genetic, biological, societal, and environmental — that are involved. Any explanation or approach which emphasizes only one factor as the cause of depression is misleading and simplistic. Individuals should avoid accepting a simplistic answer to such a devastating and complex disorder.

Treatment for depression, like for most mental disorders, usually relies on psychotherapy and medication for the quickest, strongest effects. Treatment is usually begun immediately after the initial clinical interview with a mental health professional.

Depression treatment takes time, and patience is needed.

We will just list the possible approaches to treat depressive disorder in this introductory post, while giving more related information in the separate reviews.

Depression Treatment Approaches:

  • Therapy
There are a wide number of different types of effective therapeutic approaches utilized for the treatment of depression today. These range from cognitive behavioral therapy, to behavioral therapy, to interpersonal therapy, to rational emotive therapy, to family and psychodynamic approaches. Both individual and group modalities are commonly used, depending upon the severity of the depressive episode and the local resources within an individual’s community.

  • Medications
Antidepressants work to normalize naturally occurring brain chemicals called neurotransmitters, notably serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists studying depression have found that these particular chemicals are involved in regulating mood, but they are unsure of the exact ways in which they work.

  • Hospitalization
Hospitalization of an individual is necessary when that person has attempted suicide or has serious suicidal ideation or plan for doing so. Such suicidal intentions must be carefully and fully assessed during an initial meeting with the client. The individual must be imminent danger of harming themselves (or another). Daily, routine daily functioning will likely be negatively affected by the presence of a clear and severe major depression. Most individuals who suffer from major depression, however, are usually only mildly suicidal and most also often lack the energy or will (at least initially) to carry out any suicidal plan.

§         Electroconvulsive Therapy (ECT)

For cases in which medication and/or psychotherapy does not help alleviate a person's treatment–resistant depression, electroconvulsive therapy (ECT) may be useful. ECT, formerly known as "shock therapy," once had a bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe depression who have not been able to feel better with other treatments.

§         Repetitive Transcranial Magnetic Stimulation (rTMS)

Repetitive transcranial magnetic stimulation (rTMS) utilizes an electromagnet placed on the scalp that generates magnetic field pulses roughly the strength of an MRI scan. The magnetic pulses pass readily through the skull and stimulate the underlying cerebral cortex. Low frequency (once per second) TMS has been shown to induce sustained reductions in cortical activation in multiple studies.

§         Self-Help

Self-help methods for the treatment of depression may be very successful for some individuals. Support groups are especially effective, since they allow the individual an opportunity to socialize and be with others who suffer from similar feelings. Many support groups exist both online and off where depression sufferers can share their commons experiences and feelings. 

  • Alternative Therapies.
There are many alternatives approaches to treat depression, widely publicized in the press and online, however, you should be very cautious trusting the modern gurus your life and well-being. While many of them have not been clinically proven and recognized by the doctors, you might find some of the ways to be helpful and complimentary to your conventional treatment approaches. Always consult with your doctor or therapist before trying them. Among the most popular methods are physical activities, folate supplements, St. John’s wort, essential fatty acids, acupuncture, etc.

Sources and Additional Information:


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