Treatments for Depression
What are the Best Treatments for Depression?
What can you do with depression? What are the the effective, perhaps the most effective, treatments for depression?
Most of the books or websites about depression list only two types of treatments for depression, namely antidepressants and psychotherapy. However, thank heaven and perhaps the human wisdom, the inventory is definitely longer.
It is vital to present a summary of different treatments for depression possibilities with pros and cons.
How to deal with depression?
Main types of possible treatments for depression:
Combination of antidepressants and psychotherapy
Physical (clinical) treatments for depression
detailed list of Treatments for depression with pros and cons
Treatments for Depression: Antidepressant drugs
I have always had a problem with meds, whatever side effect listed and some that or not I get, for example with buspar I got a ringing in my ear which turned into tinnitus that I have today, this is a rare side affect but I got it. I have just resigned myself to be depressed and unhappy, in fact I am familiar with the feeling, probably would not know what to do if I felt otherwise.Pam
Tricyclic Antidepressants
Tricyclic antidepressants are the oldest. They are prescribed much less frequently now, largely because of their long list of possible side effects. However, there are some patients who do not respond to the newer drugs, and the tricyclics remain a very useful group of medications.
Cons:
- Anticholinergic: dry mouth, constipation, urinary retention, accommodation problems, glaucoma
- Antihistaminergic: sedation
- Alpha blockade: postural hypotension, sedation
- Unknown mechanism:weight gain
- Cardiotoxic: QT prolongation, ST elevation, AV block, membrane stabilization, arrythmias
- Neurotoxic: delirium, movement disorders, convulsions
Monoamine Oxidase Inhibitors (MAOI)
A second, older class of antidepressants is the monoamine oxidase inhibitors. MAOIs are often used in cases of severe depression, especially those associated with lethargy and poor motivation. They are also used in cases where treatment resistance is seen (possibly also combined with lithium and/or L-tryptophan). Anxiety states can be treated with MAOIs, and they are sometimes helpful in borderline personality disorder. In association with mood stabilizers, MAOIs are given to those with bipolar disorder. They are also prescribed in certain cases of atypical depression.
Cons:
- Hypertensive crisis occurs with tyramine-containing foods and some drugs. Tyramine normally inactivated in the gut by MAO acts by releasing NE. Symptoms: flushing, headache, increased BP, rarely CVA depression.
- Stimulate and cause insomnia
- Weight gain
- Sexual dysfunction
Selective Serotonin Reuptake Inhibitors (SSRI)
The selective serotonin reuptake inhibitors were the first of the newer ‘designer’ antidepressants, introduced throughout the world in the 1980s. Compared to TCAs and MAOIs, SSRIs are somewhat better tolerated and relatively safer having broad-spectrum efficacy. The SSRIs may be much less likely to trigger mania in bipolar patients than TCAs.
Cons:
- Reduced efficacy in depressed inpatients
- Nausea/vomiting
- Sedation/dizziness
- Gastrointestinal upset
- Sexual dysfunction
- Nervousness/agitation
- Discontinuation symptoms
- Pharmacokinetic interaction
- Serotonergic syndrome
Other New Antidepressants
Since the early 1990s, many other new antidepressants have come on the market that aren’t tricyclics and aren’t SSRIs. Sometimes many of these new agents are listed as “atypical” or “second generation” antidepressants. They have a variety of effects on norepinephrine, serotonin, and other neurotransmitters.
Cons:
- Excessive sedation
- Increased appetite
- Weight gain
- Dry mouth
- Constipation
- Increased sweating
- Urinary hesitancy
- Transient increase in blood pressure
Treatments for Depression: Psychological Therapies
Short-term Dynamic and Psychoanalytic Therapies
These class of therapies are not narrowly focused on symptoms of depression, and their efficacy rates are somewhat less definite than those achieved with symptom-specific therapies. They tend to organize brief interventions around the selection of a specific dynamic focus (usually an interpersonal problem) with links to core conflicts that often originated earlier in life. The current conflict is used as a focus, or "microcosm," for addressing negative patterns in the patient’s life.
Pros: Broadly, the benefits of short-term psychodynamic therapies are equivalent in size to the effects of antidepressants and cognitive–behavioural therapy (CBT). The benefits of CBT may occur more quickly, but those of short-term psychodynamic therapies may continue to increase after treatment.
Cons: Limited number of experts. Expensive. There may be a ceiling on the effects of short-term treatments of whatever type.
Cognitive–Behaviour Therapy (CBT)
Cognitive–behaviour therapy is one of the most extensively researched and widely adopted psychological treatments for depression. It is a combination of behavioural and cognitive therapy. The first is based on the assumption that we learn on the same way as animals do, the key concepts are reinforcements and punishments. The second is based on the assumption that human cognition is organized like a computer, our cognitive functions are programming functions. According to CBT, depressive moods are perpetuated and maintained through irrational beliefs (bad programs) and a distorted attitude (bad behaviour).
CBT sessions are standardized and last between 15 and 20 min. As ‘homework’ patients are asked to perform certain tasks, such as keeping a daily record of activities and listing negative thoughts as they occur. This is often complemented by behavioral techniques, such as scheduling pleasurable tasks and breaking seemingly insurmountable problems into smaller, achievable parts.
Pros: CBT is the most rapid psychotherapy. CBT is particularly effective when combined with antidepressant therapy, and has been found effective in preventing relapse when given in monthly ‘booster sessions’ after successful acute treatment with antidepressant drugs. A sound therapeutic relationship is not required.
Cons: The underlying assumptions of CBT are not solid. CBT is to fast for a slow depressed patient. The required concentration and focus is hard to achieve by a depressed patient.
Interpersonal Therapy (IPT)
The basic assumptions of IPT are that emotional problems are a result of problematic interpersonal relationships experienced during childhood: primarily those between child and parents, but also between siblings and significant others. IPT is based on "neo-Freudian" theory.
Therapy sessions are designed to be standardized
and brief (15–20 min). Clear goals are set and
progress monitored, and new coping strategies are tried
out by the patient as ‘homework strategies’.
Pros: IPT can be a useful treatment of the acute, continuation and maintenance phases of depression. Possible advantages in IPT over CBT for reactive depression.
Cons: Patients may require good social functioning as a pre-requisite.
We investigated the efficacy of pharmacotherapy and psychotherapy for depression by searching for RCT's. Studies were classified according to chronicity and severity and a meta-analysis was applied. Ten studies were included. Remission did not differ between psychotherapy (38%) and pharmacotherapy (35%). No differences were found in chronic, or in non-chronic depression, and in mild or in moderate depression. Both treatments performed better in mild than in moderate depression. Dropout was larger in pharmacotherapy (28%) than in psychotherapy (24%). At follow-up relapse in pharmacotherapy (57%) was higher than in psychotherapy (27%). Psychotherapy and pharmacotherapy appear equally efficacious in depression. Both treatments have larger effects in mild than in moderate depression, but similar effects in chronic and non-chronic depression and at follow-up psychotherapy outperforms pharmacotherapy. De Maat et al., Psychotherapy Research, Volume 16, 2006
Combination of Antidepressants and Psychotherapy
From an empirical standpoint, across large patient groups, combination treatment of depression has not produced dramatic increases over the immediate benefits achieved with drug therapy alone or psychotherapy alone. However, its use appears helpful and appropriate when the response to the initial course of treatment of several months’ duration is unsatisfactory, when symptoms recur, or when longer-range outcomes and lengthening of the interval between episodes of relapse or recurrence are the focus of attention.
Cons: The contradictions of both classes are summing up.
Physical (clinical) Treatments for Depression
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy involves the induction of a brief seizure induced by passing an electrical current across a patient’s brain following the administration of a general anesthetic and a muscle relaxant.
Pros: Earlier onset of action than antidepressant drugs.
Cons: The real and long term effect is unknown because of the unclear mechanism of action of ECT. Long-term memory problems. Safety problems.
Transcranial Magnetic Stimulation (TMS)
TMS involves passing a rapidly alternating electrical current
through a small coil attached to the scalp, thereby
inducing an electromagnetic pulse, which induces a
change in the ionic flow of surrounding brain tissue.
Pros: No seizure activity is induced by the treatment, and therefore no anesthesia is necessary.
Cons: The evidence for its efficacy is currently still rather limited. The real and long term effect is unknown because of the unclear mechanism of action.
Sleep Deprivation
Pros: Nothing
Cons: It is a life threatening intervention.
Treatments for Depression: Alternative Medicine
Acupuncture and Acupressure
Acupuncture treatments can have a calming, mood elevating effect thus it can be considered as one of the depression cures. Acupuncture has also a simplified version, which can be used without a professional therapist, acupressure. It is one of the best depression self treatment: whenever you have a free hand just help yourself balancing your emotions. Read more...
Ayurveda
Pros: Ayurvedic methods for depression treatment are gentle, natural, and effective. They contribute to a long-lasting state of balance that reduce the tendency toward recurrences. Ayurveda offers a more effective treatment of depression without negative side effects and the real possibility of prevention.
Cons: The underlying mechanism of ayurvedic treatment remains unclear. Ayurveda is not enough to heal depression completely. Only a few experts are available.
Homeopathy
Homeopathy is a highly individualised and modern (200 years old only) alternative treatment. Homeopathic remedies are obtained from all the three big kingdoms of nature, mineral, plant and animal and are made with a special procedure, called potentisation. As a result, not to much material compounds remain in the homeopathic remedies and they act more on the soul as on the body. This makes homeopathy to a first class alternative treatment for depression. We have several thousands homeopathic remedies and the number is always growing. The main point is the selection of the right remedy matching to the patient. Finding the right remedy is a difficult procedure should be carried out by a well qualified homeopath.
Pros: Gentle way of healing, no side effects, combined well with any other method of treatment (except aromatherapy).
Cons: Finding the best matching remedy for an individual is quite difficult, should be made by a highly qualified homeopath.
Meditation and Yoga
Meditation and yoga poses can help you fighting depression - the feeling that you can't handle the demands of your life. Practice a daily yoga routine that includes 30 minutes of meditation and at least 20 minutes of poses.
Pros: It tones the nervous system, stimulates circulation, promotes concentration, and energizes mind and body. Yoga stretching exercises help improve blood circulation making it easier to break through the lethargy that often accompanies depression.
Cons: The underlying mechanism remains unclear. Meditation and yoga is not enough to heal depression completely. The breathing exercises may induce maniac episodes.
Natural Cures for Depression
There are so many different natural cures for depression, you would not even dream about it. It is of great importance what you eat or drink, what you put into your body so proper diet is the most important alternative treatment for depression.
Mother nature provides us plenty of little, humble herbs which are great natural remedies for depression.
Aromatherapy for depression is an extremely pleasant natural treatment for depression.
Find our TOP 7 collection of natural treatments for depression...
Depression Self Help
Once you were able to create your depression, you should be able to help yourself. Read more...
Cons: The very nature of depression can make self help difficult. The lack of essential knowledge might turn some trial to be dangerous.
Exercise and Depression
Pros: In a study (2000), researchers at Duke University Medical Center have found that exercise works at least as well as Zoloft, a popular prescription drug, in treating clinical depression and keeping the condition from returning. Read more...
Cons: Nothing.
Treatments for Depression: Music Therapy
According to The American Music Therapy Association (AMTA), music therapy is an effective and valid treatment for persons who have psychosocial, affective, cognitive and communicative needs. Research results and clinical experiences attest to the viability of music therapy even in those who are resistive to other treatment approaches. Music is a form of sensory stimulation that provokes responses due to the familiarity, predictability and feelings of security associated with it. Music therapy is also powerful, but, at the same time, non-threatening medium.
Cons: Nothing
Animal Therapy for Depression
Animal therapy can facilitate many positive changes one such example being increased socialization skills. Animals can be used as part of group therapy programs to encourage communication and increase the ability to focus. Helping to develop a person’s self-esteem and reducing their loneliness and anxiety are just some potential benefits of individual animal therapy.
Pros: easy to do, no side effects, etc.
Cons: not always easy to do
Treatments for Depression: Humour Therapy
Humour therapy (sometimes called therapeutic humour) uses the power of smiles and laughter to aid healing. Humour therapy helps you find ways to make yourself (or others) smile and laugh more. Because it is inexpensive, risk-free, and readily available, there is little reason not to try practicing humor therapy.
Laughing is found to lower blood pressure, reduce stress hormones, increase muscle flexion, and boost immune function by raising levels of infection-fighting T-cells, disease-fighting proteins called Gamma-interferon and B-cells, which produce disease-destroying antibodies. Laughter also triggers the release of endorphins, the body's natural painkillers, and produces a general sense of well-being. Read more...
Cons: Laughter is infectious :)
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