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Treatment for Depression

One of the biggest obstacles to getting help for clinical depression can be a person's attitude. Many people think that depression will go away by itself, or that they're too old to get help, or that getting help is a sign of weakness or moral failing. Such views are simply wrong.

Depression is a treatable psychological problem. Even the most seriously depressed person can be treated successfully, often in a matter of weeks, and return to a happier and more fulfilling life. Such outcomes are a common story, even when people feel hopeless and helpless. 

Types of treatment for depression 

The most commonly used treatments for depression are psychotherapy and antidepressant medication,  or a combination of the two. Which of these is the right treatment for an individual depends on the nature and severity of the depression and, to some extent, on individual preference. In mild or moderate depression, psychotherapy is most likely the most appropriate treatment. But, in severe or incapacitating depression, medication is generally recommended, in addition to psychotherapy. In combined treatment, medication can relieve physical symptoms quickly, while psychotherapy allows you to learn more effective ways of handling your problems. 

Psychotherapy

Psychotherapy is used to treat depression in several ways. First, supportive counseling can help to ease the pain of depression, and can address the hopelessness of depression.  Second, cognitive therapy works to change the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create the depression and sustain it. Cognitive therapy can help the depressed person recognize which life problems are critical, and which are minor. It also helps them to learn how to accept the life problems that cannot be changed. Third, problem solving therapy is usually needed to change the areas of the person's life that are creating significant stress, and contributing to the depression. Behavioral therapy can help you to develop better coping skills. Interpersonal therapy can assist in resolving relationship conflicts. Research has shown that psychotherapy is particularly helpful for treating depression. 

Medication

Except in the more severe depressions, and bipolar depression, medication is usually an option, rather than a necessity. Antidepressant medication does not cure depression, it only helps you to feel better by controlling certain symptoms. If you are depressed because of life problems, such as the loss of a loved one, financial problems, or serious medical problems in yourself or a family member, taking a pill will not make those problems go away. 

The medications used to treat depression include tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), serotonin reuptake inhibitors (SRIs), and bupropion. Each acts on different chemical pathways of the human brain related to moods. Antidepressant medications are not habit-forming. To be effective, medications must be taken for about 4-6 months (in a first episode), carefully following the doctor's instructions. Medications must be monitored to ensure the most effective dosage and to minimize side effects. 

Your prescribing doctor will provide information about possible side-effects and/or dietary restrictions. Always remember that all prescription drugs have potential side effects. In addition, any other medically prescribed medications you are using should be reviewed by your physician, because some can interact negatively with antidepressant medication. 

  • All antidepressant medications alter the action of brain chemicals to improve mood, sleep, appetite, energy levels, and concentration.
  • Different people may need different medications, and sometimes more than one medication is needed to treat clinical depression. 
  • Improvement of the more serious symptoms usually occurs within weeks
  • Medication is not a substitute for psychotherapy, it is in addition to psychotherapy

Where to Get Help

Trained professionals in numerous settings diagnose and treat clinical depression:

Family physicians, clinics, and health maintenance organizations can provide medical treatment for depression, but should also make a referral to a psychologist

Psychologists are trained to provide treatment for depression and other psychological problems. Like physicians, they have a doctoral degree, only it is in psychology, rather than medicine. Psychologists will often work with your family physician, if medication is needed.

Community mental health centers provide treatment based on the patient's ability to pay. They usually have a variety of mental health specialists in a CMHC, although most psychotherapy services will be provided by non-psychologists, with less training. 

Advocacy Organizations

National advocacy or consumer organizations provide information about depression, sources of treatment, and local community support groups: 

American Association of Retired Persons (AARP)
Widowed Persons Services
Social Outreach and Support 
601 E. St. NW 
Washington, DC 20049
(202) 434-2260

National Directory of Psychologists
PO Box 6278
Bridgewater, NJ 08807

American Psychological Association
750 First Street, NE
Washington, DC 20002
(202) 336-5500

National Depressive and Manic Depressive Association
730 North Franklin Street, Suite 501
Chicago, IL 60610 
(312) 642-0049; 1-800-826-3632

National Mental Health Association
1021 Prince Street
Alexandria, VA 22314-2971 
(703) 684-7722; 1-800-969-6942

 


More Detailed Information About Depression

Seniors: Depression and Bipolar Disorder