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Depression: Major Depression & Unipolar Varieties
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Related Topics

Anxiety Disorders
Bipolar Disorder
Suicide
Addictions: Alcohol and Substance Abuse
Pain Management

Modes of Treatment

Rashmi Nemade, Ph.D., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D.

We've been discussing the complex and muti-factorial causes of depression. At this point, you might be worried that depression is too complicated to respond to treatment. On the contrary, there are many different treatment options available to someone who is depressed. We can confidently say that depression is a HIGHLY treatable condition. However, because depression is so individual in presentation, it is important that you work with your doctor to find the treatment (or combination of treatments) that is right for you.

It might seem like finding an optimal treatment for depression should be a relatively straightforward process. Unfortunately, this is often not the case. Patients sometimes endure a long trial and error process before finally receiving the treatment (or combination of treatments) that works best for them. Finding the best treatment for your depression may try your patience; experimenting with different treatment options requires open-mindedness and flexibility. In the long run, the benefits of being free from emotional and physical pain, and developing stable social and work relationships will outweigh the inconvenience and frustration of finding the right treatment.

Depression is most often treated with a combination of medication and psychotherapy. Antidepressants help with some of the brain chemistry causes of depression, while psychotherapy helps people understand and then change the problematic behavioral, cognitive and social interaction patterns that also cause or contribute to their depressed mood.

Treatment choice depends on symptom severity and presentation. In other words, more severe cases of depression may require different and more frequent therapy than do milder cases of depression. Many depressed patients can be treated on an outpatient basis. The term "outpatient" contrasts with "inpatient" which is the term used to describe a patient who requires hospitalization. An outpatient, therefore, is a patient who does not require hospitalization, and can be treated through a clinic or other less intensive setting. Outpatient therapy may involve medication and/or psychotherapy. When psychotherapy is prescribed, patients typically meet with a therapist on an individual basis (or in the case of group therapy, with a leader and a group of individuals) approximately once per week.

People with severe depression who may be engaging in self-destructive behavior (e.g., suicide, refusing to eat, refusing to get out of bed) or may be showing signs of psychotic behavior (e.g., hallucinations and delusions), may require inpatient hospitalization. Inpatient treatment allows clinicians to continuously monitor people in order to make certain that treatments are working and to insure that they remain safe until depressive symptoms have lessened. Inpatient hospitalization for depression may also be indicated when patients require medication adjustments and must be taken off one medication in preparation for another, or when non-medication interventions such as electroconvulsive therapy are prescribed (although it should be noted that many times electroconvulsive therapy is safely administered on an outpatient basis).