Depressive Disorders - Treatment

Depressive disorders are treated by one or more of three methods: drugs, psychosocial therapy, or electroconvulsive (pronounced ih-LEK-tro cun-VUL-siv) therapy (ECT). Many drugs seem to work because of changes they produce in the way neurotransmitters work in the brain. Psychosocial therapy consists of interviews between the patient and a trained specialist to find out the causes of a person's depression. ECT makes use of severe electrical shocks to treat a person's depression.

Antidepressants

One group of drugs used to treat depression is called selective serotonin re-uptake inhibitors (SSRIs). These drugs increase the amount of serotonin (pronounced sehr-uh-TOE-nun) in the brain. Serotonin is a major neuro-transmitter. Some side effects of SSRIs include anxiety, diarrhea, drowsiness, headache, sweating, nausea, poor sexual functioning, and insomnia (see insomnia entry).

Another group of drug is the tricyclic antidepressants (TCAs). They are less expensive than SSRIs, but they have more side effects. These side effects include dry mouth, dizziness, and heart problems. Because of these effects, TCAs are often not recommended for elderly patients. They are also not recommended for suicidal patients since, if they are taken in large quantities, they cause death.

Monoamine oxidase inhibitors (MAO inhibitors) also act on chemicals present in the brain to relieve the symptoms of depression. One risk in using MAO inhibitors is that they react with certain foods, such as aged cheese and meats, to produce dangerous side effects.

Psychosocial Therapy

The purpose of psychosocial therapy is to discover possible causes for a person's depression. A therapist helps the patient to understand himself or herself better. This self-understanding may help the patient overcome the problems that led to depression.

One form of psychosocial therapy is called cognitive-behavioral therapy. The therapist helps the patient to recognize thought patterns (such as thinking about suicide) that lead to depression. The patient is then trained to change those negative thought patterns to positive patterns. If successful, this therapy can help relieve the symptoms of depression.

Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is usually a treatment of last resort. It is tried when neither drugs nor psychosocial therapy have been very helpful with a patient. In rare cases, it is used if a patient refuses to take oral medication (drugs taken by mouth) or the patient is suicidal or out of touch with reality.

ECT consists of a series of electrical shocks administered to a patient's brain. The patient is first put to sleep with a general anesthetic and is given muscle relaxants. The muscle relaxants prevent violent responses to the electric shock that can result in broken bones. ECT is accompanied by a number of side effects, such as headache, muscle soreness, nausea, confusion, and memory loss.

No one knows how ECT works or what effects it has on the brain. In fact, some experts believe that the treatment is too dangerous to use with patients. Under the best circumstances, they say, it should be tried only in the most serious cases that do not respond to any other form of treatment.

Alternative Treatment

The herb known as St. John's wort is used throughout Europe to treat depression. Unlike prescription drugs, it has few side effects. Thus far, there is no scientific evidence about the effectiveness of this herb for the treatment of depression.

Some simple methods for increasing one's mental health include a healthy diet, proper sleep, exercise, and participation in many interesting daily activities.