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Treatment Plans for Major Depression

by Yvette Sajem
  • Overview

    Treatment Plans for Major Depression
    Treatment Plans for Major Depression
    Major depression is an intrusive, debilitating mental disorder that affects approximately 14.8 million American adults and is the main cause of disability in people 15 to 44 years of age. It is characterized by a deep, overwhelming feeling of sadness, hopelessness and loss of interest in people and normal activities. The exact cause of major depressive disorder is not known, but according to the Mayo Clinic, most researchers agree that it is the result of a combination of biological, psychological and environmental factors. Fortunately, as a result of understanding these causes, treatments for major depression have seen great advancement in recent years. Based on your specific symptoms and situation, your mental health practitioner will development a course of treatment that suits you.
  • Medication

    Your doctor will most likely prescribe antidepressant medication for your depression. Antidepressants work to balance the affected neurochemical transmitters in your brain that may be contributing to your condition. You must be patient when starting antidepressant therapy. It is not unusual for your doctor to have to change your medication two or three times before hitting on the one that works best for you. The most commonly prescribed type of antidepressants are serotonin reuptake inhibitors (SSRIs) like Paxil, Prozac and Zoloft, and serotonin norepinephrine reuptake inhibitors (SNRIs) like Effexor and Cymbalta. Older classes of antidepressants called monoamine oxidase inhibitors (MAOIs) which include Parnate and Marplam, and tricyclic antidepressants (TCAs) like Norpramin, Tofranil and Vivactil, are also effective but are typically second-line treatment choices due to the number of possible side effects.
    Treatment Plans for Major Depression
    Treatment Plans for Major Depression
 
  • Psychotherapy

    According to the Mayo Clinic, psychotherapy used in combination with drug therapy is quite effective in treating major depression. There are three basic types of psychotherapy that have proved helpful, the first of which is cognitive-behavioral therapy. Cognitive-behavioral therapy works toward changing negative behavior and thought patterns, enabling you to look at and react to situations in a new and more positive manner. Interpersonal therapy is based on the idea that if a person has a good support system, she will more likely be able to cope with situations that could trigger depression. Interpersonal therapy focuses on improving relationship skills, communication, emotional awareness and confidence. Couples or family therapy should be utilized if your condition is directly related to a marital or family issue, or if your condition has had a significant detrimental effect on these relationships.
  • Hospitalization

    Most people with major depression may entertain thoughts of death and suicide, but few will actually attempt to bring it to fruition. However, if you have planned or attempted suicide, hospitalization will be necessary to protect you from harming yourself. You will typically be kept for observation and treatment until your doctor believes that you have stabilized, and until positive effects of an antidepressant are observed (three or four weeks). After your release, you will need to be closely supervised. It is not unusual for a patient, emboldened by the effects of an antidepressant, to once again entertain plans for suicide, at which point hospitalization will again be necessary.
    Treatment Plans for Major Depression
    Treatment Plans for Major Depression
  • Electroconvulsive Therapy (ECT)

    According to Psych Central, ECT is the "treatment of last resort" when all other efforts at alleviating symptoms of major depression have failed. As far as treating major depression is concerned, theory states that ECT releases blocked neurotransmitters in the brain, thus relieving the depressive condition. However, ECT is highly controversial. The German Journal of Psychiatry (2005) states that definitive proof of the effectiveness of ECT has yet to established, and a landmark study by Dr. Harold Sackheim (2007) panned ECT, stating that it causes amnesia and permanent damage to cognitive function.
  • Non-Traditional Treatments

    These treatments are, like ECT, an option for people who have not been helped by traditional major depression treatments. Vagus nerve stimulation (VNS) sends electrical stimulation into the mood center of your brain via a surgically implanted pulse generator. In 2005, VNS was given FDA approval for the treatment of severe and treatment-resistant major depression. Other alternative treatments include transcranial magnetic stimulation (TMS) which uses an electromagnetic coil to produce an electrical current, ostensibly altering brain activity, and the highly experimental deep brain stimulation therapy, which stimulates the brain via surgically implanted electrodes.
    Treatment Plans for Major Depression
    Treatment Plans for Major Depression
  • Self-Help

    Self-help methods, used in conjunction with traditional drug and psychotherapy, can, according to Psych Central, be quite beneficial. Support groups, whether in person or virtual (online) provide an opportunity for you to talk and socialize with people who have issues and difficulties similar to yours. It may also be helpful to take advantage of the many books available on dealing with depression and cultivating a positive outlook.

    References & Resources