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Depression Overview


Treating Depression
Electroconvulsive therapy is often misunderstood. This patient was treated at Hillside Mental Hospital circa 1955.
Electroconvulsive therapy is often misunderstood. This patient was treated at Hillside Mental Hospital circa 1955.
Carl Purcell/Three Lions/Getty Images

Depression's forms and symptoms vary from person to person, and so does its treatment. What works for one person may not work for another. Clinical depression is highly treatable and more than 80 percent of people who are treated show improvement [source: Mental Health America].

Effective and common treatments for major and chronic depression are antidepressant medications to relieve symptoms and psychotherapy to learn effective coping methods, or a combination of the two.

Antidepressant medications help to normalize levels of mood-regulating chemicals in the brain, specifically neurotransmitters called serotonin, norepinephrine and dopamine.

The newest types of antidepressants are selective serotonin reuptake inhibitors (SSRIs), known commercially as Prozac, Paxil and Zoloft, among others. Also commonly prescribed are serotonin and norepinephrine reuptake inhibitors (SNRIs), known to us as Effexor and Cymbalta. SSRIs and SNRIs generally have fewer side effects than the more established tricyclics and monoamine oxidase inhibitors (MAOIs), which are known to have food and drug interactions. One type of antidepressant may work better than another from person to person, and doctors encourage patients to try different forms until the right one is found.

Antidepressants are taken regularly for at least four weeks (in some cases eight weeks) before improvement is noticed, and it usually takes six to 12 months for complete therapeutic effect. In cases of severe or chronic depression, long-term treatment may be needed.

Psychotherapy is typically used in conjunction with medication, although for mild cases of depression, it may be best used solo. In psychotherapy, also known also as talk therapy, people speak with a mental health professional about ways to deal with their depression and symptoms, thoughts of suicide and other problems. There are two main types of psychotherapy: cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). CBT teaches people new ways of thinking and behaving, whereas IBT helps people understand and work on personal relationships that may be contributing to their depression.

One of the most misunderstood therapies used to treat severe depression is Electroconvulsive Therapy (ECT). ECT is used when medications and psychotherapy are not effective, usually in suicidal patients, patients who experience treatment-resistant depression or patients who suffer from depression and mania. Formerly known as shock therapy, ECT has improved since the 1940s and 1950s when stories of misuse and controversy were in the media. During treatment, a patient is given a muscle relaxant and anesthesia. Electrodes are affixed at specific placements on the head and are used to deliver electrical impulses of about 30 seconds, causing a seizure within the brain. ECT is usually given three times per week for several sessions.

For people looking for more natural remedies, St. John's Wort and other alternatives such as acupuncture, herbal remedies, biofeedback, massage and yoga have been gaining increased attention in the last several years. In recent scientific studies, St. John's Wort proved effective for mild depression, but acted no better than a placebo when treating major depression [source: National Institute of Mental Health].

For more information about depression and other mood disorders, including where to find help near you, visit the following resources.