Treating Depression
Treatment for depression includes more than just depression medication and therapy, although both options can effectively treat depression symptoms. Controversial treatments, such as electroconvulsive therapy, may be used when therapy and depression medication fails. A new treatment for depression — transcranial magnetic stimulation (TMS) — offers a noninvasive alternative to traditional treatments.
Depression Medication
Depression medication alters levels of neurotransmitters, which are naturally occurring brain chemicals. Neurotransmitters are necessary for proper communication between brain cells. Imbalances in neurotransmitters are a possible cause of depression.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are usually the first depression medications prescribed. SSRIs affect the neurotransmitter serotonin, while SNRIs affect levels of both serotonin and norepinephrine.
Other types of depression medications include bupropion and mirtazapine, as well as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). TCAs and MAOIs are older-generation antidepressants that can cause serious side effects, so they aren’t as frequently prescribed as SSRIs and SNRIs.
Treating depression with medication can take up to a month before providing symptom relief, and all depression medication can cause side effects.
Talk Therapy, Support Groups and Depression
Depression treatment traditionally includes talk therapy, in one-on-one settings with a therapist or as a group; both can be effective depression treatments.
Individual therapy often employs cognitive behavioral therapy. Cognitive behavioral therapy teaches new ways to think about emotions and situations that trigger depression symptoms. This helps people break out of established thought patterns and habits that encourage depressive thinking.
Group therapy may also employ cognitive behavioral therapy. One benefit of group therapy is the ability to share experiences with other people who understand what it means to suffer from depression, who can offer their own perspective on dealing with the disease.
Depression Medication and Therapy
Treatment for depression often requires a combination of depression medication and therapy. Depression medication reduces symptoms of depression, giving people the ability to focus on therapy without the debilitating effects of depression.
Electroconvulsive Therapy
Electroconvulsive therapy treats depression by using electric current to stimulate a seizure while under general anesthetic. Despite a controversial early history (when ECT involved large electric currents and no anesthesia), ECT is a possible depression treatment for people who don’t respond to medication or standard therapy.
Advances in ECT have made the treatment much safer, yet many people shy away from it based on its controversial reputation.
Transcranial Magnetic Stimulation
Transcranial magnetic stimulation is a relatively new treatment for depression that stimulates brain cells with magnetic fields. The U.S. Food and Drug Administration cleared TMS as a treatment for depression when therapy and depression medication fail to improve symptoms.
Transcranial magnetic stimulation is noninvasive. The patient sits in a special chair while magnetic pulses stimulate brain cells involved in mood and depression.
Exactly how TMS works is unclear. A lessening of depression symptoms and improved mood may be seen within a few weeks of starting TMS treatment, which requires multiple treatments over four to six weeks.
Because TMS is a new treatment for depression, its long-term effectiveness is unknown. Further TMS research aims to identify which areas of the brain respond best to transcranial magnetic stimulation. These discoveries will further improve the depression treatment.
Resources
American Academy of Family Physicians Staff. (2007). Cognitive therapy. Retrieved May 8, 2010, from the Family Doctor website: familydoctor.org/online/famdocen/home/common/
mentalhealth/treatment/882.printerview.html.
Mayo Clinic Staff. (2008). Electroconvulsive therapy. Retrieved May 8, 2010, from the Mayo Clinic website: www.mayoclinic.com/print/electroconvulsive-therapy/MY00129/METHOD=print&DSECTION=all.
Mayo Clinic Staff. (2009). Transcranial magnetic stimulation. Retrieved May 8, 2010, from the Mayo Clinic website: www.mayoclinic.com/health/transcranial-magnetic-stimulation/MY00185.
U.S. Food and Drug Administration Staff. (2009). Understanding antidepressant medications. Retrieved May 8, 2010, from the U.S. Food and Drug Administration website: www.fda.gov/ForConsumers/ConsumerUpdates/ucm095980.htm.