Guidelines For Treating Depression
The APA, CANMAT BAP NICE and Texas Medication Algorithm Project have released a number of guidelines for treating depression. They recommend psychotherapy, exercise and antidepressant drugs.
The guidelines generally recommend the use of CBT or an SGA before starting on medications and gradually increasing dosages as needed. Augmentation with psychostimulants, lithium SSRIs and SNRIs, as well as TMAPs may be helpful in patients who do not respond to monotherapy.
1. Diagnosis
The first step to treat of depression is obtaining the diagnosis. This involves a conversation with an expert in mental health or a doctor, as well as certain forms of therapy.
innovative depression treatment will ask you about your symptoms and how they have affected your life in the last month. They'll also ask whether you've ever been a victim of thoughts of self-harm or suicide. Your GP will also take a look at your general health, family history, and lifestyle to determine if you have depression or another mental health issue.
You should be honest and open with your doctor so that they get a full picture of how you're feeling. This will make it easier for them to identify the signs of depression. These symptoms can be used to rule out other diseases like heart disease.
Once your GP has determined that you may be suffering from depression, they'll rule out the possibility of other illnesses through tests. For instance, blood tests can check for anemia or thyroid problems that might be causing your depression. They'll also test your blood for vitamin deficiencies or drugs and alcohol that can mimic depression.
If your GP discovers you have depression, they'll explain the reasons behind it and the best approach to treat it. This could include psychotherapy or a combination of therapy and medication. Antidepressants are the most effective medication to treat depression. They alter the balance of chemicals in the brain. These can be taken either orally or via injections and it could take several weeks before they begin to work. They can also cause adverse effects, such as dry mouth and constipation.
2. Medication
Many people can benefit from taking medication. Your doctor may initially prescribe a medication or a combination of antidepressants. If the initial treatment doesn't provide a satisfactory outcome your doctor might suggest that you try another medication or alter the dosage or frequency at which you take it. To get the most benefits of your medication, it is important to take it regularly. You should not stop taking your medication unless instructed to do so by your doctor.
Based on your symptoms, a general antidepressant may be prescribed or an SSRI. An SSRI boosts the levels of serotonin, a chemical that is found in the brain. SSRIs include escitalopram, citalopram, and fluoxetine. Your doctor might also prescribe a serotonin-norepinephrine reuptake inhibitor, or SNRI. Examples of SNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor XR, Khedezla).
If your doctor believes tetracyclics are more effective than SSRIs or SNRIs, they could prescribe them. SSRIs or SNRIs can be used safely by children and adolescents.
It is recommended to inform your doctor if you have any allergies or other health issues before you begin taking treatment. Some medications can result in side effects like an dry mouth or stomach that is upset. These side effects are generally minor and will disappear by themselves in around a week. Do not drive or operate machinery if you are taking medication.
Alcohol and other recreational drugs can exacerbate depression symptoms like restlessness or difficulty sleeping. These substances should not be used as they can make depression difficult to treat. Continued use, especially over a prolonged period, can lead to more serious issues.
3. Psychotherapy
Psychotherapy, also known as talk therapy, can help you deal with issues that contribute to depression. This type of treatment is long-term but has been proven to be effective in treating depression. Psychotherapy can be done in many different settings such as private therapy offices, hospitals, psychiatric clinics, and rehabilitation facilities. It's usually one-on-one therapy, but it is also possible to do group therapy.
Your therapist will ask about your thoughts, feelings, and relationships, and will discuss these with you in a private and confidential setting. In the initial sessions your therapist gets to know you better and recommends a treatment program. This could include psychotherapy, medication, activity and exercises or other treatments such as repetitive transcranial magnetic stimulation (rTMS), or electroconvulsive treatment (ECT).
Some are short-term, and they concentrate on specific issues. Interpersonal therapy (IPT) is one example. It helps people comprehend the root issues such as unresolved grievance or conflicts with other people. Depression can be triggered by a range of factors that range from loss and stress to unresolved traumas or abuse. These may require more intensive therapy or other treatments.
Cognitive behavioral therapy (CBT), also known as cognitive restructuring, aids people to change their thinking patterns, which cause symptoms. It also improves coping skills and helps them to manage the stress and conflicts of life. Dialectical behavior therapy (DBT) blends elements of CBT with mindfulness techniques, that help you to observe and accept your emotions.
Sometimes, psychological treatment can help with acute, moderate or severe depression as effectively as antidepressants can. It can take a bit longer for it to take effect and not everyone will respond in the same manner. It is important to be present at your therapy sessions and to complete your homework between sessions (like journaling or meditating).
4. Counseling
If you are experiencing depression symptoms that are mild or severe it is important to seek treatments that help. It is often counseling or psychological therapy. The assistance of an outside professional with your issues could be life-changing. It might take a few therapists to find the one who resonates with you. But it is worth the effort.
There are many types of psychotherapy. However the majority of them involve discussing your concerns and learning strategies to deal with depression. It can also be beneficial to discuss your experiences with a group of people who are experiencing similar issues. Group counseling is available in medical clinics, hospitals, therapists' offices, and even over the phone via online Telehealth services.
Counseling for depression aims at changing negative thoughts and behaviors that can contribute to the disorder. For instance, a therapist might help you to manage stress to improve your mood. You might be taught to recognize irrational thoughts and challenge preconceptions that make you feel depressed. You can utilize EMDR to release painful or traumatic memories that may be causing depression.
Other therapies, like cognitive behavioral therapy and behavioural activation therapy, can be used to assist you in identifying and alter your behavior patterns. For instance behavioural activation therapy can be helpful when depression causes you to withdraw from social activities. The goal is to promote more social interaction and to determine the ways your actions affect your mood. In general, these strategies are employed together with medication. You can find a qualified therapist in your local area by asking your doctor to refer you or by calling the community mental health center.
5. Exercise
The benefits of exercise in the prevention and treatment of depression are well-established. It's not a typical treatment. Psychotherapy and medication are more frequently used. A growing body of research suggests that exercise is just as effective as antidepressants and other talking therapies in treating depression.
A meta-analysis of over 150 studies showed that it was more efficient than drugs or psychotherapy alone. The study found that, on average, those suffering from depression who exercised improved their symptoms by five points with one measure and 6.5 points using another, which is clinically significant. The results were similar regardless of whether they exercised for just a few minutes or an hour each day.
Exercise is an excellent alternative to psychotherapy or medication, which are not suitable for everyone. And it has the added benefit of keeping us physically fit and helping to ward off other mental health problems like anxiety.
What's more exercising doesn't come with the stigma that can be associated with taking drugs or going to talk therapy. Exercise is available to everyone and comes at a low cost and can be a empowering method.
It's difficult to study the effects of exercise on health because it's difficult for researchers to regulate factors like how much people exercise in their normal routine and any other medications they might be taking. So more research is needed to determine the best amount, frequency, and duration of exercise to prevent and treating depression. To aid in that, GPs and other health professionals are increasingly prescribing exercises to their patients as part of their treatment plan. It's called a 'green prescription' and involves writing a fitness program based on the patient's needs and encouraging them to become active through regular face-toface or phone calls with a certified fitness professional like an physical therapist or exercise physiotherapist.