In this article

• Treatment of depression is psychological and medication
• Psychotherapy
• Role of medication in the treatment of depression

Treatment of depression is psychological and medication.

Psychotherapy

The psychological treatment of depression is now referred to as psychotherapy and it is used as a two pronged attack on depression. Firstly the benefit of supportive counseling eases the isolation and sense of hopelessness that accompanies depression.

Cognitive therapy changes the way depressed people perceive the world. Cognitive behaviour leads to an examination of thought processes, and how we arrive at those processes as an individual. Patients are encouraged to examine the assumptions that have been made to establish the thought patterns.

Cognitive therapy can alter pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create not only causes depression, but also sustain it. Cognitive therapy helps the depressed person to establish the difference between critical major life problems and minor difficulties. This type of treatment is often accompanied by the development of realistic life gaols, and positive self-assessment. The theory underpinning the treatment is that if a depressed person can alter the decisions that are causing stress then they can cope better with life.

Supportive counseling whilst a helpful aspect of treatment will never relieve the symptoms on its own. Internal changes have to occur and that includes a more balanced evaluation of the result of life’s problems. External changes can include management and problem solving skills.

The level of depression to a certain extent dictates the length of appropriate treatment. Many people start to experience a level of relief between the sixth and tenth session. The majority will have experienced a significant life changing experience between twenty and thirty sessions. How often they are scheduled does depend on the level of crises, but once a week is average.

The Role of medication in the treatment of depression.

Anti-depressants were once the mainstay of the treatment of depression. Modern research has shown them to be an adjunct to other therapies, in the treatment of mild depression. If you are feeling that you cannot cope with life’s problems, whether it be temporary as in a reaction to grief, or a more permanent sense of hopelessness, then an anti depressant will suppress and control the symptoms not cure them.

Having said that they can control some of the symptoms such as chronic fatigue or appetite disturbances that are preventing you from making life-changing decisions.

Medication is often used in cases of severe depression and bi-polar disorder. The decision whether or not to take medicine should be taken after consultation with your physician, to assess your clinical symptoms, and a trained psychologist to assess what other treatments are appropriate. If you have a pre-existing chronic medical condition or a serious illness, and part of the treatment for that illness includes medication then that is also considered.

Antidepressant medications can make psychotherapy more effective, If a person is introspective as a result of their depression, then all the benefits of psychotherapy or counseling may be lost. To respond to treatment you need to be aware of the options that you can undertake to change things for the better. Often the severely depressed cannot see the wood for the trees. This means that temporary medication may be advisable.

How long someone must take a psychotherapeutic medication depends on the disorder, and the length of time the person has been suffering untreated. For some the medications have taken effect within a few months and they never need it again. Others need it on a long term or permanent basis. There are grades in between whereby some benefit from treatment, and can stop taking the drugs, and then they experience a relapse and need to undergo clinical treatment again.

Like any medication, psychotherapeutic medications do not produce the same effect in everyone. Some people may respond better to one medication than another. Some may need different dosages, either larger or smaller. The side effects are also different some experience none whilst others can have disturbing side effects. Personal habits also affect the efficacy of the treatment; they are age, sex, body chemistry drug or alcohol or tobacco abuse; as well as the existence of other illnesses.

There is a great deal of online help regarding depression, but it is a specialist area, and self-diagnosis is rarely accurate. Anti depressant medicines must never be regarded as “uppers” they help to control the more severe symptoms of depression, and may help the sufferer to regain the mental state they had before being depressed. What they are useful for is blocking the physical symptoms of a panic attack. These include an increased heart rate, irrational feelings of terror, palpitations and dizziness, breathing difficulties and the feeling of nausea.

Unfortunately there is no such thing as a typical medication, for a typical condition, the patient may respond better to one treatment than another. This needs a trial and error hands on approach. Some patients begin to get relief in one to three weeks, other take longer. If there has been no significant relief within six weeks then your doctor may change your medication. Sometimes additional treatments are used in a form of maintenance treatment; lithium is often used in bi-polar disorder.

The different medicines differ in their effectiveness and also their side effects. As in other areas of medicine, technological advances have altered the medications. Tricyclic antidepressants used to be the most common types of medication of major depression, and Monoamine oxidase inhibitors (MAOIs) were often used for anxiety, panic attacks, sweating, and oversleeping.

Newer anti depressants with fewer side effects are being developed all the time. Most of them contain selective serotonin reuptake inhibitors" (SSRIs). The brand names include fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). (Luvox has been approved for obsessive-compulsive disorder, and Paxil has been approved for panic disorder.)

All thse medicines have different structures but they are all designed to act on one specific neurotransmitter, and that is serotonin.The older medicines did not target serotin as effectively. They are often used in the treatment of obsessive treatment disorders (OTD)

Before any decisions about treatment is made it is essential that your doctor is waware of your full medical history. Tricyclic medicines can cause side effects, and whilst they are different for each person they include blurred vision, dry mouth, constipation, weight gain, dizziness when changing position, increased sweating, difficulty urinating, changes in sexual desire, decrease in sexual ability, muscle twitches, fatigue, and weakness. Not everyone suffers from all or any of these symptoms, but the level does vary.

Also the medicine causes heart complication in some people. Tricyclics also may interact with thyroid hormone, antihypertensive medications, oral contraceptives, some blood coagulants, some sleeping medications, antipsychotic medications, diuretics, antihistamines, aspirin, bicarbonate of soda, vitamin C, alcohol, and tobacco.

As these medication have potentially lethal side effects it is important to keep your doctor in the picture, it is important not to misrepresent the amount of alcohol you drink, the amount you smoke, or the other medications you may be taking.