Treating Depression

General physicians are trained to treat patients experiencing ongoing depression.  Health care professionals are specifically trained in medical school to treat all psychiatric disorders.  The same holds true for nurses, nurse practitioners and physicians assistants. Generally though, if a patient’s condition seems fairly severe, a referral will be made to mental health care providers who are better equipped to deal with more intense and specific cases of mental illness.

Mental health care providers who may be referred include psychiatrists (as mentioned earlier), psychologists, and sometimes even social workers.

Psychiatrists are trained to provide counseling and medical diagnosis and treatment for mental illness patients.  Psychologists are well-trained in the area of psychotherapy although they cannot offer medical treatment for severe cases of depression that required medication for the patient.  Social workers are great resources for re-integrating the depressed patient into their normal life and relationships, although they are not as specialized as the other available professionals.  A psychiatric nurse may be of assistance to some patients who require assistance in getting accustomed to their specific treatment plans.

Symptoms, overall health assessment and medical/mental history of the patient’s family will be reviewed by the health care professional prior to any diagnosis of depression. A physical exam is also necessary, along with blood tests to rule out other physical problems in most cases.

Depression is an emotional illness, and treatment will require not only the support of medical professionals but also the support of friends and family.  Some doctors will request that a friend or family member attend sessions with the patient in order to analyze improvements or downgrades. It will also ensure that the patient is following treatment plans correctly.

The initial visit with a mental health professional will be used to determine the diagnosis and the severity of the symptoms and condition. It will allow for classification of depression; mild, moderate or severe.  It will be important for you to be completely honest about how the symptoms are happening and when. It is crucial to explain areas of your life that are disrupted as a result of the symptoms of depression that you are and have been experiencing. Severe depression affects a patient’s ability to function normally as a member of society. Recurrence is very common with this variety of depression.
Mild depression may be the diagnosis if the person just needs more of a push to do all of the things they have to in the course of a normal day – and if symptoms do not appear severe or life-impacting.

Depression is very real! It should never be ignored or underestimated by the patient, the professional or family members.

Depression is a real illness. Many people will dispute this fact because everyone gets upset from time to time.  So the answer is still yes, depression is very real.  Clinical depression has physical causes that can and should be treated once a diagnosis is made. Medical professionals agree that at some point in their lives, about 10% of Americans will experience some level of depression. Sometimes, it is a one time thing and sometimes it is recurring throughout the lifetime of the patient. Nearly 80% of all depression cases are capable of being managed with a specifically designed personal treatment program developed by the medical professional and the patient.

The following are some of the treatment options available to depression sufferers:

Psychotherapy for Depression

Behavioral modification therapy, cognitive behavioral therapy, rational emotive therapy, and interpersonal therapy are all common methods used by professional therapists to treat the symptoms and causes of depression. Other possible types of therapy include psychodynamic and family group therapy. The decision about what type of therapy to use for a particular case will depend on the type and severity of the individual patient, their insurance or financial resources and the type of therapist being considered by the patient and their other physicians.

The most commonly used method of treating depression with psychotherapy is cognitive behavioral therapy.  It tends to serve the purpose of treating depression very well for most patients.  There have been numerous studies performed to assess the safety and effectiveness of this type of therapy in conjunction with depressed patients on varying tiers of severity.

Cognitive behavioral therapy generally starts by addressing the depressed patients negative thought processes, otherwise known as cognitive distortions.  The techniques used in this type of therapy are fairly simple for the therapist and the patient.  Studies have shown that depression is often made worse when the patient begins to rely on their negative processes.

The intention of using therapy is to create for the patient a warm, supportive environment in which they feel safe. It’s very important that there therapist educate the patient about depression, and what it means. Teaching the patient that their depression is connected to their negative thought processes is usually the second part.  Logical distortions and cognitive distortions are often addressed at the point when the patient is aware of the effects of these processes.  Faulty logic can include “all or nothing” thinking, overgeneralization and other types of thinking.  Patients are often requested to keep a journal of their daily thought processes throughout the course of therapy in order to track what is happening in terms of their depression – and also to draw conclusion about triggers, etc. This allows the patient and the therapist to have a better idea of the types of thought processes being employed by the patient and can assist in gearing their treatment toward the removal of faulty logic and negative thinking.

Thoughts and behavior are analyzed deeply in this form of therapy primarily in order to form connections between thought patterns and resulting behaviors. The key is to understand why the connections occur – more important even then addressing the underlying emotions of the depressed patient. The reason that this is true is because therapists have discovered that when one experiences a change in their thinking process, the emotions that are related will eventually come into the control of the patient. The process has proven effective for many depression patients over many years of practice and research. Cognitive-behavioral therapy is almost always a short term solution offered to a patient, generally spanning around twelve sessions. It works most effectively for patients experiencing mild to moderate depression that is related to some sort of traumatic experience that has led to their developing these negative thought processes. It gives patients the ability to develop problem solving skills and to adopt a perspective on their life that is cognitively-oriented.  People with high levels of cognitive intelligence are generally the best candidates for this type of treatment regimen.

Interpersonal psychotherapy is another short-term treatment option for mild to moderately depressed patients.  The focus is not on the thinking patterns of the individual so much as it is on the relationships established by the patient. The attempt in this type of therapy is to develop methods to improve and maintain relationships within the patient’s life. The reason that this type of therapy proves effective is that the support a person receives from those surrounding them in their life is often the key to happiness and to beating depression.

Unhealthy relationships will often lead to the development of depression, and when one begins to realize the important of improving unhealthy relationships within their life they are better equipped to deal with the causes and symptoms of their depression, which is what lead them to therapy to begin with. The goal is to improve the capacity for the patient to express their emotions and communications skills and to develop assertiveness and happier relationships.  Initially, this type of therapy may be individual although many times the therapy regimen will benefit from the inclusion of those people who have relationships with the patient in order to see the interactions and reactions that the people have to one another.

Individual therapy places the responsibility to recovering from depression on the patient. The role of the therapist is to encourage and entice the patient to be an active participant in their own recovery. This is a good approach because it gives the patient the ability to slowly make lifestyle and thought process changes that will allow them to counteract the negative effects that depression has had on their lives.  The warm and safe environment of a therapist’s office is also the stepping stone that an individual patient needs to be able to handle group therapy sessions and will often help then the most during the time when they first begin taking depression medications, which can take weeks to begin having a positive effect on the patient’s depression.

Psychodynamic or psychoanalytic approaches to the treatment of depression are not extremely common because there is a lack of research and studies available to tell of the effects of the treatment regimens.  Psychodynamic therapy is often used by the treating mental health professional to get a true picture of the patient’s personality. There is still little supporting evidence to show the effectiveness of this type of analysis therapy.

Group therapy for couples and families might also be considered a treatment option for a patient if the depression seems to be seriously impacting family relationships – or to stem from relationships.  The focus is placed upon the interrelations of those involved with the patient and can prove effective at smoothing out differences among all members of the family when used effectively.  Of course, the patient is the primary focus, but the effects are usually positive for everyone who participates actively. Communication within the family or couple is key and the therapist will be able to get a good idea on the role of the others in the patient’s depression.  This also provides a great opportunity for the couple or family to become more educated about depression and it’s causes and effects – and most importantly to destruct popular myths such as using the command to “snap out of it.”

Medication for Depression

Many medications have been approved by The Food and Drug Administration (FDA) for treating depression. The drugs belong to several different drug classes; each medication works different with brain chemicals and contains a different chemical structure.

All FDA approved drugs are safe and recommended for the treatment of depression. It is important to realize though that the reason there are different drugs available is that not every drug works the same way for every person.

A patient should be a part of the process used to determine the best drug for his or her particular case.  In some patients it is necessary to use a combination rather than a single drug.  Someone taking depression medications should never just stop taking the medication due to the possibility of severe side effects resulting from a sudden stoppage.



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