Depression Treatment: What Is Best For Me?

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Depression Treatment: What Is Best For Me?

The landscape of mental health treatment can be complicated and difficult to navigate. As a result, many people find it overwhelming and challenging to find the right type of depression treatment for them. We have identified some of the reasons why the right course of treatment can be so hard to find, shared tips for securing an accurate diagnosis, and outlined a few of the most effective treatment options for people living with depression.

Depression: A Complex Condition with Complex Solutions

Before discussing the options for treating depression, it’s important to know a few things about the condition and why it might be so difficult to choose the right depression treatment.

Depression is a highly complex syndrome with a wide range of presenting symptoms and causes. It can be challenging to come to a correct diagnosis, and therefore, to utilize the correct treatments.

To receive a diagnosis of depression, five of nine possible symptoms must be present for at least two weeks. In other words, there are more than 100 different combinations that these nine symptoms can form, making each person's experience of depression remarkably unique.

Symptoms of depression may include:

  • persistent depressed mood
  • anhedonia (reduced ability to experience pleasure)
  • changes in appetite
  • feelings of guilt and worthlessness
  • feelings of being “slowed down”, both physically and cognitively
  • fatigue
  • feelings of guilt and worthlessness
  • difficulty concentrating and/or making decisions
  • thoughts of death and/or suicide

Adding to the difficulty of accurately diagnosing depression is the fact that all of the above symptoms are subjective. There isn’t a blood test or radiographic image that can provide a definitive diagnosis of depression. Mental health providers must rely solely on self-reporting from the patient and information from family members when diagnosing depression.

The diagnosis and treatment of depression can also be complicated by the presence of physical and mental disorders that share features of depression. For example, alcohol use disorder can also cause cognitive slowing. Hypothyroidism can cause fatigue. ADHD can cause difficulty concentrating. The list goes on.

In addition to the challenges in accurately diagnosing the condition, depression treatment is also complicated by the variability of underlying causes. In fact, depression seems to emerge for different reasons in different people due to a combination of genetic, biological, environmental, and psychological factors.

If you find yourself feeling overwhelmed or perplexed by this information, you aren’t alone. The good news is, there are a few depression treatments with a great track record of success, and people living with depression often find relief no matter which option they choose. It is also worth noting that using these depression treatments in combination with one another can significantly augment the effects.

Taking the First Step: Diagnosing Depression

Something that is often overlooked when people are in search of depression treatment is the importance of having the right diagnosis. The wrong diagnosis can lead to treatments that are ineffective at best, and dangerous at worst.

So, how can you make sure the diagnosis you receive is correct? Here are a few things to consider:

  1. Visit your General Physician (GP) for a full check-up: If you find that you’re experiencing symptoms of depression, your GP can help rule out underlying medical conditions that could be causing your symptoms. For example, symptoms like fatigue and difficulty concentrating can be caused by medical conditions like anemia, hypothyroidism, and low blood pressure.
  2. Visit a mental health practitioner for a mental health diagnosis: It is possible that in the course of your checkup, your GP will suggest a mental health diagnosis like depression. While this input might be helpful, mental health providers like psychiatrists, psychologists, and clinical social workers have more comprehensive training in the diagnosis of mental health conditions.
  3. Be transparent with your providers: Be sure to be forthcoming with both your GP and your mental health provider about all the medications you’re taking, how you are feeling, and any medical conditions you are aware of. The more information they have, the more likely they will be able to accurately diagnose your condition.

Having an accurate diagnosis is the first step in finding the depression treatment that’s right for you. Below, we’ve outlined four of the most effective treatment options for depression.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is considered to be one of the most effective depression treatments.

In CBT, clients are guided to make changes to both their behaviors and their thought patterns, which have been shown to reduce the severity of depression symptoms. CBT is highly structured and clients tend to see a reduction in symptoms in just a few sessions.

One of the most important techniques in CBT is called behavioral activation. When a therapist works with a client in depression treatment using behavioral activation, they may help the client engage in daily activities that are known to help depression symptoms. For example, they may help the client schedule activities with friends, develop an exercise routine, or make changes to their diet.

Another aspect of CBT focuses on what are called cognitive distortions. Cognitive distortions are maladaptive thought patterns, such as catastrophizing. People who experience cognitive distortions might also minimize positive thoughts and inflate negative thoughts. In CBT, therapists help their clients to transform their cognitive distortions and encourage more positive and realistic ways of thinking. In turn, most clients experience an improvement in mood and affect.

One of the greatest benefits of CBT is the speed at which it takes effect. This also means that CBT tends to be less costly than other kinds of therapy. That said, it is worth noting that studies have shown CBT’s effectiveness is often temporary, as it does not necessarily tackle the issues underlying the depression. For those who feel they need longer-term treatment, they may be suited better for psychodynamic or psychoanalytic styles of therapy.

Psychodynamic Therapy and Psychoanalysis

Psychoanalysis and other psychodynamic therapies were developed according to the belief that many psychological issues are caused by the repression of our fears, desires, and unconscious thoughts. In other words, these therapies seek to “make the unconscious conscious” by inquiring deeply about a person’s life events, their feelings, and their relationships.

In more contemporary psychodynamic and psychoanalytic therapies, a lot of emphasis is placed on the importance of relationships and the unhealthy relationship patterns that might lead to negative affect, and even depression. These therapists might even draw attention to dynamics that develop between a therapist and their patient in order to work on relationship challenges in real time.

When it comes to depression treatment, these therapies can be effective because they help clients gain insight into what causes them to feel the way they do. In turn, insight often leads to changes in affect and behavior. Many people also find great relief through developing a safe, secure relationship with the therapist, especially if that is something that they did not experience with their earliest caregivers.

Some of the drawbacks of psychodynamic and psychoanalytic treatment for depression are that they can be expensive and take longer to work than other treatments.

Antidepressant Medication

While therapy is often enough for people experiencing depression, others find medication to be effective either on its own or in conjunction with therapy.

Antidepressant medication must be prescribed by a medical doctor. While general physicians are able to prescribe antidepressant medication, it is advisable to visit a psychiatrist for these types of medications. Psychiatrists are medical doctors who have specialized training in the treatment of mental health conditions and may be more skilled in selecting the medication that will be effective in your depression treatment.

Antidepressant medications work to alter the behavior of neurotransmitters in the brain, which can lead to improvement in depression symptoms. Antidepressant medication has what is called a therapeutic effect, meaning that it does not usually cause immediate or drastic changes in mood or symptoms. Antidepressants usually take four to six weeks to reach their full effectiveness.

Some of the most common antidepressants are called SSRIs (selective serotonin reuptake inhibitors), and are designed to augment the amount of serotonin available for the brain to utilize. Other antidepressants also interact with neurotransmitters called norepinephrine and dopamine, and they are often referred to as NDRIs or SNRIs.

When considering antidepressant medication for depression treatment, it is important to note that many of these medications come with side effects. It is important to ask your doctor about the potential downsides of the medication they suggest. Some people also find it difficult to discontinue medication when their depression is under control because of the withdrawal symptoms that can occur. This is also something to discuss with your psychiatrist before beginning treatment.

These are only a few of the depression treatment options available. CBT, psychodynamic psychotherapy, and antidepressant medications are three of the most effective treatments for depression. However, new research indicates that mindfulness meditation, ketamine-assisted psychotherapy, and psychedelic therapies hold tremendous promise. The bottom line? Finding depression treatment that works for you is possible.

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