Treatments for Depression
Last week we mentioned some crisis intervention strategies, including mental health first aid and support systems for suicide ideation. But some people with depression may not be in a crisis but might benefit from longer-term treatments to improve their quality of life.
To wrap up our focus on depression, we are going to discuss some of the treatment options available. As with the causes, treatments can be roughly categorised into behavioural and biological methods.
Often, a combination of biological and behavioural treatments will be used. As we now know, nature and nurture work together to form each person, so they can also work together to treat us.
So, here is the most common treatments for depression: antidepressants and cognitive-behavioural therapy.
Antidepressants
Antidepressants come in many forms, and Australians seeking medical treatments for depression will be prescribed one or a combination after having discussions with their doctor.
The most common antidepressant are Selective Serotonin Reuptake Inhibitors (SSRIs). In simple terms, SSRIs stop neurons from re-absorbing the body’s serotonin, leaving more available to improve a person’s mood. SSRIs are popular because they usually have minimal side effects and have a high success rate.
A person with severe depression that experiences side effects from SSRIs might be recommended Serotonin and Noradrenalin Reuptake Inhibitors (SNRIs) instead. SNRIs increases the availability of both serotonin and noradrenaline in the brain neurons and results in improving a person’s mood.
There are too many types of antidepressants to produce an exhaustive list, but some others include Tricyclic Antidepressants, Tetracyclic Antidepressants, Monoamine Oxidase Inhibitors and Atypical Antidepressants.
Some doctors also try alternative types of drug therapy, including Cannabinoid Oils and Ketamine. If these treatment options are being considered, a psychiatrist will usually help to guide us as well.
Antidepressants can treat depression effectively.
Brain Stimulation Therapies
Other biological therapies aim to directly stimulate the brain with systems other than drugs. Electroconvulsive therapy (ECT) uses different forms of electric currents on the brain to stimulate certain areas and reduce symptoms of depression and psychosis.
ECT is – as you can imagine – quite an intense procedure so it is generally only used in life-threatening scenarios or those that are unresponsive to other treatments. It is also given under general anaesthetic and can cause permanent side effects, so will not be recommended first.
Repetitive transcranial magnetic stimulation (rTMS) and Transcranial direct current stimulation (tDCS) use magnetic fields and light electrical current, respectively, to achieve a similar goal as ECT with a less invasive procedure.
Brain stimulation directly affects the brain and improves moods significantly, but do have side effects and are more invasive than other treatments.
Psychological Therapies
The most common behavioural therapy for treating depression is Cognitive-Behavioural Therapy (CBT). It aims to understand the way that our cognition (way of thinking) affects our behaviour and the way that we feel, and vice versa.
CBT teaches people to explore why they have certain negative thoughts and to take control of them by making more realistic affirmations about their experiences.
For example, someone that assumes their friend ignored them because they have done something awful to upset them might re-evaluate this experience. CBT would encourage them to think that, actually, their friend might have had a bad day that day.
CBT also teaches patients to strengthen their psychological toolkit and develop healthy coping mechanisms. Someone that self-harms when they feel wronged might learn to write down their frustrations instead. Someone that drinks a lot to numb embarrassment might take up exercise.
The other common psychotherapy for treating depression is Interpersonal Psychotherapy (IPT), which aims to identify and treat causes that stem from a person’s relationships.
IPT is based on the understanding that our mental health is influenced by every relationship, from our attachment with our primary caregiver as an infant to our friendships and relationships throughout our lives.
IPT is a brief therapy, meaning the psychotherapist actively seeks to find a solution to a single problem. This approach means that IPT is often completed after fewer sessions than CBT.
There are also longer forms of Psychotherapy, such as Psychodynamic Psychotherapy and Schema Therapy that some people find more helpful than shorter-term, strategies-based therapy.
The best form of therapy for you may ultimately depend on how you respond to treatment and how you get along with the therapist. We will usually say: hang in there. Try a few different styles and we will help you find one that works for you.
Psychotherapies establish and treat the causes of depression using talk-based treatment. They provide holistic, long-term healing.
Treatments for Depression
Most treatments for depression are used in conjunction with one another. They are all different tools working in different ways to help us manage depression.
Depression manifests itself in many different ways, so remember that what works for one person might not be the right option for you.
Your GP will be able to work with you and come to a decision together on which treatment choices may work best for you. It might take some trial and error until you find the ideal combination. If you are worried about new or current treatment for depression, reach out to your doctor who will be happy to have a chat.
Felicity Thompson
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