Finding The Best Depression Treatment For You
When youre depressed, it can feel like youll never get out from under a dark shadow. However, even the most severe depression is treatable. So, if your depression is keeping you from living the life you want to, dont hesitate to seek help. From therapy to medication to healthy lifestyle changes, there are many different treatment options available.
Of course, just as no two people are affected by depression in exactly the same way, neither is there a one size fits all treatment to cure depression. What works for one person might not work for another. By becoming as informed as possible, though, you can find the treatments that can help you overcome depression, feel happy and hopeful again, and reclaim your life.
Cognitive Therapy In Primary Care
Family physicians usually are the first to diagnose and treat patients with depression. They should inform patients that psychotherapy and pharmacotherapy are valid options, and that cognitive therapy, and therefore CBT, is the most studied psychotherapy. If the patient and physician initially elect to use pharmacotherapy, and the patient does not respond adequately, the physician should again suggest adding psychotherapy or CBT. CBT should be strongly considered as initial therapy for patients with severe or chronic depression or for adolescents. If the patient declines referral, or if the family physician provides CBT, longer appointments could be scheduled. Resources are available for the physician and patient , and further physician training should be considered.
Effective Methods Of Treating Depression
Depression, Self DevelopmentLisa Firestone, Ph.D.
Depression is a serious problem in the United States. According to the Anxiety and Depression Association of America, a major depressive disorder affects about 6.7 percent of the U.S. population over 18 and is the leading cause of disability in the country for those aged 15 to 44. Depression can arise from a combination of biological susceptibility and early childhood experiences that leave an individual more vulnerable, in addition to significant stressful life events such as loss. Like any affliction, depression requires attention and targeted treatment. Yet, contrary to the hopelessness those suffering often experience, depression should be seen as an eminently treatable disorder.
Depression is striking people at younger and younger ages, making it all the more important to treat depression early and well. There are now many therapies that are effective. In deciding on which is best, it is helpful for a person suffering to address what might be the underlying issue. People who have a history of trauma seem to benefit more from talk therapy with a therapist with whom they form a good alliance. Those with no history of trauma may benefit from medication in addition to psychotherapy. For any individual, treatment should always be case-specific, and for many, a combination of therapy and medication may be most effective to reduce symptoms.
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How Does Cbt Help With Depression
CBT uses a combination of cognitive and behavioral approaches to reduce depression.2 Therapists may challenge depressive thinking patterns that are leading to inaction or self-harming behaviors. By targeting both thoughts and actions, CBT aims to change someones feelings, as CBT posits that each can influence the other.
Cognitive Methods To Change Depressive Thinking Patterns
Cognitive methods teach you to challenge and rationalize negative thoughts, eventually reducing their power over you. Techniques like cognitive restructuring can help you understand your thought patterns, the emotion or trigger behind them, and the actual reality of the situation. Then, the therapist could present a more rational or realistic perspective to help reduce cognitive distortions.
A common cognitive distortion among those with depression is mind reading, where you believe you know what others are thinking. By challenging this and other depressive thoughts, you can build a healthier pattern of thinking and self-talk.2,3
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Are Some Types Of Therapy Especially Effective Against Depression
Depression is a multifaceted disorder, and it responds to therapies that specifically target one or another area of dysfunction. Four types of therapy have proved effective in patients with depression extensively studied during treatment and followed up for significant periods of time afterwards. They are: Cognitive and Behavioral Therapy , Interpersonal Therapy , Psychodynamic Therapy, and Behavioral Activation .
Family Or Couples Therapy
Family or couples therapy can help if depression is impacting your family dynamic or the health of your relationships.
These therapies tend to focus on:
- interpersonal relationships of family members
- clear and straightforward communication
- the roles of family members in managing your depression
- education about depression and mental health
Therapy is an active collaboration between you and your therapist .
Whatever therapy you choose, taking a proactive approach can help. This means keeping up with assignments between sessions and letting your therapist know if you have any concerns.
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How Soon Will I Notice Any Effect
Research indicates that 50 percent of patients recover within 15 to 20 sessions, and many patients experience some improvement within a few sessions. Patients differ in the nature and severity of their problem and in their progress, but most patients experience a gradual return of ability to function. They also notice a lessening of hopelessness. The first sign that depression is improving may be a reduction in sadness or reduced pessimism about the future. There may be a lessening of irritability or a renewed interest in something once enjoyed. Feelings of guilt may also begin to abate.
Types Of Cbt For Depression
Cognitive behavioral therapy is not only a treatment type, but it is also the main branch for a number of different therapy styles. While CBT is the basis of these styles, it is not the only one that can be effective for treating depressive symptoms and episodes.
Here are the three most common offshoots of CBT used for depression:
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What Types Of Therapy Are Used To Treat Depression
- Psychotherapy: Psychotherapy involves talking to a therapist and receiving counseling individually or in a group. Psychotherapy can help patients cope with negative feelings and improve quality of life.
- Light therapy: Light therapy can help those with seasonal affective disorder. For example, doses of white light exposure have been shown to improve mood and reduce symptoms of depression.
- Alternative therapies: Alternative therapies, such as acupuncture, meditation, and herbal therapies, may help with depression, although this type of treatment should only be started after medical consultation
How To Find A Cbt Therapist
If youre looking for a therapist, ask your primary care provider or a trusted loved one for a list of recommendations. You can also search through an online therapist directory to find a licensed CBT provider in your state. Many therapists now offer video-based therapy which has enabled many people to get CBT online.
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Health Intervention Under Review
Three common types of psychotherapy for the treatment of major depressive disorder and generalized anxiety disorder are cognitive behavioural therapy , interpersonal therapy, and supportive therapy.
The Royal Australian and New Zealand College of Psychiatrists defines structured psychotherapy as the treatment of mental or emotional illness by using defined psychological techniques, pre-planned with clear goals and employed within a specific timeframe. According to the College, patients must be seen by their treatment provider, either individually or in a small group, on at least a monthly basis. CBT and interpersonal therapy are considered structured psychotherapies, but supportive therapy is not.
Cognitive behavioural therapy focuses on helping patients become aware of how certain negative automatic thoughts, attitudes, expectations, and beliefs contribute to feelings of sadness and anxiety. Patients learn how these thinking patterns, which may have developed in the past to deal with difficult or painful experiences, can be identified and changed to reduce unhappiness.
Interpersonal therapy focuses on identifying and resolving problems in establishing and maintaining satisfying relationships. Such problems may include dealing with loss, life changes, conflicts, and increasing ease in social situations.
How Is Progress Evaluated In Therapy
While unstructured interactions with patients under their care can provide a window into patient functioning, therapists providing good care make regular assessments of a patients clinical status using criteria that have been validated in many studies. To know whether and how much depression is improving, they regularly monitor treatment progress by measuring the severity of multiple symptoms of depression on standardized scales. The most widely used assessment instrument is the Hamilton Rating Scale for Depression, or Ham-D, which gauges progress in 21 constellations of symptoms, from level of sadness to degree of guilty feelings to lack of energy to sleep problems. Severity is rated for each cluster of symptoms. Comparison of results over several sessions provides an accurate picture of treatment effectiveness and indicates areas where more intensive work may be needed.
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When Should I Contact My Healthcare Provider
Contact your healthcare provider immediately if you experience thoughts about suicide, hurting yourself, or hurting others. Remember, you should always follow your healthcare providers instructions. Never stop taking your medications or start an alternative therapy without approval and supervision.
What Types Of Psychotherapy Are Helpful For Anxiety And Depression
More info on this topic
Just as no two people are affected the exact same way by depression and anxiety, there is no one size fits all treatment. What works for one person might not work for another.
The best way to treat depression or anxiety is to become as informed as possible about the treatment options, and then tailor them to meet your needs. In many cases, it is helpful to work with a professional to determine the best fit.
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Nature Of Cognitive Therapy
Cognitive therapy is a treatment process that helps patients correct false self-beliefs that lead to certain moods and behaviors. The fundamental principle behind cognitive therapy is that a thought precedes a mood, and that both are interrelated with a persons environment, physical reaction, and subsequent behavior.6 Therefore, changing a thought that arises in a given situation will change mood, behavior, and physical reaction. Although it is unclear who benefits most from cognitive therapy, motivated patients who have an internal locus of control and the capacity for introspection likely would benefit most.
During cognitive therapy, the therapist helps the patient work through several steps. First, the patient accepts that some of his or her perceptions and interpretations of reality may be false and that these interpretations lead to negative thoughts.5 Next, the patient learns to recognize the negative thoughts and discovers alternative thoughts that reflect reality more closely.5 The patient then decides internally whether the evidence supports the negative thought or the alternative thought. Ideally, the patient will recognize distorted thinking and reframe the situation.6 As cognitive therapy progresses, it focuses more on reframing deeply held or core beliefs about self and the world.
What To Expect During Cbt Treatment
While the rigor and homework of CBT therapy may sound daunting, this is not necessarily the case. CBT treatment was intended to be short-term to allow people to thrive with the help of their therapist, but then on their own. CBT treatment generally lasts between 8 to 12 sessions, depending on the persons history, and a number of studies from the Beck Institute indicate that most people may see improvement in 8 to 10 sessions.18
Each CBT session will generally last about 50 to 55 minutes, akin to other therapy types, and happen once a week. The format of each session is usually quite structured.
Each CBT session consists of:18
While this may not always be the case in a CBT treatment plan, this is the expectation for treatment. Your therapist may take some different approaches, but CBT treatment tends to be short-term and active in attempting to reduce the impact of your mental health symptoms on your life.
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Cbt For Major Depressive Disorder
Jody, a 35 year old female, has recently started to feel tired all the time. This began about two and a half weeks ago.
Along with sleeping all the time, she reports these other symptoms that all started around the same time:
- Experiencing negative thoughts
- Constantly worrying about different aspects of her life
- Finding it difficult to stay still
- Does not have an appetite
- Has generally been feeling sad, hopeless, irritable , and numb
She reports that she had other times of feeling this way in her teens and mid-20s she also experienced brief suicidal thoughts in her 20s.
Jody began meeting with her therapist last week and the therapist diagnosed major depressive disorder after they finished their assessment. During sessions, her therapist began asking her to challenge her thoughts and restructure her thought process. She also recommended journaling every day. Part of the journaling homework includes documenting something that she chose to do to make her feel happy or productive daily, a CBT technique called behavioral activation.
When Jody started reporting an increase in her worry and rumination, the therapist encouraged her to add meditation to her daily work, to help reduce the incessant worrying and increase calm in Jodys mind.2,5
Clinical Need And Target Population
The lifetime prevalence of major depressive disorder in Canada is 10.8% annual and 1-month prevalence estimates are 4.0% and 1.3%, respectively. Depression affects occupational functioning both through absenteeism and through loss of productivity while attending work when unwell. While occupational impairment receives much attention, depression also negatively affect people’s ability to perform personal activities, such as parenting and housekeeping. A study in the United States found that people with major depressive disorder were able to perform better at work than in their personal activities.
Treatment for acute major depressive disorder often consists of pharmacological interventions and psychological interventions . The prescribing of antidepressant medications has increased over the last 20 years, mainly owing to the development of a new type of antidepressant medication called selective serotonin reuptake inhibitors, as well as other newer agents. While antidepressants continue to be the mainstay of treatment for major depressive disorder, adherence rates remain low in part because of patients’ concerns about side effects and possible dependency. In addition, surveys have demonstrated patients’ preference for psychological interventions over treatment with antidepressants. Therefore, psychological therapies can provide an alternative or additional intervention for major depressive disorder.
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Eye Movement Desensitisation And Reprocessing
EMDR is another talking therapy that’s been developed to help people who have post-traumatic stress disorder .
People who have PTSD may experience intrusive thoughts, memories, nightmares or flashbacks of traumatic events in their past.
EMDR helps the brain reprocess memories of the traumatic event so you can let go of them.
EMDR can be a distressing process, so it’s important to have a good support network of family and friends around you if you plan to try it.
A course of treatment is likely to be 8 to 12 sessions.
What Alternative Therapies Are Recommended For Depression
No alternative therapy is guaranteed to cure depression, but the same can be said about several Western medicines and psychotherapies. To be safe, be sure to consult with your healthcare provider before you try one or more of these recommended therapies:
- Herbal remedies: Herbal remedies are made from plants. Of the wide variety of available herbal therapies, St. John’s wort and ginkgo biloba are the products most often used for treating depression.
- Acupuncture: Acupuncture is an ancient Chinese method of healing that prevents and cures specific diseases and conditions.
- Reflexology: For this treatment, the reflexologist applies pressure to different pressure points on your feet, hands, ears and face.
- Exercise: In general, exercise is a safe and easy way to improve your well-being.
- Meditation: Meditation is a form of relaxation and introspection.
- Massage: Massage uses touch to promote relaxation while decreasing tension and stress.
- Guided imagery: Guided imagery is a form of focused relaxation that helps create harmony between the mind and body.
- Yoga: Yoga is a type of exercise and spiritual practice.
- Deep breathing: Taking slow, deep breaths in, then slowly exhaling, while your mind focuses on the breath.
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Why Is Therapy Important For Treating Depression
From one perspective, depression can be seen as a state of depletion that occurs when problems overwhelm a persons resources for solution. Therapy aims directly at the development of new solution patterns. It is at least as effective as medication during the period of treatment but its effects last longer and it is effective in preventing recurrence of depression. The coping techniques, problem-solving skills, and understanding of ones own vulnerabilities gained during therapy are useful over the course of a lifetime.
Using Mbct To Treat Depression In Adults
MBCT is typically conducted in a small-group format that meets once a week for two hours for eight weeks. The first two sessions consist of educating the group on the theory of mindfulness and how ruminating on stressful situations contributes to the development of depression. Exercises that teach people how to attend to and be in the moment include body scanning, mindful eating, breathing and sitting practice. Cognitive exercises such as affect labeling are integrated with the mindfulness exercises.
In sessions three and four, group members are taught to remain in the present moment through the practice of sitting and, at the same time, to identify alternative ways of responding to a stressful situation. Group members continue in sessions five and six with the practice of mindful breathing as well as learning that thoughts are not facts and that people have choices in how to respond to a situation.
Homework is assigned after each session and consists of practicing various mindfulness meditation exercises as well as completing brief worksheets on how to accept and acknowledge negative emotions. The group typically participates in a retreat or day-long session that goes over all of the mindfulness and cognitive skills they acquired throughout the course of treatment.
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