Depressive disorder—also commonly known as depression—is a common mental health condition disorder that causes feelings of intense sadness and no longer being interested in doing things that used to be fun. Depression can have a major effect on how you think, behave, and interact with others.
There is no cure for depression, but there are several treatments you can use to manage your condition and significantly reduce symptoms. Keep in mind: the earlier you start treatment, the more effective it can be. Possible treatment options for depression include medications, psychotherapy, and brain stimulation therapies. Because depression can affect people differently, treatment plans for depression will vary.
The overall goals of treatment are to reduce symptoms and improve your quality of life. During your treatment process, you may work with a variety of providers who treat depression including primary care physicians, psychologists, and other mental health professionals—all of whom can recommend treatment options that are best for you.
Medications for Depression
A common treatment for depression is medication—and the most commonly prescribed medications for depressive disorder are called antidepressants.
While antidepressants help reduce symptoms, it's important to note that they may not work right away. It can take between four to eight weeks for you to see any improvements in your mood. However, other symptoms such as low energy or changes in your appetite tend to improve before your mood does.
There are a host of antidepressants that your healthcare provider may prescribe you. The most common ones include:
- Selective serotonin reuptake inhibitors (SSRIs): SSRIs work to regulate and increase how much active serotonin (often called the "feel-good" hormone) you have in your brain. SSRIs are first-line medications for depression and help improve your mood.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs regulate serotonin and norepinephrine (a hormone that plays a role in your fight-or-flight response). These medications are often prescribed if you are not responding well or seeing improvement with SSRIs. SNRIs can also be beneficial when a person if you experience fatigue or physical pain with depression.
- Norepinephrine-dopamine reuptake inhibitors (NDRIs): NDRIs help control the levels of norepinephrine and dopamine (often known as the "happy hormone"). The only NDRI currently on the market for depression is Wellbutrin (bupropion). Your provider may recommend this medication if you want to avoid problems related to sex and libido or if you are in the process of quitting tobacco use.
However, like most medications, drugs that treat depression don't come without side effects. If you are taking an antidepressant, you may experience one or more of the following side effects:
- Dry mouth
- Sexual issues
- Serotonin syndrome, which occurs when the body makes too much serotonin and can potentially be life-threatening
Your primary care provider or psychiatrist will typically be responsible for prescribing medications and monitoring your health while you are taking antidepressants.
If you experience any issues or side effects with antidepressants, consult with your provider before changing your medication, and do not stop taking medications on your own—as this can cause additional side effects to occur. However, if you have any issues with antidepressants, consult with the prescribing provider and do not stop taking medications on your own.
There are two primary types of therapy that you may consider trying to improve symptoms. These therapies include psychotherapy and brain stimulation therapy.
Psychotherapy—often called mental health therapy or talk therapy—can help you talk through your stressors, emotions, and thoughts with a licensed professional. If you begin traditional therapy, you will likely be working with a mental health professional such as a psychologist, licensed counselor, social worker, or marriage and family therapist.
The primary focus of this type of therapy is to assist help you understand your thoughts, feelings, and actions and make changes to harmful habits or thinking patterns, if needed. Oftentimes, people with depression use combination therapy (also known as using more than one treatment), which may include taking antidepressants and going to psychotherapy sessions.
A therapist may use one type of therapy or elements from different therapies during your sessions. Whatever approaches they use will be personalized to your symptoms, needs, and treatment goals.
There are seven types of psychotherapy that the American Psychological Association (APA) recommends, which include:
- Behavioral therapy: Identifies and helps change unhealthy or harmful behaviors
- Cognitive therapy: Focuses on understanding your thoughts and changing self-destructive thinking patterns
- Cognitive behavioral therapy (CBT): Uses a combination of behavioral and cognitive therapies
- Interpersonal psychotherapy (IPT): Helps you improve relationships or resolve conflicts with others that may have occurred due to depression
- Mindfulness-based cognitive therapy (MBCT): Combines mindful meditation with cognitive therapy to help improve self-esteem
- Psychodynamic therapy: Utilizes understanding unconscious thoughts and your past experiences to gain a better insight about what is going on in the present
- Supportive therapy: Features supportive techniques such as empathy and active listening to help you move through stressors and make decisions
Brain Stimulation Therapy
In some cases, brain stimulation therapies—like vagus nerve stimulation (VNS) or transcranial magnetic stimulation (TMS)—might be necessary for treatment. The purpose of this type of therapy is to directly activate or block the processes that determine how your brain is functioning.
The process of brain stimulation therapy uses electricity by placing electrodes (small patches that carry electricity) on the scalp. Sometimes, your provider can also use magnetic fields to send electricity. Some of the therapies will require anesthesia while others will not.
It's important to note that brain stimulation therapy is not widely used—and the standard for treatment for depression are medication and psychotherapy. However, brain stimulation may be helpful for situations where a person has not seen an improvement in symptoms, despite using other treatments.
Generally, brain stimulation is only recommended for people who have:
- Not responded to medications
- Stated they are interested in this form of treatment
- Experienced psychosis or suicidal thoughts
- Already responded well to prior use of brain stimulation therapies
Among the types of brain stimulation therapies, electroconvulsive therapy (ECT) is the most common and most studied by experts.
How ECT Works
Before ECT sessions begin, a person is put under general anesthesia and given a muscle relaxant. A trained provider will place electrodes in specific places on the person's head and send an electric current through the brain.
The current will result in a short-term seizure (less than one minute), but the person will not feel the current. Around an hour after the session ends, the person will wake up and become alert, allowing them to go back to their regular daily activities.
Brain stimulation therapy typically lasts from six to 12 weeks, which sessions that occur two to three times weekly. The length of your personal treatment plan will be based on how severe your depressive symptoms are and how symptoms change in response to treatment.
This type of treatment does come with risks such as complications with anesthesia, confusion, fatigue, and short-term memory loss (in rare cases).
Living With and Managing Depression
There is no cure for depression, and almost 50% of individuals with depression may not respond to treatment when it first starts. But, 40% of individuals will see a decrease in depressive symptoms within 12 months of treatment.
However, depressive disorder is still one of the most treatable mental health conditions. Treatment can be effective in relieving your symptoms, especially when you start early. Combination therapy (such as using medication and psychotherapy together) may also be helpful, as it can result in:
- An improvement in depressive symptoms
- A better quality of life
- An increased likelihood of sticking with treatment and getting the support you need to manage symptoms
If they’re not part of your formal treatment recommendations, it may also be helpful to engage in positive lifestyle habits, which include activities such as exercise, spending time with your loved ones, eating nutritious meals, participating in the activities you enjoy (or used to enjoy), and relaxation techniques like deep breathing, progressive muscle relaxation (PMR), or yoga.
A Quick Review
There is no formal cure for depression, but depressive disorder is among the most treatable mental health conditions. Several treatments are effective in reducing your symptoms and improving your quality of life.
The most common treatments for depression include medication and talk therapy. In some cases, brain stimulation therapy can also help improve symptoms—but this is a less common form of treatment and your provider will only recommend it in specific situations.
Depression can be difficult to go through—but, it's important to remember you don't have to deal with it all alone. Getting screened for depression or visiting your healthcare provider when you begin to notice changes in your mood for more than two weeks can help you receive the support and care you need to improve your quality of life.
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