Treatment of Depression

Drug Treatments

A lot of work has gone into the development of drugs to combat mood disorders. Roughly speaking, each drug falls into one of two categories. The first category contains drugs that level out or stabilize mood swings. The most well known example is lithium, which is available in various forms for prescription. It is often extremely effective at preventing the huge highs and lows associated with bipolar affective disorder. However, there are serious possible side effects, including dry skin, diarrhea, thirst, memory loss and many more. Furthermore, lithium has a narrow therapeutic range. Not enough, and it’s not effective; too much, and it can be toxic. Blood levels of the medication need to be closely monitored.

The second category contains drugs that lift or improve the mood of the sufferer. Many practitioners will now recommend serotonin reuptake inhibitor drugs over the older-style tricyclic antidepressants and monoamine oxidase inhibitors. While the older drugs tend to be cheaper, serotonin reuptake inhibitors normally have fewer and less serious side effects.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy has a very high level of effectiveness in the treatment of people with depression. In this context, cognitive-behavioral therapy aims to change the mental processes that lead to a depressive episode (the cognitive part) as well as improve the negative behavior that goes with depression (the behavioral part).

While effective, cognitive-behavioral therapy requires the participant to be relatively stable, and able to make rational decisions. Therefore, it may be necessary for a sufferer to begin taking appropriate medication before therapy begins. For example, lithium may be prescribed to a manic-depressive to help level out their moods, or Prozac may be prescribed to help lift a deep depression.

Rational Emotional Theory

The ‘cognitive’ part of any cognitive-behavioral therapy (which aims to change unhealthy thought patterns) will often be backed up by a theoretical framework. Many practitioners refer to Albert Ellis’ rational emotional theory.

This theory postulates that when we experience an event, it is filtered through a framework of beliefs that show us how to respond. According to the theory, some sufferers of depression have a faulty set of expectations about life. For example, they may feel that they should constantly strive to do well in life or risk being a ‘bad person’. They might believe that others should treat them better. They may feel that life should be better arranged to suit them, instead of getting in their way.

These views lead to what Ellis calls “the tyranny of ‘should’”. The world cannot and will not be exactly as the sufferer would prefer. Some depressive individuals need to stop setting such high standards for themselves, feeling bad about others’ treatment of them, or expecting life to be easy. Therapy, in this case, will aim to challenge the faulty beliefs which lead to dashed expectations, anxiety, and finally depression.

Electro-Convulsive Therapy

The idea of electro-convulsive therapy sounds terrifying to many people. The treatment involves running an electric current through the brain of the sufferer, and is certainly seen as a last resort. Possible side effects include slight, temporary memory loss and trouble with complex thinking for a few days. The participant is given a muscle relaxant and a general anesthetic, and so in fact feels nothing during the procedure. When the treatment is helpful (it does not work for every sufferer), it is extremely effective. For example, it has been used to ‘rescue’ chronically depressed individuals from notions of suicide. However, we still do not fully understand why the treatment works.