Depression causes tremendous suffering for many people. A 2008 statistical report by the National Institute of Mental Health says depression affects 15 million American adults each year and is the leading cause of disability in the U.S. for ages 15 to 44. Effective treatments that reduce depression symptoms and relapse risk are available.
Cognitive-behavioral Therapy
Cognitive-behavioral therapy (CBT) remains the most empirically validated talk therapy approach used in treating depression. It is a structured therapeutic approach that focuses on identifying then modifying irrational, negative thought patterns and self-defeating behaviors. In the article "Cognitive Therapy vs. Medications in the Treatment of Moderate to Severe Depression," published in the April 2005 issue of the Archives of General Psychiatry, Dr. Robert DeRubeis found that cognitive therapy worked as well as a popular antidepressant in treating moderate to severe depression, but at lower cost and with lowered risk of relapse.
Interpersonal Therapy
Interpersonal therapy (IPT) is another structured, empirically-validated therapy that effectively treats depression. IPT differs from CBT by concentrating on changing maladaptive ways of relating to others instead of focusing on negative cognitions and behavior. IPT helps people improve relationships and leave the self-imposed social isolation that maintains depression. In 2004's "Psychology" textbook, Henry Gleitman, Ph.D. reports IPT treats mild to moderate depression as effectively as CBT.
Antidepressants
Antidepressants may help if talk therapy has not. They are generally considered more effective than talk therapy in treating severe and biologically-based depressions. Antidepressants and talk therapies work best in combination. They can provide symptom control but, without the addition of talk therapy and other treatment modalities, do not decrease relapse risk.
Selective Serotonin Reuptake Inhibitors (SSRIs) work on the brain chemical serotonin and remain the most commonly prescribed antidepressants. Their popularity is partly because SSRIs contain fewer and milder side effects than tricyclic (older generation) antidepressants.
An atypical antidepressant that works on dopamine instead of serotonin, wellbutrin effectively alleviates depressive symptoms without producing common negative sexual side effects.
Electroconvulsive Therapy
Electroconvlusive therapy (ECT) may help when other treatment approaches have failed. The most effective treatment currently available for severe treatment-resistant depression, ECT is also referred to as shock therapy. In 2004, Gleitman noted in "Psychology" that ECT works in 70 to 80 percent of patients who have not responded to antidepressants.
Though controversial, ECT acts quicker than antidepressants, and works in many cases where other treatments have failed. It also produces 30 to 60 second convulsive seizures and possible memory impairment, however.
While antidepressants and talk therapies remain primary treatments of depression, the highly stigmatized, but much improved ECT may benefit acutely suicidal people who have severe, treatment-resistant depression.
References
- "Psychology: Sixth Edition"; Henry Gleitman, Ph.D; 2004
- "Archives of General Psychiatry"; Cognitive Therapy Vs Medications in the Treatment of Moderate to Severe Depression; Robert DeRubeis, Ph.D.; April 2005
- National Institute of Mental Health: Statistics on Mental Disorders
