Depression is a serious mood disorder that often requires medical treatment to reduce symptoms. Each treatment targets different aspects of the disorder. For example, psychotherapy focuses on the cause of the depression, while medication works on reducing the severity of the symptoms. The patient may need to try multiple treatment options or use a combination of two or more treatments to find the best result.
Psychotherapy
HelpGuide states that psychotherapy focuses on helping the patient "reframe negative thinking and employ behavioral skills in combating depression." Different forms of psychotherapy are available that are either one-on-one with the therapist or in a group setting, in which the patient interacts with other depression patients. Three types of psychotherapy are effective in uncovering the cause of the depression and aiding the patient in creating healthy coping strategies: cognitive behavioral therapy, psychodynamic treatment and interpersonal psychotherapy. Cognitive behavioral therapy helps the patient find the source of her negative thoughts and change them to positive ones. Psychodynamic treatment also has the patient take an in-depth look at the underlying cause of the depression but takes longer than cognitive behavioral therapy. Interpersonal psychotherapy, on the other hand, has the patient resolve relationship issues that contribute to the depression.
Medication
Medications, such as antidepressants, improve depressive symptoms by increasing the amount of neurotransmitters in the brain. Reuptake inhibitors, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and norepinephrine and dopamine reuptake inhibitors (NDRIs) are the first choices for medication. SSRIs, such as fluoxetine, target one neurotransmitter; SNRIs, such as duloxetine, and NDRIs, such as bupropion, increase levels of two neurotransmitters. If reuptake inhibitors do not work, the patient may be prescribed an older antidepressant, such as a tricyclic antidepressant or a monoamine oxidase inhibitor (MAOI); imipramine is an example of a tricyclic antidepressant, and phenelzine is an example of a MAOI. The Mayo Clinic recommends that patients who do not find an effective antidepressant have a cytochrome P450 genotyping test, which checks how the body uses the antidepressant.
Brain Stimulation
The Mayo Clinic states that brain stimulation is an option for patients whose symptoms do not improve with the use of antidepressants. Three options are available: electroconvulsive therapy (ECT), vagus nerve stimulation and transcranial magnetic stimulation. ECT works by sending electrical currents to the brain through electrodes, causing a mild seizure. The seizure quickly improves the patient's mood, though the exact mechanism is not known. Vagus nerve stimulation is similar to ECT but requires a pulse generator to be implanted into the brain. With transcranial magnetic stimulation, an electomagnetic coil is held up next to the patient's head, which also results in an electrical current.
Lifestyle Changes
HelpGuide notes that lifestyle changes can also help with depression symptoms, especially if the patient has mild symptoms. The patient can reduce stress with relaxation techniques, such as meditation and breathing exercises. Getting enough sleep at night, eating a well-rounded diet and exercising 30 minutes a day can also improve symptoms. Social support, such as from family and friends, can help the patient overcome his depression.
