Different Approaches to Treat Depression

Depression, or Major Depressive Disorder is a common and serious medical illness that negatively affects how you feel, the way you perceive things and how you behave in your environment. However, it is also treatable with different approaches to treat depression being continually investigated. Depression causes feelings of worthlessness and/or a loss of interest in activities once enjoyed. It can be due to many factors like childhood abuse, traumatic experiences, substance abuse etc. and it can hinder the emotional and behavioural functioning of an individual in their daily life.

Depression is not the same as bereavement or grief for death of a loved one. When you grieve for someone’s death, you are sad for a shorter time period and you move on with positive changes by yourself. Whereas Major Depressive Disorder lasts for a longer period, and at least two weeks for a diagnosis, with frequent symptoms as follows:

• A loss of interest or pleasure in daily chores
• Feelings of guilt or shame
• A loss of appetite or overeating
• Insomnia or hypersomnia; disrupted sleep
• Feelings of worthlessness
• A lack of thinking, concentrating or making decisions

Depression can be treated with a variety of intervention techniques; however, the severity and individual differences in patients with depression indicates which approach to take to treat them. Treatment approaches are broadly classified into three types:

• Drug therapy/ Pharmacotherapy: Depression is found to be treated by a range of medications as they attack the inhibition of certain hormones such as dopamine and serotonin. Antidepressants are basically a set of drugs which are inhibitors of serotonin, and they balance the levels of serotonin and dopamine. Selective serotonin reuptake inhibitors (SSRIs) and Serotonin-norepiknephrine reuptake inhibitors (SNRIs) are the most widely used drugs for the treatment of depression. (Galecki, 2018). In the latest psychopathology reports, SNRIs such as Levomilnacipran and SMSs like Vilazodone have been approved to be used for effective intervention in major depressive disorders as well as in PTSD. (Smith, 2018). In recent studies, Eketamine and Breaxanolone were found to be effective medications for Postpartum Depression Disorder.

• Brain Stimulation: Non-surgical brain stimulation treatment has been effective for Major Depressive Disorder and Bipolar Depression Disorder. Techniques like Electroconvulsive Therapy (ECT), Repetitive Trans Cranial Magnetic Stimulation (rTMS) and Magnetic Seizure Therapy are the most effective, as they direct the magnetic fields into the depolarization of neurons in the specific parts of the brain. Deep Brain Stimulation (DBS) and Vagus Nerve Stimulation (VNS) are more complicated, yet effective strategies for major depressive and PTSD patients with severe conditions, and before using ECT. It does not only uses a singular method but modulate the plasticity and the oscillations of the brain waves in question.   (Mutz, 2019)

• Psychotherapy: Therapies like Dialectical Behavioural Therapy and Schema Therapy are used to treat depression with comorbidities such as Borderline Personality Disorder or Mixed Anxiety. Dialectical Behavioural Therapy is a form of Cognitive Behavioural Therapy which attempts to identify what negative thoughts are coming into the mind of the patient. It is mostly commonly used for severe cases of depression with suicidal ideation or life threatening thoughts. Schema Therapy is a form of Psychotherapy with the combined theories from Object Relations theory, Cognitive Behaviour theory and Gestalt theory. It is used to treat chronic disorders and personality disorders.

• E-health Interventions – In these critical circumstances, patients with severe mental illnesses suffer more than the other patients. So online psychotherapy such as eCBT portrays as a saviour for all those who have experienced a lot during the pandemic. Cognitive Behavioural Therapy is based on changing the negative or intrusive thoughts and cognitions and enable the patient to move forward to positive changes in life. Now you must be thinking about the efficacy of this new emerging treatment approach, but be assured, eCBT is just as effective as face-to-face CBT. Factors such as waiting lists, perceived negative control and negative functionalities due to the personal visits to their therapy was reduced in the eCBT process. (Lisanne Warmerdam, 2010)

All these approaches are currently being used for different patients, ranging from mild depressive disorders to severe depression. It has shown that the combination of two or more therapies gives a better response to treatment compared to a singular intervention technique. It is more conducive to assess the patient thoroughly to ensure the most appropriate treatment plan is devised for them.

Orchestrate Health offers bespoke mental health services that people can access from the comfort of their own home or within their community, with rapid response times and even daily visits if needed. Orchestrate Health can provide help for those struggling with depression, and remove the inconvenience of travelling to and from appointments.

References

1. Galecki, P. a.-W. (2018). The anti-inflammatory mechanism of antidepressants-SSRIs, SNRIs. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 291-294. https://doi.org/10.1016/j.pnpbp.2017.03.016
2. Lisanne Warmerdam, A. v. (2010). Online_cognitive_behaviour_therapy. Journal of Behvaiour Therapy and Experimental Psychiatry, 64-70. Retrieved from https://d1wqtxts1xzle7.cloudfront.net/40058372/Online_cognitive_behavioral_therapy_and_20151116-7257-zxys6p.pdf?1447670930=&response-content-disposition=inline%3B+filename%3DOnline_cognitive_behavioral_therapy_and.pdf&Expires=1591793576&Signature=BVlkPdTz
3. Mutz, J. a. (2019). Comparative efficacy and acceptability of non-surgical brain stimulation for the acute treatment of major depressive episodes in adults: systematic review and network meta-analysis. Bmj, 1079. : https://doi.org/10.1136/bmj.l1079
4. Smith, B. a. (2018). Effective Medications for Treating Internalizing Disorders. Springer, 69-82. https://link.springer.com/chapter/10.1007/978-3-030-15541-4_5