depression treatment

Depression treatment help most people with depression get better. Once identified, depression almost always can be treated either by therapy, medicine called antidepressants, or both.

Some people with milder forms of depression do well with therapy alone. Others with moderate to severe depression might benefit from antidepressants. It may take a few weeks or months before you begin to feel a change in your mood. Some people do best with combined depression treatment -- therapy and antidepressants.

The most common depression treatment are psychotherapy and medication.

Psychotherapy

Several types of psychotherapy-or "talk therapy"-can help people with depression. There are two main types of psychotherapy commonly used to treat depression: cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). CBT teaches people to change negative styles of thinking and behaving that may contribute to their depression. IPT helps people understand and work through troubled personal relationships that may cause their depression or make it worse.

For mild to moderate depression, psychotherapy may be the best depression treatment option. However, for major depression or for certain people, psychotherapy may not be enough. For teens, a combination of medication and psychotherapy may work the best to treat major depression and help keep the depression from happening again. Also, a study about treating depression in older adults found that those who got better with medication and IPT were less likely to have depression again if they continued their combination depression treatment for at least two years.

Medications

Medications help balance chemicals in the brain called neurotransmitters. Although scientists are not sure exactly how these chemicals work, they do know they affect a person´s mood. Types of antidepressant medications that help keep the neurotransmitters at the correct levels are:

SSRIs (selective serotonin reuptake inhibitors)
SNRIs (serotonin and norepinephrine reuptake inhibitors)
MAOIs (monoamine oxidase inhibitors)
Tricyclics

These different types of medications affect different chemicals in the brain.

Medications affect everyone differently. Sometimes several different types have to be tried before finding the one that works. If you start taking medication, tell your doctor about any side effects right away. Depending on which type of medication, possible side effects include:

Headache
Nausea
Insomnia and nervousness
Agitation or feeling jittery
Sexual problems
Dry mouth
Constipation
Bladder problems
Blurred vision, or
Drowsiness during the day

Other therapies

St. John´s wort

The extract from St. John´s wort (Hypericum perforatum), a bushy, wild-growing plant with yellow flowers, has been used for centuries in many folk and herbal remedies. The National Institutes of Health conducted a clinical trial to determine the effectiveness of the herb in treating adults who have major depression. Involving 340 patients diagnosed with major depression, the trial found that St. John´s wort was no more effective than a "sugar pill" (placebo) in treating major depression. Another study is looking at whether St. John´s wort is effective for treating mild or minor depression.

Other research has shown that St. John´s wort may interfere with other medications, including those used to control HIV infection. On February 10, 2000, the FDA issued a Public Health Advisory letter stating that the herb may interfere with certain medications used to treat heart disease, depression, seizures, certain cancers, and organ transplant rejection. The herb also may interfere with the effectiveness of oral contraceptives. Because of these potential interactions, patients should always consult with their doctors before taking any herbal supplement.

Electroconvulsive therapy

For cases in which medication and/or psychotherapy does not help treat depression, electroconvulsive therapy (ECT) may be useful. ECT, once known as "shock therapy," formerly had a bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe depression who have not been able to feel better with other treatments.

ECT may cause short-term side effects, including confusion, disorientation and memory loss. But these side effects typically clear soon after depression treatment. Research has indicated that after one year of ECT treatments, patients show no adverse cognitive effects.

Getting help for depression

Below are some people and places that can help you get depression treatment.

Family doctor
Counselors or social workers
Family service, social service agencies, or clergy person
Employee assistance programs (EAP)
Psychologists and psychiatrists

If you are unsure where to go for help, check the Yellow Pages under "mental health," "health," "social services," "suicide prevention," "crisis intervention services," "hotlines," "hospitals," or "physicians" for phone numbers and addresses.