Clinical Depression Treatments
Depression is usually treated with medication and psychotherapy (talk therapy). Medication can relieve some symptoms but is not a cure.
Talk therapy is a form of cognitive behavior therapy, which focuses on in identifying and changing negative thoughts. Interpersonal psychotherapy is a therapy that focuses on the relationships and problems which may contribute to depression. Other treatments, like ECT or vagus nerve stimulator, are also sometimes used.
Medication
Clinical depression is often treated by psychotherapy (talk therapy) and medication. Antidepressants are the most popular medication prescribed for depression in clinical cases and, sometimes, mood stabilizers or antipsychotics. It is important to recognize that it can take time for these medications to begin working and you should not give up if you don't feel better immediately. It could take several months, or perhaps longer, for you to feel better. This is particularly true when your symptoms are extreme.
Some people aren't able to respond to antidepressants, or can experience unpleasant adverse effects, like weight gain, dry mouth, dizziness, or shakiness. You should tell your doctor about any adverse effects and discuss with him the possibility of altering your medication or your dosage. It may take some trial and error to discover the right medication for you.
The first step to get treatment is to schedule an appointment with your doctor or mental health professional. They'll ask about your symptoms and the time they started. They'll also inquire about any other factors which could affect your mood, such as stress and substance abuse. They'll likely need to conduct an examination to rule out any medical issues.
A doctor can diagnose clinical depression by looking at your symptoms and medical history. They can assist you in understanding the cause of your depression, and will offer assistance and advice. They'll also refer you to a mental health specialist if they think you need it.
Psychological treatments can lessen the symptoms of depression and may even stop them from recurring. Cognitive behavioral therapy (CBT) and interpersonal therapy are both proven to be effective at treating depression. Both therapies involve speaking with an experienced therapist in one-on-one sessions. You can get these in person or online through the internet via telehealth.
Other treatments for depression that are clinical include electroconvulsive therapy (ECT) and vagus nerve stimulator. ECT involves sending electrical currents through your brain, impacting the functioning and effects of neurotransmitters to relieve depression. Esketamine is a second option. It is FDA-approved and suitable for people who aren't improving with other medications or are at risk of taking their own life.
Psychotherapy (talk therapy)
Psychotherapy is a form of therapy for talking that can help treat depression in the clinical sense. Studies show that psychotherapy is usually more effective than medications alone. It involves speaking with an expert in mental health like a psychologist or social worker. It assists people in learning how to change unhealthy attitudes, thoughts and behavior. There are depression treatment for adults www.iampsychiatry.com of types of psychotherapy. Cognitive behavioral therapy (CBT) and interpersonal therapy are among the most frequent.
Talk therapy can be done in a one-onone session with an professional, or it could be conducted in groups. Group therapy is typically cheaper than individual sessions. It may also be less intimidating for certain people. It may take longer for the results to be seen.
If you have depression, it's important to seek treatment immediately. Early treatment can prevent the symptoms from becoming worse. Treatment can also stop the condition from returning. Discuss with your doctor the best treatment for you.
Before diagnosing depression, it is essential to rule other medical conditions out. A physical examination and blood tests can prove beneficial. The doctor will also ask questions about your symptoms and how they affect your life. The professional in mental health will use a standard list of criteria, known as the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5 to determine if you suffer from depression.
Prescription antidepressants can help by altering the brain's chemical chemicals. They are used to treat mild or moderate depression. It could take some time and trial and error to discover the appropriate dosage and medication for you. Side effects of antidepressants may be uncomfortable, but they generally improve over time.
Certain people suffer from severe, life-threatening depression disorders that aren't responsive to medication. In those cases electroconvulsive therapy or ECT can be extremely beneficial. During ECT the slight electrical current is passed through your brain, causing an occasional seizure. It can be very effective, however it is not recommended as the first-line treatment. It is reserved for those who have not seen improvement after trying other treatments.
Light therapy
A light therapy device emits bright, intense light to compensate for the lack of sunlight, which can cause seasonal affective disorders (SAD). It is commonly used in conjunction with antidepressant medication. Research shows that light therapy works for both SAD and nonseasonal depression, but it seems most effective if started in the fall or early winter, before symptoms start to manifest and continued until spring. Treatment usually lasts 30 minutes each day however, you can alter the amount of time as necessary.
Some people may experience more pain, but others will see rapid improvement. If symptoms get progressively worse or you're experiencing suicidal thoughts, call 911 or your local emergency department. Symptoms of clinical depression include extreme feelings of despair or sadness, lack of enthusiasm for things that once brought joy, difficulty sleeping (insomnia) fatigue, low energy levels, trouble thinking and speaking about weight gain or loss, and sometimes psychomotor agitation (sped-up speech or movements). Bipolar disorder sufferers should not attempt light therapy without a psychiatrist's guidance as it could cause an episode of mania.
Talking therapies, also known as psychological treatments, have been shown to be effective in treating depression. Cognitive behavioral therapy (CBT) is one of the most popular kinds of psychotherapy, and it helps you change unhelpful patterns of thinking and enhance your coping skills. Other psychotherapies, such as psychodynamic psychotherapy, allow you to look back at your past experiences and examine how they might be impacting you in the present.
Brain stimulation therapy, though not as popular as a treatment for depression, can be an alternative when other treatments are unsuccessful. It involves sending gentle electric currents through the brain, causing brief seizures which alter the balance of chemicals and reduce the symptoms. This type of treatment is typically used after someone has tried psychotherapy and medications, but it is sometimes used earlier in severe life-threatening depression that do not respond to medication. Psychiatrists may also recommend lifestyle changes, such as increasing physical activity or altering sleeping patterns to ease symptoms. They may also suggest family and social support. Some people find it beneficial to share their feelings with family members and trusted friends while others prefer to seek for support from peers.
Vagus nerve stimulation
Vagus nerve stimulation is a clinical depression treatment that has been approved by the FDA for use in patients suffering from refractory monopolar or bipolar depression. It is implanted surgically and sends impulses from the neck via the vagus nerve to target the locus ceruleus and dorsal raphe nuclei within the brain stem. It can be used as an alternative to antidepressants and psychotherapy. The FDA recommends using it in combination with other treatment options.
The device has been demonstrated to alleviate depression symptoms by stimulating the locus cereruleus which is a region of the brain that regulates impulsivity. It also increases the release of norepinephrine dopamine, and other neurotransmitters that are believed to be involved in depression improvement. It is important to note that the device must be prescribed by psychiatrists who have been trained in its use.
Multiple studies have shown that VNS can enhance the effectiveness of antidepressants and can enhance the effects of psychotherapy in treatment-resistant depression. In a recent registry study, the addition of VNS significantly improved the outcomes of depression when compared with pharmacotherapy in a population treatment-resistant patients. This registry is the largest naturalistic study to date, and provides further evidence that VNS is a viable treatment for this difficult to treat disorder.
Studies have demonstrated that VNS affects monoamine activity within the forebrain. For instance, VNS is associated with increased gamma-aminobutryric acid (GABA) activity in the LC and with a decrease in noradrenergic activity in the retrosplenial cingulate. Moreover, cerebral spinal fluid (CSF) studies in epilepsy patients treated with VNS show increases of homovanillic acid (HVA) and decreases of 5-hydroxyindoleacetic acid (5-HIAA), the major metabolites of dopamine and serotonin, respectively (Ben-Menachem et al, 1995; Naritoku et al, 1995).
In one study, subjects receiving VNS demonstrated a deactivation correlated with the VNS in the medial prefrontal cortex, the left superior temporal gyrus, and the right insula. The insula also displayed a dynamism in response to depression severity with VNS-induced deactivation increasing over time as reflected by decreased depression symptoms. The study's authors propose that this dynamic response to depression is consistent with the role of the insula in vicero-autonomic functions and pain modulation.