Major depressive disorder affects more than 15 million adults in the United States and presents with feelings of sadness, sleep disturbance, loss of interest in activities, feelings of guilt, loss of energy, difficulty concentrating, changes in appetite, psychomotor agitation, sadness and even suicidal ideation. It can occur in adult men and women as well as adolescents and can affect any individual regardless of race, religion or social economic status.
Depression is the leading cause of disability in the United States and costs the U.S. society $210 billion per year. Approximately only 40% of this amount is associated with depression itself whereas the other 60% of this money is spent on lost wages, interventions for suicidal attempts and treatment for other co-occurring disorders associated with depression.
Treatment for depression consists of a combination of medications and psychotherapy. Although studies have shown that these medications and psychotherapy approaches can be used alone for mild depression, when used in combination, individuals receive the best outcomes in terms of symptoms relief for moderate depression. The most common pharmacological treatments include antidepressant classes such as selective serotonin reuptake inhibitors (SSRIs), serotonin/norepinephrine reuptake inhibitors (SNRIs), atypical antipsychotics, and tricyclic antidepressants (TCAs).
Medication generally takes approximately 6-8 weeks for results to take effect. Psychotherapy includes cognitive behavioral therapy, interpersonal therapy, problem-solving therapy and mindfulness-based cognitive therapy.
An antidepressant medication is usually the first-step in the treatment plan for an individual with mild to moderate depression. There is a vast array of medications available and the initial selection often depends on the known medication side effects, safety and tolerability of these side effects, duration of timing it takes for the drug to work, an individual’s response to prior antidepressant medications, cost of the medication, interactions with other medication and the individual’s preference. Antidepressants take two-six weeks, at the correct dosage, for a clinical response to occur and therefore it is imperative individuals stay motivated and compliant during this time period. Additionally, psychotherapy can be initiated at the start while these medications take their time to produce clinical effects. The following are classes of antidepressants widely used in the general population to treat depression:
Electroconvulsive therapy (ECT) is a form of somatic therapy that has been shown to have the highest treatment rate for depression. It is indicated for the treatment of severe major depression in individuals who are unresponsive to both medications and psychotherapy. Electrodes are places on one or both sides of the forehead and an electrical stimulus is generated in order to produce seizure activity for at least 20 seconds in the brain to rewire brain communication cells (neurons) and their hormones (neurotransmitters). This procedure is performed under anesthesia and is usually conducted two to three times a week and usually consists of six to 12 treatments.
Cognitive behavioral therapy and interpersonal psychotherapy are the two most common therapy approaches to treating depression. Cognitive behavioral therapy focuses on reducing depressive symptoms by recognizing the thought the irrational thought patterns, emotions, beliefs and distorted attitudes toward oneself and their environment that results in symptoms of depression. Once the recognition of maladaptive thoughts occurs, an individual can then work on their behavioral patterns to turn these negative symptoms around into positive outlooks, and gain insight and self-appreciation in order to develop behavioral techniques such as self-control therapy, problem solving, and social skill training. Interpersonal psychotherapy focuses on acknowledging the triggers associated depression such as the loss of a loved one, a stressful social situation, the loss of a job, financial burdens, social isolations, or the loss of a romantic relationship. In this form of therapy, depression is viewed as a medical illness and the illness is the cause of the depression. Techniques that involve building relationships, learning coping mechanisms, and developing conflict resolution skills can help diminish these triggers and form positive insight in future conflicts. Other forms of psychotherapy that have been implanted to treat depression include the following:
Discovery's Resilience Palm Beach Gardens, FL specializes in residential treatment for depression with unique treatment programs for every individual to get them on their way to mental health disorder recovery.
For more information, resources, or to consult with a mental health treatment specialist, call 561.413.9961