Depression is a common disorder in the United States. Current estimates suggest that more than 20 million adults suffer from depression in a given year, while approximately 10 percent of those people are over the age of 18. However, depression is a treatable condition and there are several therapeutic approaches that can help an individual restore their quality of life.
What is Depression?
At some time, everyone feels down in the dumps, blue or sad. Yet for most people these feelings pass in a short amount of time. For those with depression, these feelings can last longer than anticipated, effect the person’s ability to perform everyday activities, and interfere with normal life roles. Individuals with depression may experience a number of symptoms including:
• Feeling hopeless or helpless.
• Low self- worth or self-esteem.
• Feeling worthless, guilty or shameful.
• Feeling blue, sad, down in the dumps or grey.
• Feeling emotionally numb.
• Being unable to experience pleasure from previously enjoyable activities.
• Social withdrawal.
• Lack of motivation.
• Poor performance at school or work.
• Physical symptoms such as headaches, stomachaches, nausea, fatigue/lack of energy, and aches and pains.
• Irritability or agitation.
• Problems maintaining attention, making decisions, or concentrating.
• Insomnia or excessive sleep.
• Increased or decreased appetite.
• Suicidal thoughts or attempts.
Effective treatments exist for even the most serious cases of depression. It’s best if treatment is begun early to prevent the condition from worsening. The longer an individual suffers from the condition the more hopeless they feel and the less likely they are to seek help. Research has also shown that treatment for depression results in the best outcome when started as close to the onset symptoms as possible.
The first step in treating depression is having the individual undergo a physical. Some illnesses such as thyroid disease or certain medications can result in depressive symptoms.
Once potential medical causes have been ruled out, the individual is referred for a psychological evaluation. A mental health professional will explore personal and family history of mental illness and obtain a complete history of the individual’s symptoms. Treatment options will then be discussed. Research has shown that the most effective depression treatments are medication and psychotherapy.
Antidepressants tend to work well by effecting chemicals in the brain called neurotransmitters. The newest medications on the market are called serotonin selective reuptake inhibitors (SSRIs). Older anti-depressants such as tricyclics and monoamine oxidase inhibitors (MAOIs) may be more effective for certain individuals.
The SSRI’s generally have fewer side effects than the earlier anti-depressants. It can take several trials to determine the best medication for a particular individual. Anti-depressants may begin to work within 2-4 weeks, but must be taken regularly for at least 3-4 weeks before the full therapeutic effect can be determined.
The most effective type of psychotherapy for depression is cognitive behavioral therapy. This approach combines behavioral strategies such as having the individual engage in a previously enjoyed hobby with cognitive strategies to restructure depressive thinking and alter behavioral patterns that contribute to the depression.
Therapists also help individuals better understand their depression and resolve problems that contributed to symptoms onset or resulted from the disorder.
Research has shown that a combination of medication and psychotherapy is the best option for those with moderate to severe depression.
Levels of Depression Treatment
Individuals with mild to moderate depression can often be successfully managed with outpatient therapy. When suicidal ideation is present or when the depression is so severe the individual cannot follow through with treatment recommendations, hospitalization is usually necessary.
Once the individual is stabilized and engaged in the therapeutic process they are stepped down to a residential treatment facility, partial hospitalization program or intensive outpatient therapy program. The latter two options allow the individual to sleep at home and differ predominantly in the number of hours per week service is provided.
All of these step-down programs include group and individual therapy, medication evaluation, and skills based psycho-educational instruction such as coping, skills training or relapse prevention strategies. They also generally include specialized groups for problems such as co-occurring substance abuse or family therapy.
Although depression is a common and serious condition, the current state of depression treatments can help tremendously with even the most severe cases.