Depending on the diagnosis and the severity of the symptoms of depression, there are several types of treatments that might be recommended by your health care professional. The most common include various types of psychotherapy and anti-depressant medications, or perhaps a combination of these two approaches. For very severe cases of depression, more drastic measures can be employed.
The following is a brief description and explanation of the main options recognised as being effective in the treatment of depression and depressive disorders.
This approach is based on developing a trusting, safe and understanding environment for you to talk through your thoughts and feelings with the help of a trained counsellor. By sharing your experiences either on a one to one basis or perhaps in a group therapy session with people in a similar situation or with similar feelings, can allow you the necessary emotional support you need to enable you to cope. This type of treatment lends itself well to mild and moderate types of depression sometimes alongside medication.
Cognitive Behavioural Therapy
Sometimes negative thoughts and ideas or the way you think about things can contribute to feelings of depression. This type of therapy helps you to look at these in detail in order to change the way you think about them, so that you change your behaviour accordingly. By focussing on specific difficulties that are happening in your life now, new ways of coping and dealing with situations can be identified. It is particularly helpful for anxiety related and panic disorders and disorders affecting behaviour, for example, obsessive compulsive disorder and eating disorders, amongst others.
Persistent depression may require the use of anti-depressants for a period of time. Just like all treatments, they are not an overnight fix and can take anything up to several weeks for the effect of the medication to be felt, and just like all medications they can carry side effects.
There are many kinds of anti-depressants available but the four main types fall into the categories of:
Tricyclics including Anafranil
Selective Serotonin Reuptake Inhibitors SSRIs like Prozac
Serotonin and Noradrenaline Reuptake Inhibitors SNRIs such as Endronax
Monoamine Oxidase Inhibitors for example, Manerix and Nardil
Basically, they are all believed to work by impacting on the activity of the chemicals in the brain responsible for making us “feel good” such as Serotonin and Noradrenaline. The most commonly prescribed anti-depressant drugs today fall into the SSRI category as they appear to have fewer side effects and are considered less dangerous than the others.
Lithium Carbonate has a mood stabilising effect and is sometimes prescribed to people with severe depression; however, it is dangerous if the levels in the blood become too high so constant medical checks and blood tests are a necessity.
St John’s Wort is a herbal remedy that has gained a lot of recognition in recent years for being effective in cases of mild to moderate depression and anxiety and is already widely used in Germany. It appears to work in much the same way as Prozac by inhibiting the reuptake of Serotonin in the brain.
Electro Convulsive Therapy
The National Institute for Health and Clinical Excellence (NICE), recommend that ECT is only used “for the treatment of severe depressive illness, a prolonged or severe episode of mania, or catatonia” but certain conditions apply including one that other forms of treatment have proved ineffective. It is a controversial procedure that involves placing electrodes on the head and administering a short electrical shock to the brain. The person receiving ECT is given an anaesthetic and muscle relaxants beforehand. It is usually given in twice weekly sessions over a period of several weeks and possibly monthly after that to prevent a relapse. The most common and distressing side effect reported is long term and/or short term memory loss.
Vagal Nerve Stimulation is a treatment that is used in cases of Epilepsy but has also been found to be effective in the treatment of severe depression. Although still classed as experimental, in 2005 it was approved by the FDA in the USA for severe treatment-resistant depression. One of the main differences with this type of treatment and others is that it takes quite some time for the effect to be noticed, up to a year or even two years in some cases, however, the indications are that those receiving the treatment appear to stay better for longer. A nerve stimulator similar to a heart pace maker, is placed in the chest where it delivers regular electrical impulses to the Vagal nerve in the neck, which in turns stimulates the brain. No one really understands why it appears to be effective or exactly how it works but research by Dr.Charles Conway, assistant professor of psychiatry at Saint Louis University School of Medicine, who led a four year research project into Vagal Nerve Stimulation from 2000 to 2004, found that it appears to produce the same type of effect in the brain as ECT, but that the effect doesn’t seem to wear off as it does with ECT. More research is required.