Depression Treatment
Depression Treatment
Treatments for Depression
Most patients with depression benefit from medication and counselling. Medications can be prescribed by your primary care physician or psychiatrist to alleviate symptoms. However, contacting a psychiatrist, psychologist, or other mental health experts can help many people with depression.
If you have severe depression, you might need to go to the hospital or enrol in an outpatient treatment programme until your symptoms improve.
Depression is usually treated with a combination of self-help, talking therapy, and medications.
The sort of depression you have will determine the treatment you receive.
A closer look at depression therapy alternatives is provided here.
Medications
Antidepressants come in a variety of forms, including those listed below. Make sure to talk to your doctor or pharmacist about any serious side effects.
Antidepressants
Antidepressants are medications that help with depressive symptoms. There are numerous types to choose from.
Antidepressants help the majority of patients with moderate to severe depression, but not everyone.
You might respond to one antidepressant but not another, and you might need to take two or more therapies before finding one that works.
Antidepressants of several sorts perform similarly to one another. However, side effects vary depending on the treatment and the individual.
You should see a GP or specialist nurse every week or two for at least four weeks after you start taking antidepressants to see how well they’re working.
If they’re helping, you’ll need to keep taking them for at least 4 to 6 months after your symptoms have subsided.
If you’ve had previous bouts of depression, you may need to take antidepressants for up to 5 years or more.
Antidepressants are not addictive, but if you stop taking them suddenly or skip a dose, you may have withdrawal symptoms.
Selective serotonin reuptake inhibitors (SSRIs)
If your doctor thinks you’d benefit from antidepressants, you’ll most likely be given a modern variety called a selective serotonin reuptake inhibitor (SSRI).
Paroxetine (Seroxat), fluoxetine (Prozac), and citalopram are some of the most regularly prescribed SSRI antidepressants (Cipramil).
They aid in the increase of serotonin, a natural chemical in the brain that is regarded to be a “feel-good” hormone.
Although they can induce nausea, headaches, dry mouth, and sex issues, SSRIs function just as well as earlier antidepressants and have fewer adverse effects. However, these negative effects normally fade with time.
Some SSRIs are not recommended for children and teenagers under the age of 18. Self-harm and suicidal behaviour are more likely to occur in under-18s, according to research.
Fluoxetine is the only SSRI that can be supplied to people under the age of 18, and only with the approval of a specialist.
Tricyclic antidepressants (TCAs)
TCAs (tricyclic antidepressants) are a class of antidepressants used to treat mild to moderate depression.
TCAs have been around longer than SSRIs, notably imipramine (Imipramil) and amitriptyline.
They act by increasing the levels of the brain neurotransmitters serotonin and noradrenaline. Both of these things can help you feel better.
They’re generally harmless, but smoking cannabis while on TCAs is not a good idea because it can cause your heart to race.
TCAs can cause a dry mouth, blurred vision, constipation, trouble passing urine, sweating, lightheadedness, and severe sleepiness, which differ from person to person.
As your body adjusts to the treatment, the adverse effects normally fade in 10 days.
Vortioxetine
The National Institute for Health and Care Excellence (NICE) recommends vortioxetine (Brintellix or Lundbeck) for treating people who are experiencing a first or recurring major depressive episode and have not responded to two previous antidepressants.
Abnormal dreams, constipation, diarrhoea, dizziness, itching, nausea, and vomiting are all common side effects of vortioxetine.
Other antidepressants
Venlafaxine (Effexor), duloxetine (Cymbalta or Yentreve), and mirtazapine (Zispin Soltab) are new antidepressants that function in a somewhat different way than SSRIs and TCAs.
Serotonin-noradrenaline reuptake inhibitors include venlafaxine and duloxetine (SNRIs). They, like TCAs, affect serotonin and noradrenaline levels in the brain.
Although studies have indicated that an SNRI is more beneficial than an SSRI, they are not commonly prescribed because of the risk of blood pressure elevation.
Lithium
If you’ve tried multiple different antidepressants and still don’t feel better, your doctor may prescribe lithium in addition to your current medication.
Lithium carbonate and lithium citrate are the two forms. Both are usually effective, but it’s best not to switch if you’re on one that works for you.
The level of lithium in your blood might become harmful if it rises too high. As a result, you’ll require blood tests every three months to monitor your lithium levels while on the medication.
You should also avoid eating a low-salt diet, as this may cause the lithium to become poisonous. Consult your doctor about your diet.
Finding the right medication
If a family member has responded well to an antidepressant, it may be one that could help you. Or you may need to try several medications or a combination of medications before you find one that works. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as your body adjusts.
Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of genetic tests (done by a blood test or cheek swab) may offer clues about how your body may respond to a particular antidepressant. However, other variables besides genetics can affect your response to medication.
Risks of abruptly stopping the medication
Do not stop taking an antidepressant without first consulting your doctor. Antidepressants are not as addictive as illegal narcotics or cigarettes, but you may have withdrawal symptoms if you stop taking them.
Among them are:
- An upset stomach
- Flu-like symptoms
- Anxiety
- Dizziness
- Vivid dreams at night
- Sensations in the body that feel like electric shocks
Most of the time, they are moderate and only last a week or two, but they can be fairly severe on occasion.
They appear to be most common with the drugs paroxetine (Seroxat) and venlafaxine (Efexor).
Withdrawal symptoms appear quickly after stopping the medications, making them simple to distinguish from depression relapse symptoms, which usually appear after a few weeks.
Antidepressants During pregnancy
Some antidepressants may enhance the health risk to your unborn or nursing child if you’re pregnant or breastfeeding. If you become pregnant or plan to become pregnant, consult your doctor.
Antidepressants and increased suicide risk
Although most antidepressants are typically safe, The Medicines and Healthcare products Regulatory Agency (MHRA) requires that all antidepressants be labelled with a warning, the most serious warning for prescriptions. When children, teenagers, and young adults under the age of 25 start taking antidepressants, they may have an increase in suicidal thoughts or behaviour, especially in the first few weeks or when the dose is altered.
Anyone on an antidepressant should be closely monitored for signs of depression worsening or strange behaviour, especially when starting a new medicine or changing their dosage. If you or someone you know is having suicidal thoughts while taking an antidepressant, seek medical care right once.
Keep in mind that antidepressants, by increasing mood, are more likely to minimise suicide risk in the long run.
Psychotherapy
Psychotherapy is a broad term for talking with a mental health expert about your depression and related difficulties in order to get help. Talk therapy or psychological treatment are other terms for psychotherapy.
Cognitive behavioural therapy and interpersonal therapy are two types of psychotherapy that can help with depression. Other forms of therapy may be suggested by your mental health practitioner. Psychotherapy can assist you with:
- Adapt to a crisis or other pressing issue
- Replace unhealthy, negative thoughts and habits with healthy, positive ones.
- Develop positive interactions with people by exploring relationships and experiences.
- Improve your ability to cope with and solve challenges.
- Identify the factors that contribute to your depression and alter the habits that aggravate it.
- Regain a sense of fulfilment and control in your life while also reducing depression symptoms like hopelessness and rage.
- Learn how to develop realistic life objectives.
- Using healthy practices improves your ability to tolerate and accept distress.
Psychodynamic psychotherapy
During a psychodynamic session, a psychoanalytic therapist will encourage you to say whatever is on your mind.
This will assist you in recognising hidden meanings or patterns in your actions or words that may be contributing to your troubles.
Counselling for Depression Treatment
Counselling is a type of therapy that helps you think about the problems you’re having in your life and come up with new solutions.
Counsellors assist you in discovering solutions to difficulties, but they do not direct you. You can confide in a counsellor, who will listen to you and offer practical guidance.
On the NHS, you may be offered a single counselling session, a short series of sessions spread out over a few weeks or months, or a lengthier course lasting several months or years.
It’s designed for those who are typically healthy but need assistance dealing with a current crisis, such as rage, relationship problems, grief, redundancy, infertility, or a major disease.
Alternate formats for therapy
Alternatives to face-to-face office appointments for depression therapy are available and may be a helpful option for some people. Therapy can be delivered in a variety of ways, including as a computer programme, online sessions, videos, or workbooks. A therapist can guide the programme or it can be completely self-contained.
Before deciding on one of these formats, consult with your therapist to see if they are appropriate for you. Also, see if your therapist can offer a reliable source or programme. Some may not be covered by your insurance, and not all developers and online therapists are qualified or trained.
Smartphones and tablets with mobile health apps that provide support and general education about depression are not a replacement for seeing a doctor or therapist.
Hospital and residential treatment
Depression can be so severe in some people that they require hospitalisation. This may be necessary if you are unable to properly care for yourself or are in immediate danger of injuring yourself or others. A hospital’s psychiatric care can keep you quiet and protected until your mood improves.
Some persons may benefit from partial hospitalisation or day therapy programmes. These programmes offer outpatient support and counselling to help people manage their symptoms.
Other treatment options
Other operations, known as brain stimulation therapies, may be recommended for some people:
- Electroshock therapy (ECT). Electrical currents are sent through the brain during ECT to affect the function and effect of neurotransmitters in the brain, which helps to alleviate depression. ECT is typically used for those who do not respond to drugs, are unable to take antidepressants due to health concerns, or are at high risk of suicide.
- Magnetic stimulation of the brain (TMS). For people who haven’t responded to antidepressants, TMS may be an option. TMS uses a treatment coil that is placed against your scalp to deliver brief magnetic pulses to nerve cells in your brain that are involved in mood regulation and depression.
Lifestyle and home remedies
Depression isn’t usually something you can address on your own. These self-care steps, in addition to professional treatment, can help:
- Maintain your treatment schedule. Don’t miss any treatment appointments or sessions. Don’t forget to take your meds, even if you’re feeling OK. If you stop taking it, your depressive symptoms may return, and you may also have withdrawal symptoms. Recognising that feeling well will take time.
- Understand depression. Knowing more about your disease might help you feel more empowered and motivated to stick to your treatment plan. Encourage your family to educate themselves on depression in order to better understand and support you.
- Keep an eye out for warning signs. Learn what might be causing your depression symptoms by working with your doctor or therapist. Make a strategy for what you’ll do if your symptoms worsen. If you notice any changes in your symptoms or how you feel, contact your doctor or therapist. Request assistance from family or friends in spotting warning flags.
- Alcohol and recreational drugs should be avoided. While it may appear that alcohol or drugs alleviate depression symptoms, in the long run, they exacerbate symptoms and make depression more difficult to treat. If you need help with alcohol or substance abuse, go to your doctor or therapist.
- Look after yourself. Eat well, exercise often, and get enough rest. Consider going for a stroll, running, swimming, gardening, or another enjoyable activity. Sleeping soundly is beneficial to your physical and mental health. Talk to your doctor about what you can do if you’re having difficulties sleeping.
Depression Treatment Alternative medicine
The use of a nonconventional approach instead of conventional medicine is known as alternative medicine. Complementary medicine, often known as integrative medicine, is a nontraditional technique used in conjunction with conventional care.
If you decide to try an alternative or complementary therapy, be sure you are aware of the hazards as well as the potential advantages. Alternative medicine should not be used to replace traditional medical care or psychotherapy. Alternative remedies for depression are not a substitute for medical care.
Supplements
The following are some supplements that are sometimes used to treat depression:
- St John’s wort. A herbal remedy for depression that some individuals use. It can be found in health food stores and pharmacies. Although there is some evidence that it may help with mild to moderate depression, doctors do not prescribe it. This is because the amount of active substances fluctuates between brands and batches, making it impossible to predict how it will affect you. St John’s wort can interact negatively with various medications, including anticonvulsants, anticoagulants, antidepressants, and the contraceptive pill. If you’re pregnant or breastfeeding, you shouldn’t take St John’s wort because its safety is unknown. St John’s wort can also interfere with the effectiveness of the contraceptive pill.
- SAMe. This dietary supplement, pronounced “sam-E,” is a synthetic version of a molecule found naturally in the body. The S is an abbreviation for S-adenosylmethionine (es-uh-den-o-sul-muh-THIE-o-neen). In the United Kingdom, the MHRA has not authorised SAMe for the treatment of depression. It could be beneficial, but additional research is required. In individuals with bipolar disorder, SAMe may cause mania.
- Fatty acids with omega-3. Cold-water fish, flaxseed, flax oil, walnuts, and other foods contain these beneficial lipids. Omega-3 supplements are being researched as a possible depression therapy. Omega-3 supplements, while typically safe, may interact with other drugs in excessive amounts. More research is needed to see if eating omega-3 fatty acid-rich foods can help with depression.
The MHRA does not regulate nutritional and dietary supplements in the same manner that it does pharmaceuticals. You can’t always be sure what you’ll get or whether it’ll be safe. Also, because some herbal and dietary supplements can mix with prescription medications or create harmful interactions, consult your doctor or pharmacist before beginning any supplement regimen.
Mind-body connections
Integrative medicine practitioners think that being healthy requires a balance of mind and body. The following are some examples of mind-body methods that may be beneficial for depression:
- Acupuncture
- Relaxation techniques such as yoga or tai chi
- Meditation
- Guided imagery
- Massage therapy
- Music or art therapy
- Spirituality
- Aerobic exercise
In most cases, relying exclusively on these therapies is insufficient when managing depression. They could be beneficial when combined with medication and psychotherapy.