Treating Depression: An Overview

If you think you are depressed, you should see a psychiatrist for an evaluation. If you think you might harm yourself, you should check into a hospital. In the US, you go to an emergency room, tell them you are suicidal and they send you to a mental hospital by ambulance.

Here is a list of treatments for depression. Your psychiatrist or hospital may recommend some combination of what I describe below.

There is no one method that works for everyone. When treatments are studied, the results are that a certain percentage of subjects found significant improvement.

Many people find relief using antidepressants, psychotherapy or antidepressants with psychotherapy.

Many people will find relief from a selective serotonin reuptake inhibitor (SSRI), such as Prozac and Zoloft. If this fails, the psychiatrist may add a mood stabilizer.

Psychotherapies that have been tested and found effective for a significant percentage of subjects is called evidence-based.

A list of psychotherapies that are considered to be evidence-based

  • cognitive behavioral therapy (CBT)
  • interpersonal therapy (IPT)
  • schema therapy
  • cognitive behavioral analysis system for psychotherapy (CBASP)

The last two are so new it is difficult to find therapists trained in them.

 If you live in the US or Canada, you can find a therapist near you by using this site: Find a Therapist

Some people have seasonal affective disorder (SAD). This is caused by a lack of sunlight. The treatment for SAD is to use a full-spectrum light box for a length of time each morning.

Less common treatments:

Neurofeedback You are hooked up to a brainwave monitor. When you are creating the correct brainwaves, a bell rings and a picture on a computer monitor changes.  It is a way of training the brain. The jury is still out on the effectiveness of this one. It also requires you to go twice a week for 20 or more weeks.

Transcranial magnetic stimulation (TMS) Electromagnets are placed over your head for a period of time. The results are supposed to be similar to ECT without requiring anesthesia.

electroconvulsive therapy (ECT), commonly known as electroshock therapy. This is not as scary as it sounds. I have had it several times and when it worked, it was amazing!

Invasive treatments:

Vagus nerve stimulator (VNS) a  stimulator unit is installed in your chest and a wire is run up into your neck to connect to the vagus nerve. It only has a 17% success rate.

Deep Brain Stimulation (DBS) This is brain surgery. Electrodes are implanted deep in the brain and is driven by a stimulator unit which is installed in either the chest or abdomen. It is my understanding that this technique is making the cingulotomy obsolete.

cingulotomy I believe that this technique has been made obsolete by DBS. A cingulotomy is brain surgery. Lesions are created around a small part of the brain called the anterior cingulate cortex effectively disconnecting it from the rest of the brain. Many people have to have it done multiple times before it works. This is only for those who have tried everything else and still have debilitating depression.

©2016 Stephen L. Martin

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