Depression…treatment

Treating depression early and effectively can prevent it from becoming more severe and lasting longer. The type of depression a person is suffering with will determine the best choice for treatment.

Major Depression and Dysthymia can be treated with both psychotherapy and medication. Most people respond well to these in combination. Psychotherapy should focus on learning coping strategies, problem solving skills, challenging negative mindsets and changing critical as well as pessimistic thought patterns. Improvement comes when a person begins to feel empowered and more in control of his life (and emotions).
Supportive therapy should also be used to help address painful feelings of hopelessness and despair. However this type of therapy should be a part of the treatment and not the only method.

Medication is an option with major depression. Antidepressant medication can often help to relieve the painful impact of symptoms such as the inability to concentrate or sleep, inability to work, control emotions or make decisions necessary to effectively conduct everyday life.

Antidepressants work by increasing the availability and level of certain neurotransmitters in the brain. Neurotransmitters carry information to the different parts of the brain.  These chemicals and their levels of availability affect the range of moods we experience.

In severe cases of depression where other forms of treatment have not helped, electroconvulsive therapy (ECT) may be recommended. In this type of therapy electric current is passed through the brain of the patient while under anesthesia causing convulsive seizures to occur for about 15 seconds each. ECT has been shown to be effective, especially as a treatment of last resort, but its side effects can include some memory loss and disorientation.

The treatment of Bipolar Disorder will most likely include medication. As explained in the previous article, this is a very serious and disabling mental illness. It is chronic and manic episodes followed by depressive episodes are likely to recur if treatment is not ongoing.

Lithium and anti-convulsive medications such as Depakote, Lamictil and Neurontin are often used in combination to achieve mood stabilization. Getting the patient on the best combination of medication is both science and art and can be trying for the patient and his family.

People with bipolar disorder are sometimes discouraged by the difficult task of keeping their moods in check over long periods of time. The patient sometimes complains that the edge or “high” he used to enjoy feeling has been replaced by a different mood, one he may interpret as being flat and boring.

When this occurs he may stop taking the medication and go back to “cycling” through his moods again. That is why long-term counseling that includes the monitoring of the patient’s medication, moods, sleep patterns and general health is often critical in maintaining control over bipolar disorder.

Postpartum Depression has similar symptoms to major depression. If left untreated the consequences of postpartum depression can be dire. The attachment bond that is so important for a child’s healthy development will likely not occur if mother is not getting the help she needs.

Treatment here should be multifaceted and involve the entire immediate family. Counseling should educate the family members and enlist them to help more around the home. Individual therapy is necessary to help the mother learn and implement the coping skills that are so important for her new role.

The option for medication needs to be weighed against the severity of the depression. If a mother is breast feeding for example, taking medication can be dangerous to the health of the baby. The same problem exists when hormone replacement therapy is recommended.

With proper treatment postpartum depression will often lift in a matter of months.

Self help

In addition to getting professional help there are several things a person can do to improve his mood.

Exercise: Any activity, however mild it might be, can lift the spirit.

Friends & Family: Having one or more close friends or family members to confide in and spend time with helps to prevent isolation.

Reduce stressors: Limit your responsibilities and only do tasks that won’t overwhelm you. (See article on Stress Busting Basics)

Postpone making big decisions: Your objectivity and judgment are most likely to be affected by your depression. Refrain from making important decisions until you feel better.

Force yourself to do things with friends.