Current Depression Treatment Options

Psychotherapy

• Also referred to as “talk therapy.”
• Based on a unique relationship between a therapist and patient.
• Therapist can be a psychiatrist, psychologist, social worker, or counselor.
• Many people benefit from the support they receive through short-term psychotherapy. At the same time, many people do psychotherapy over a long period of time, possibly several years.
• The changes you see are likely to be subtle.

Goals of Psychotherapy

• Target specific problems
• Eliminate or manage symptoms
• Stimulate overall growth and healing

Different approaches to psychotherapy

Much psychotherapy is not limited to a particular type or technique. Many therapists are trained in several different approaches. They then combine techniques from these various approaches to fit their own style and personality and the needs of the patient.
Medication may be used with psychotherapy. For many people, this is the best approach to treatment. People with moderate-to-severe depression typically do best with a combination of antidepressants and some form of psychotherapy.

The following are the common types of psychotherapy used:

Group therapy
In group therapy, a small group of people meets regularly to discuss individual issues and help each other with problems with the guidance of a trained therapist.

Behavior therapy
Behavior therapy sets up rewards and punishments to change thinking patterns and shape behavior. Behavioral therapy can involve relaxation training, stress management, biofeedback, and desensitization of phobias. Behavioral therapists help patients learn how to get more satisfaction and rewards through their own actions and how to unlearn the behavioral patterns that contribute to, or result from, their problems.

Cognitive therapy
Cognitive therapy seeks to identify and correct thinking patterns that can lead to troublesome feelings and behaviors. Beliefs and expectations are explored to identify how they shape a person's experiences. If a thought or belief is too rigid and causes problems, the therapist helps the client to modify his or her belief so that it is less extreme.

Cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT) helps a person to recognize his or her own negative thought patterns and behaviors and to replace them with positive ones. Used both with and without medication, cognitive-behavioral therapy is the most popular and commonly used therapy for the treatment of depression. A major aim of CBT is to reduce anxiety and depression by eliminating beliefs or behaviors that help to maintain problematic emotions. CBT generally lasts about 12 weeks and may be conducted individually or in a group.

Antidepressant Medicines

There are a number of antidepressant medications available to treat depression. Pharmacology has improved over the past 10 years. More effective medications are now available, often with less severe side effects. It is believed that most of them are equally effective for elderly adults.

Things to consider with regard to antidepressant medications:

• Side effects or interactions with other medicines must be carefully considered and monitored. This is particularly important with older adults, since they tend to be more sensitive to medication side effects and tend to take more medications than younger people.
• Antidepressants may take longer to start working with an elderly person than with a younger person.
• Lower doses are prescribed because as we grow older our body changes also affect the way in which we breakdown medication.
• Some older adults may forget or not want to take their medication.

Common side effects of antidepressants:

• Drowsiness, lethargy, sedation
• Cognitive impairments
• Constipation
• Blurred vision
• Dry mouth
• Urinary retention

If your loved one takes antidepressant medications, it is essential that his/her primary care physician knows all medications he/she is taking. This is especially important if multiple doctors are prescribing medications for various conditions. Different drugs can interact in unanticipated ways.

Electroconvulsive Therapy (ECT)

• ECT is a safe procedure that has been much refined over the years.
• It is an important treatment option for depression in older adults. It is used only to treat severe, debilitating mental disorders and not to control behavior.
• ECT is generally used with severely depressed patients for whom psychotherapy and medication are proving ineffective.

There are several other non-medical interventions that may help alleviate depression

• Having a pet for company
• Proper nutrition
• Exercise
• Social contact