Choosing A Technique And Therapist
Finding a psychologist or therapist can seem like a daunting process since there are so many to choose from and you might not know where to start. Recommendations from others can often be a great way to find a good therapist.
Another place to start is by asking your doctor or another health care professional or by conducting your own online research. The American Psychological Association recommends contacting your local or state psychological association.
You can also connect with a mental health center in your community. The APA has a helpful psychologist locator service to help you find a therapist in your area as well.
When deciding on a potential psychotherapist, you will want to find out what their credentials are and whether they are qualified to treat you for depression. Ask if they take your health insurance or if they’re able to work with you on a sliding scale.
Once you determine that the therapist is adequately trained and licensed, you can read their bio on their website if they have one or send an email inquiry to find out where they received their education and how many years of experience they have. Youll also want to know if they have any particular areas of expertise.
Norepinephrine And Dopamine Reuptake Inhibitors
Norepinephrine and dopamine reuptake inhibitors can help with depression by blocking both norepinephrine and dopamine transporters. NDRI medications include Focalin , Ritalin , and Wellbutrin .
Wellbutrin is sometimes preferred because it is less likely to have the sexual side effects that are common in the other antidepressants. Plus, the side effects that are common this medication, which can include headache, trouble sleeping, and dizziness, generally go away within one to two weeks.
When Does Depression Need Treatment
Any bout of depression that lasts more than two weeks can benefit from treatment, and the earlier it is begun, the better. Early treatment has the highest likelihood of bringing about full remission of symptoms and preventing relapse or recurrence. The so-called burden of depression is great, as the disorder is a major cause of missed work and poor productivity, and it has a devastating effect on relationships, family life, physical health, and general quality of life.
There are four main approaches to treatmentpsychotherapy, antidepressant medications, neuromodulation, and lifestyle measuresand all address different facets of the disorder. Chronic and severe depression responds best to a combination of medication and cognitive behavioral therapy . Signs that depression is responding include less irritability, increased energy, feeling less overwhelmed, normalization of appetite, improved ability to concentrate, return of libido, and improved sense of self.
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Should You Start With Therapy Before Taking Antidepressants
Talk therapy is often very effective, and it is something you can try out for a few weeks and quit if it isnt right for you. This is not the case with an antidepressant because there are serious side effects that can occur if you suddenly stop taking it.
Lifestyle changes like improved diet, regular exercise, and better sleep habits can also help. However, if the symptoms of your depression to make lifestyle changes or find a therapist, your doctor may suggest starting your treatment with antidepressant medication.
Therapy Vs Medication For Children With Mental Health Conditions
As with adults, there is no one-size-fits-all approach to choosing between therapy or medication for children. Some conditions require medication to successfully treat, while others respond better to therapy.
Combining therapy and medication can improve outcomes for a range of childhood mental health conditions including depression and anxiety disorders. Therapy can help even very young children address and improve psychiatric symptoms and associated behavioral problems.
Medications can play an essential role in stabilizing severe psychiatric symptoms that put children at risk of harm. However, lack of certainty about how psychiatric medications affect a childs developing brain intensify the dilemma of therapy versus medication for parents and clinicians. What should you do when a child is not in crisis, but is experiencing symptoms that are disruptive or painful?
Nowhere is the debate more intense than over how to treat children with attention-deficit hyperactivity disorder .
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What Are The Major Types Of Brain Stimulation
In transcranial magnetic stimulation , one or two externally placed electromagnetic coils deliver magnetic pulses to generate currents in deep brain tissue implicated in depressions stall-out. The pulses generated are of the same type and, most often, of the same strength as those generated by magnetic resonance imaging machines. No anesthesia is required, and stimulation is applied during a series of sessions in a doctors office. Approximately 60 percent of people who do not benefit from antidepressant medication improve significantly or achieve full remission with TMS treatment.
Transcranial direct current stimulation applies a weak electrical current to brain sites through the scalp from a headset-like device. The goal is to target brain circuits involved in attention, perception, learning, and memory that affect mood.
In deep brain stimulation, reserved for highly treatment-resistant depression, an externally programmable device is implanted in the chest to deliver electrical signals to targeted sites in the brain. It is like a pacemaker for the brain.
Intermittent theta-burst stimulation is a noninvasive form of brain stimulation approved for use in treatment-resistant depression.
Outcomes Of Ct Versus Adm
Findings from initial studies that compared CT with ADM, which were conducted in the 1970s and 1980s, suggested that CT is as efficacious as ADM in reducing acute distress, and that its effects are more enduring.23–30 However, in a major placebo-controlled trial of ADM versus CT, Elkin et al. reported that, for patients who began the trial with severe symptoms, ADM was more efficacious than CT, and CT was not demonstrably more efficacious than placebo.31 Moreover, there was little evidence for an enduring effect of CT.32 However, there were suggestions in these data that the outcome of CT varied across research sites as a function of therapist experience, which might account for the apparent discrepancy between these findings and those that have been obtained in other randomized trials of CT and ADM.33 Indeed, a mega-analysis of data pooled across the major CT-ADM comparisons showed that the two types of treatment are comparably effective in severely depressed patients.34
Cognitive therapy and antidepressant medication have comparable short-term effects
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Therapy Vs Medication For Depression
Most research on therapy versus medication focuses on treatment for depression. The results show that both medication and therapy are effective treatments for it.
Depression can range in severity from mild seasonal changes in mood to serious, disabling symptoms that can limit your ability to work, maintain relationships, or engage in everyday self-care tasks. Medication and therapy can effectively treat mild, moderate, and major depression.
Depression Statistics: How Prevalent Is Depression?
Depression is one of the most prevalent psychiatric disorders. Each year, 7 percent of American adults, or about 17 million people, experience a major depressive episode. Of those, 64 percent experience severe impairment as a result of their depression.
The results of research on medication versus therapy for depression vary. Some studies show that therapy is more effective. Others show that medication is more effective, while several studies show that both are equally effective.
Based on these findings, it would be false to say either therapy or medication was the winner or the best choice for everyone. The World Health Organization advises that both are considered to be effective evidence-based treatments for depression and that personal factors should play a role in which you choose.
How Popular Are Antidepressants?
Dosage And Side Effects
It is rare for a person to stay on the same dose she is initially prescribed. Instead, doctors adjust dosage once every week or every two weeks in the beginning, as the medication builds up in the brain to reach an effective level. During this time your childs clinician will ask questions about how she is tolerating the medication, including side effects she might be experiencing.
Most uncomfortable side effects will present early, says Dr. Nash. I tell patients you might experience side effects before the desired effects. Clinicians should stay in touch with families during these first several weeks, monitoring how children are feeling and providing guidance because, as Dr. Nash says, It can be a hard time for patients, who might feel headaches or insomnia, but not feel better yet. She says the side effects can go away after one to two weeks.
It can take a while for a patient to start feeling the full effect of an antidepressant medication. The medication might start to work at two to four weeks, but you can still be feeling more benefit at six weeks further out, says Dr. Nash.
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How To Find The Right Treatment
Sticking to your treatment plan is one of the most important things you can do. Its easy to get discouraged in the first few weeks of treatment, and you may feel like you dont want to continue. All types of treatment can take a few months before you notice a difference.
It can also feel like youre doing much better, causing you to stop treatment altogether. Never stop treatment without consulting your doctor first.
You should feel comfortable talking to your therapist. If you dont, try switching to a new one. You may have to meet with several therapists before you find the one thats right for you.
You should also talk to your therapist about your feelings toward your therapy sessions and your overall treatment plan. This allows them to work with you and make changes if your treatment plan isnt working.
Finding the right treatment is often a trial-and-error process. If one doesnt work, its good to move on. If 2 or more months have gone by and youve stuck to a treatment but dont feel any relief from the depression, its likely not working for you. You should experience relief from depression within 3 months of starting a medication.
Talk to your doctor immediately if your:
- depression doesnt improve after several month of treatment
- symptoms have improved, but you still dont feel like yourself
- symptoms get worse
What Is Psychotherapy’s Role
Itâs also called talk therapy. You meet with a psychiatrist, psychologist, social worker, or other trained mental health professional. You will learn new ways to handle the challenges and mindset that depression can bring on.
If your depression is mild to moderate, psychotherapy may work as well as an antidepressant.
You can get talk therapy on your own, with your family, or in a group. Your doctor will help you find the best type for you.
Exercise is another good treatment for mild depression. In one review of studies on the topic, experts concluded that it works as well as drugs or psychotherapy in easing depression symptoms and keeping them at bay.
Different âdosesâ of exercise may work for different people. You may want to start working out for 45-60 minutes, 3-5 times a week. If that sounds like too much, remember that some is better than none. And you may still need medicine or psychotherapy to feel better.
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How Are Antidepressant Medications Selected
The type of drug prescribed will depend on your symptoms, the presence of other medical conditions, other medicines you are currently taking, the cost of the prescribed treatments, and potential side effects. If you have had depression before, your provider may prescribe the same medicine that worked for you in the past. If you have a family history of depression, medicines that have been effective in treating your family member may also be considered.
Usually you will start taking the medicine at a low dose. The dose will be gradually increased until it has reached the therapeutic dose, or until you start to see an improvement .
Tap Into Your Spirituality
Religion can be an impactful source of support for many people dealing with depression, but there is no need to join a church, synagogue, or mosque unless you wish to. Simple daily practices such as meditation or adding to a list of things you’re grateful can help boost mood and overall well-being.
Meditation can have a range of beneficial effects such as lowering stress levels and helping people to become more aware of their thoughts and reactions.
Research indicates that an intervention called mindfulness-based cognitive therapy , which combines elements of cognitive behavioral therapy with mindfulness meditation, can be helpful in treating depression and preventing future relapses of symptoms.
Studies also suggest that different types of mindfulness meditative practices can also be effective in the treatment of depression.
There are many different types of meditation, but you can get started with a simple meditative exercise with these steps:
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S For Meeting Your Need To Give And Receive Attention
Monitoring For Suicidal Thinking
The Food and Drug Administration has issued a warning that children and adolescents taking some antidepressant medications may experience an increased risk of suicidal thoughts. Many studies have shown that the benefits of antidepressant medications outweigh the risks of going without treatment, so they are still prescribed to young people. To keep patients safe, a protocol has been developed for prescribing clinicians to help them closely monitor patients for any worsening in depression or emergence of suicidal thinking as they are adjusting to a new medication.
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Depression And Your Children
Like adults, children and teens can also feel depressed. You should watch your children for signs of depression. Talk to your children if you notice changes in their behavior. Talk to your childs healthcare provider if you are still concerned.
Prozac is the only medicine that is approved by FDA for use in children with depression. Prozac and Lexapro are the only FDA-approved medicines for teens with depression. Talk to your healthcare provider about important warnings for children and teens who take medicine for depression.
What Does Interpersonal Therapy Do
Like CBT, IPT is a short-term, present-oriented therapy. Its primary target, however, is the difficultiy in interpersonal functioning that both gives rise to and results from depression. Many studies support the value of ameliorating interpersonal distress as a route to relieving depression. IPT focuses on four major interpersonal problem areasunresolved or complicated grief, struggles with a significant other , role transitions such as the end of a marriage or becoming physically ill, and frank deficits in interpersonal skills. Patients learn to understand which problem area is linked to onset of their episode of depression and to directly redress those difficulties, often by learning how to better express their emotions. With supportive guidance from the therapist, they learn new communication strategies and may even rehearse through role play new solutions to longstanding social difficulties.
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What To Expect From A Clinician
Having a good relationship with your childs clinician is essential, because the more engaged and committed your child is in treatment, the more likely it is to be successful. A good clinician should make sure you understand the goals of treatment and make you feel like your questions are being taken seriously. You should also feel that you can be honest about how your child is doing.
Jill Emanuele, PhD, senior director of the Mood Disorders Center at the Child Mind Institute, says one of the first things she does with a new patient is try to establish a good rapport. You get to know the person, you make them comfortable. You establish a safe space where you show them that youre listening and you care. Often enough were the first person thats actually listening to them in a way they havent experienced before, or have not experienced often.
If a person is resistant to treatment, Dr. Emanuele says she tries to address that. Maybe theyve had a difficult experience with therapy before, or they dont really trust adults, or perhaps they are shamed by their behavior or what theyre feeling, and they dont want to show it to another person.
Individual Or Group Therapy
When you hear the word therapy you might automatically think of one-on-one sessions with a therapist. However, group therapy can be very useful in depression treatment as well. Both group and individual therapy sessions usually last about an hour. What are the benefits of each? In individual therapy, you are building a strong relationship with one person, and may feel more comfortable sharing some sensitive information with one person than with a group. You also get individualized attention.
In group therapy, listening to peers going through the same struggles can validate your experiences and help build self-esteem. Often group members are at different points in their depression, so you might get tips from both someone in the trenches and someone who has worked through a challenging problem. As well as offering inspiration and ideas, attending group therapy can also help increase your social activities and network.
When the going gets tough in therapy
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