What are the different types of treatment?
The most common treatment for depression includes the combination of antidepressant medicine and psychotherapy.
Psychotherapy
Psychotherapy is sometimes called “talking therapy.” It is used to treat mild and moderate forms of depression. A licensed mental health professional helps people with depression focus on behaviors, emotions, and ideas that contribute to depression. They also help the depressed person identify and understand life problems that contribute to their illness in order to enable them to regain a sense of control. Psychotherapy can be done on an individual or group basis and can include family members and spouses. It is most often the first line of treatment for depression.
Medicines
Medicines are commonly used to treat depression. Your family doctor or a psychiatrist can prescribe the medications, which are chosen based on your symptoms. The cost of medicines and potential side effects are important considerations when choosing this type of treatment for depression.
Electroconvulsive therapy
Electroconvulsive therapy (ECT) is a procedure in which of an electric current is used to produce a seizure in the patient. It is believed that ECT results in the release of chemicals in the brain that aid communication between nerves. It is one of the fastest and most effective ways to relieve symptoms in severely depressed or suicidal patients or patients who are suffering from mania. ECT is used when severe depression is unresponsive to other forms of therapy. It also is used when medication is considered unsafe. Although it is safe and effective, ECT remains the most controversial treatment for psychiatric illnesses because of potential risks from incorrect administration, and because of misconceptions about ECT — from the media and in movies like One Flew Over The Cuckoo's Nest. ECT is usually followed by psychotherapy and medication under a psychiatrist's care. On occasion, ECT is prescribed on a regular basis (monthly to quarterly) to prevent further episodes of depression.
Alternative treatments
Alternative treatments can sometimes provide relief that traditional western medicine cannot. While some alternative treatments have become accepted as part of modern health care practice, others still have not been proven safe and effective.
Whether they are scientifically effective, alternative therapies—by providing forms of relaxation and relief from stress—have a place in healing and general health and well-being. Examples of alternative therapies include acupuncture, guided imagery, chiropractic treatments, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage, and many others.
In general, alternative therapies by themselves are effective for mild, but not more severe forms of depression.
Experimental therapies
Experimental therapies are treatments that are not regularly used by doctors. Their safety and effectiveness are still being studied.
Some experimental therapies currently being investigated for treatment of depression include:
- Vagal nerve stimulation (VNS) – Traditionally used for epilepsy, this treatment uses electrical pulses to stimulate the vagus nerve, a nerve thought to affect the area of the brain that controls depression. A tiny pacemaker-like device implanted in the chest sends electrical impulses to an electrode in the neck to stimulate the nerve and provide relief. This has only been used for patients who have not responded to standard treatment methods. Research is underway to prove its safety and effectiveness.
- Transcranial magnetic stimulation (TMS) – Also called repetitive transcranial magnetic stimulation (rTMS), this is a technique in which magnets are placed on the head for a short time to alter the electrical currents in the part of the brain thought to control mood. Transcranial magnetic stimulation has been shown to help some people with depression and has few, if any, side effects. It is not, as originally anticipated, a replacement for ECT. Although these results are promising, more studies are needed to determine any long-term side effects and benefits.
- Hormone replacement therapy (HRT) in women – Depression is more common in women than in men. Changes in mood with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), after childbirth, and following menopause are all linked with sudden drops in hormone levels.
Hormone replacement is a treatment currently used to relieve symptoms of menopause such as night sweats and hot flashes. By using HRT, women can help prevent osteoporosis and possibly reduce memory loss. There are many advantages to using HRT for relieving symptoms of menopause; and although they may, in the future, be found to help depression in some women, these hormones can actually contribute to depression. Be sure to tell your doctor if you have had depression before and are considering HRT.
Can depression come back?
Even when treatment is successful, depression can return. Psychotherapy and/or maintenance antidepressant medication can help prevent depression from coming back by correcting the beliefs, perceptions, and behaviors that contribute to your depression. If you do experience recurring symptoms, don’t hesitate to seek help again.
What is the outlook?
The outlook for depressed people who seek treatment is very promising. By working with a qualified and experienced mental health care professional, you can regain control of your life.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/1/2003…#9297
