What is Depression Treatment and how can we get rid of this condition that causes us so much suffering? At times when we feel the burden of this disorder weighing on us daily, we want to know how to get rid of it quickly. Whether or not we have sought help before, lingering depression can greatly affect the lives of people who struggle with it.
- Depression in most people takes up about 10-15% of our lives in women and 5-12% in men. The onset of the first depressive episode can be at any time, even as a young child. The calculated average age is about 40 years.
- The ratio of women to men is 2:1. After the age of 50, the rate for women equals the rate for men.
- The 2-fold higher frequency of major depression in women is universal regardless of culture or country.
So it is a common condition. There are fewer and fewer people who don’t know the term or have at least an opinion on how to deal with it.
Depression is treatable!
It is a truth known to everyone. What is wrong is the labelling of society. This is radical. They consider you depressed or depressive or not. They leave no room for middle interpretations that can put you in a positive situation as a person.
Also on the same principle many people consider themselves experts in “Depression Treatment”.
We continue to give you the expert opinion on depression, treatment and cure.
Depression – The right treatment
There are effective treatments for depressive episodes. It addresses both the biological changes (antidepressant drugs) and the psychological mechanisms affected (specific psychotherapies). So don’t hesitate to see your doctor if you recognise symptoms of depression.
Depression lowers your quality of life. It also affects the well-being of the people around you who value you.
If a depressive episode has occurred, it is often difficult to overcome it on your own. Most likely you need outside help to get through it. Ask your doctor for help.
Depression Treatment:
- is effective, depression can pass without a trace
- a risk of recurrence of the disease remains
- in mild depression the first option is physical exertion or cognitive-behavioural therapy
- in moderately-severe depression, drug treatment is effective
Depression treatment – What is it?
Acute episodes of reactive depression do not require medication. They can be resolved in psychotherapy sessions.
Sports and recreational activities are very helpful. An example would be playing your favourite sport or cultivating a hobby that puts you in touch with a group of people who share the same passion. For people of faith, depression can also be overcome with the help of a priest or spiritual parent. But the key is awareness of the problem.
You can’t get out of depression if you deny what’s happening to you or if you lie to yourself. Chronic depression, which started many years ago and is untreated, is harder to treat but not impossible.
Experts recommend combining psychotherapy sessions with antidepressant treatment.
You don’t have to be scared of taking antidepressants. The role of these drugs is to normalise serotonin levels in the brain (in the case of endogenous depression) and thus induce a state of calm. With effective Depression Treatment in place, symptoms can improve and the patient’s life can return to normal, even weeks after the start of therapy.
Depression treatment – medication:
- is done with antidepressants
- preferably a single medicine
- average duration 1 year
- antidepressants don’t make you dependent on them and don’t sedate
- anxiolytics and sedatives (another class of drugs) should not be taken for more than 1 month
There are up to 30 different drugs for treating depression, suggestively called antidepressants. They are divided into five main classes, the most commonly used now being those in the Selective Serotonin Reuptake Inhibitors (ISRS) class. These medicines differ in the way they work and the side effects they can cause. What they have in common is that they regulate the amount of certain neurotransmitters in the brain. Neurotransmitters are naturally occurring chemicals in our bodies that facilitate neuronal processes and communication between cells.
One of the main targets of antidepressants is serotonin, as it appears to play a role in triggering or persisting depressive symptoms.
Antidepressant medication can only be prescribed by a psychiatrist. He will monitor progress and adjust the dose to ensure the best results.
The most commonly used are the ISRS class of antidepressants, serotonin reuptake inhibitors.
The increase in serotonin leads to a decrease in symptoms of anxiety, worry and lack of pleasure and their frequency and intensity, until they disappear. Patients prescribed an ISRS may experience an increase in anxiety and depressive ideation during the first two weeks of Depression Treatment, which is why it is recommended to start therapy with low doses, possibly in combination with a benzodiazepine.The intensity of side effects generally tends to decrease over time, but they may persist in some patients and may lead to a change of treatment. It is not possible to predict which patient will experience a particular adverse effect.
Adverse effects
The most common side effects encountered are:
- anxiety;
- nausea;
- increased or reduced appetite;
- insomnia/somnolence;
- decreased libido,
- rarely headache.
When treatment with an ISRS is stopped abruptly, the following can occur:
- anxiety;
- irritation;
- flu-like symptoms (myalgia, sore throat, nausea, vomiting, diarrhoea);
- feelings of dizziness;
- frequently accentuated by movement;
- feeling unsure of balance or position in space.
Dual-action antidepressants
They are selective serotonin and norepinephrine reuptake inhibitors (ISRSN) and are a choice if drugs in the first category could not be tolerated. They increase both serotonin, reducing anxiety, worry, pessimistic thoughts, but also noradrenaline, with effects on fatigue, lack of energy and activity.
The most common side effects are nausea and headache, which usually subside after the first week or two of therapy. Other side effects may include:
- drowsiness;
- dry mouth;
- nervousness;
- increase in blood pressure
Tricyclic antidepressants (ADT)
They are less commonly used than ISRS due to more frequent side effects. Doses are increased very slowly to avoid side effects, so optimal therapeutic effects occur after 8-12 weeks of treatment.
Other antidepressants
that have proven effective in depression are mirtazapine and trazodone.
Benzodiazepines
Drugs related to diazepam – have similar effects, i.e. anxiolytic, sedative/hypnotic, relaxing effect. As a result of these actions, benzodiazepines are indicated for the treatment of symptoms of restlessness and worry, commonly seen in depressive disorder.
Benzodiazepines are frequently used as adjuncts to antidepressant therapy. That is why it is not recommended to use them for more than 2 months and only on the advice of a psychiatrist!
In general, the duration of antidepressant treatment is 9-12 months, but in severe conditions it can take 1-2 years. Discontinuation of treatment is only with the consent and under the supervision of the psychiatrist.
Psychotherapy can help successfully stop treatment with both antidepressants and benzodiazepines.
Depression treatment – Psychotherapy
Many people are reluctant when it comes to psychotherapy, because they don’t understand how talking can heal conditions. But psychotherapy is much more complex.
Psychotherapy is a process for
- discovering deep wounds and healing them;
- identifying negative thinking patterns and replacing them with beneficial ones;
- replacing maladaptive behaviours with healthy ones.
Also, the benefits of psychotherapy have been scientifically studied and proven in a multitude of conditions, not just depression, so its value cannot be disputed.
There are countless types of psychotherapy. Some of them, such as cognitive behavioural therapy (TCC) and dialectical behaviour therapy (DBT), have proven effectiveness in treating depression. They are systematic therapies. They are designed to change thoughts and behaviours through practical exercises and psycho-education.
For example, a TCC therapist can help you identify the automatic negative thoughts that are so common in depression, such as “I’m no good”, “life isn’t worth living”. He/she will then help you understand why these thoughts are not rational, by finding counter-arguments. And eventually, you will find positive thoughts together to replace them with. But there are many other types of psychotherapy, and it is important to identify the type that suits you.
Last but not least, perhaps the most important aspect of therapeutic success is the relationship with the psychotherapist. The so-called “therapeutic alliance”, i.e. the connection you have with your therapist, is the most important predictor of success. It must be based on trust, openness, an accepting attitude.
Depression treatment – alternative:
St. John’s wort extracts (Hypericum perforatum) and those of Passiflora are the only extracts with mild antidepressant action (not risk-free) and the most studied extracts, including in clinical trials.
Physical exertion is another effective natural treatment option. There are breathing techniques that can be learned in psychotherapy, because hyperventilation plays a big role during a panic attack. We solve this part through exercises. Abdominal breathing exercises are very effective, learning to breathe slowly and using the abdomen. Relaxation techniques are many, the idea is that breathing and relaxation exercises should also be practiced cold, we do not start practicing relaxation in the middle of a panic attack, because it is something that is learned.
There are now several therapeutic options for treating depression.
Medications given to patients fall into the antidepressant class and include:
- monoamine oxidase inhibitors,
- tricyclic antidepressants,
- tetracyclic,
- serotonin reuptake inhibitors,
- serotonin and nor-adrenaline reuptake inhibitors.
The mechanism of action of antidepressants is based on interference with certain neurotransmitters, increasing their availability.
These neurotransmitters, in turn, have the ability to improve mental function and emotional tone. However, the mechanism depends on each group. Selective serotonin reuptake inhibitors are the first-line treatment for this disorder. One of the causes of depression is thought to be inadequate serotonin. (the chemical responsible for transmitting nerve signals between neurons).
Selective serotonin inhibitors
They are able to interfere with the reuptake of serotonin in neurons, thus maintaining high levels of serotonin in synapses. They are considered to be more suitable for patients than monoamine oxidase inhibitors because of their lower adverse effects.
Treatment of dysthymia (nervous depression)
So far, we’ve been talking about the treatment of major depressive disorder, known as depression for short. In the Diagnostic Manual of Mental Disorders (DSM), however, there are several mental conditions referred to as depressive disorders, which can be generically referred to as depression. One of these is dysthymia, or persistent depressive disorder. It was also known in the past as nervous breakdown. It does not differ much from major depressive disorder in terms of symptoms, only in age and severity.
To be diagnosed, dysthymia must have been present for at least 2 years, and usually the symptoms are at a lower intensity than major depression. The prognosis is also different from that of major depression. Dysthymia has by definition a chronic course. It usually appears early and lasts a lifetime. People with this diagnosis will usually say they have always been like this. There is no before and after, as there is with depression.
People with dysthymia are less likely than those with major depressive disorder to be diagnosed and treated. Because, as I said, the disorder has an early onset, usually in puberty or adolescence. Symptoms are reduced in number and intensity, people do not seek psychiatric help. Many of them come to believe that it’s part of their personality, or that it’s just how life is. And other doctors or people around them don’t realise there’s a problem.
But when they are diagnosed with dysthymia, they can benefit from the same treatment as in major depressive disorder: antidepressants and psychotherapy.
Depression remedies
Treating depression or preventing it should not only happen in a doctor’s or psychotherapist’s office, but also at home. There are many activities and changes we can make to reduce our symptoms of depression and prevent new episodes. But it is important to remember that this advice should be followed once we have stabilized with medication and therapy. If we are in the midst of a major depressive episode, such advice can further demoralize and discourage us.
Physical activity
It reduces inflammation in the body, gives us energy and makes us feel better. One of the impediments, however, is that we see it as a chore. Humans were not made to run like hamsters on a wheel, we need goals, targets we can achieve and challenges. Find something you like to do that involves exercise and try to include it in your schedule three times a week. Some ideas are: dancing (classes or in a club); climbing (outdoors or in the gym); walking (in the park, in the woods, with the dog, with friends); preparing for a marathon; yoga.
Healthy diet
It affects both our physical and mental health. Depression makes us crave carbohydrates and other unhealthy foods. As we treat depression, we can also replace the unhealthy habits we have picked up as a result. Healthy dieting is not about starvation or counting calories. Rather, it is the care we take of our body, in gratitude for what it does for us. An extremely tasty and healthy diet with a proven role in protecting against depression and cardiovascular disease is the Mediterranean diet. This includes lean meat (fish, chicken); seeds and nuts; salad and vegetables; olive oil; fruit.
Meditation
It is a practice thousands of years old, which has only recently reached the Western world. It consists of concentrating on the present moment, on the breath or on a mantra, in order to clear the mind and achieve a state of calm. Although it may seem impossible or frustrating at first, by persevering, we will notice an evolution and changes in everyday life. Meditation can be practiced anywhere, anytime, and helps us to care for and protect our mental health. Just as we brush our teeth every day to protect our dental health, we can practice meditation daily as a kind of mental hygiene.
Myths and prejudices about medication
It drives fear into the minds of people suffering from depression, and prevents them from getting the help they need. They are caused by ignorance and lack of quality information about antidepressant and psychiatric medication in general. Here are some of them and what is actually the truth:
Antidepressants will make you “a zombie”, they change your personality.
People who say this confuse the problem with the solution. This is a description of depression and its effects. When we suffer from depression, it’s as if a black veil is placed between us and the world, preventing us from interacting as we would like with others. We withdraw socially, we break ties with friends and family, we stop doing the things we used to enjoy, and we are slow, tired, forgetful. People around us don’t recognise us any more, they don’t know what’s wrong with us. Antidepressants can help us get back to normal. To become who we were before the depression. They increase our energy, reduce the symptoms of depression and allow our true personality to surface again.
You will never be able to give up antidepressants.
Unfortunately, here too there is probably some confusion. Many people tend to throw all their psychiatric drugs into one pile. But there is a plethora of medication for many mental health conditions. They are extremely different in terms of mechanism of action, side effects and beneficial effects.
Benzodiazepines, a class of drugs to treat anxiety, tend to make you take them over and over again, the subject of countless articles and books. This is also the reason why their use has been restricted to short durations of several months under close supervision. But it’s very important to understand that antidepressants make you dependent on them. Some people take them for years. When they are ready, under the doctor’s guidance, they discontinue treatment. It is also important to understand that decisions about taking antidepressants and other psychiatric medications should only be made by psychiatrists.
I’ll get fat from the antidepressants.
Although this side effect is more common for first antidepressants, there is still a risk of weight gain with newer antidepressants. But it is important to weigh the pros and cons. Antidepressants can indeed lead to gaining a few extra pounds. They can get us out of the grip of depression and help us get better. After a few weeks or months of treatment, we will regain our energy and desire to do things. So we will be able to be more active, which will help us lose the weight we have gained.
Remember!
Patients on antidepressants are advised to follow their doctor’s recommendations exactly. Any exceeding of the therapeutic dose can be dangerous. If treatment includes IMAO antidepressants, the diet should be modified to avoid possible interactions.
If significant side effects occur or both physical and mental health worsens, patients should notify their doctor. The administration of substances affecting the nervous system should be done with great caution in young patients, children and adolescents. Recent studies have shown that there is an increased risk of suicidal tendencies among them.
Healing begins with a doctor’s consultation
Make an appointment in our clinic in Bucharest, Cluj or Iasi
Healing begins with a doctor’s consultation
Make an appointment in our clinic in Bucharest, Cluj or Iasi