Guidelines For Treating Depression The APA, CANMAT BAP NICE and Texas Medication Algorithm Project have published several guidelines for treating depression. In general, they recommend psychotherapy, exercise, and antidepressant medication. The guidelines suggest that patients who do not respond to monotherapy, use CBT or SGA prior to beginning treatment and increase dosages as necessary. Augmentation with lithium, psychostimulants, SSRIs and SNRIs, as well as TMAPs may be helpful in patients who do not respond to monotherapy. 1. Diagnosis The first step in the treatment of depression is getting the diagnosis. This involves a discussion with your doctor or mental health professional, and certain kinds of psychotherapy (talk therapy). Your GP will inquire about your symptoms and how they've affected your life in the last month. They'll also inquire whether you've ever had thoughts of self-harm or suicide. https://www.iampsychiatry.com/depression-treatment might also look at your general health, family background and lifestyle when determining whether you have depression. You should be honest and open with your doctor so that they get a complete picture of how you're feeling. This will make it easier for them to spot the symptoms of depression. They can then analyze these symptoms to rule out other illnesses like heart disease or cancer, which may cause similar symptoms. Once your GP has decided that you might be suffering from depression, they'll rule out other ailments with tests. For instance blood tests can test for thyroid issues or anemia which could be the cause of your depression. They can also test your blood to look for vitamin deficiencies or alcohol or substances that mimic depression. If your GP diagnoses depression the doctor will explain the causes and the best treatment options. This could involve psychotherapy or an array of therapies and medication. The most effective drugs for depression are antidepressants which work by altering the balance of chemicals within the brain. They can be taken orally or via injections and it can take a few weeks for them to start working. They may also cause side effects such as constipation and dry mouth. 2. Medication Medications can help many people who suffer from depression. Your doctor may initially prescribe one or more antidepressants. If initial treatment doesn't produce an effective response Your doctor may suggest that you try another medication or alter the dosage or time of day you take it. To get the most benefits of your medication, it's essential to take it regularly. You should not stop taking your medication unless instructed to do so by your doctor. Depending on the symptoms you are experiencing the general antidepressant might be prescribed or an SSRI. An SSRI boosts the levels of serotonin, which is a chemical found in the brain. SSRIs include escitalopram, citalopram, and fluoxetine. Your doctor might also prescribe a serotonin-norepinephrine reuptake inhibitor, or SNRI. SNRIs include duloxetine, (Cymbalta), and venlafaxine, (Effexor XR or Khedezla). Other antidepressants, including tetracyclics, may be prescribed if your doctor believes that these medications will be more efficient than an SSRI or an SNRI. SSRIs and SNRIs are usually considered safe for use by children and adolescents. Before taking any medication, inform your doctor if there are any health issues or allergies. Some medications can cause side effects like stomach upset or dry mouth. In general, they are minor and go away on their own within one or two weeks. If you're taking medication do not drive or operate machinery until you feel relaxed and clearheaded. Other recreational drugs and alcohol can exacerbate depression symptoms like insomnia or restlessness. These substances should be avoided as they can make depression harder to manage. If you continue to use them, especially for an extended period of time, can also result in more serious problems. 3. Psychotherapy Psychotherapy, also referred to as talk therapy, can aid you to deal with issues that are contributing to your depression. This type of treatment may be long-term, but it has been proven to be effective for many people with depression. Psychotherapy can be found in many different settings such as private therapy offices and hospitals, psychiatric clinics, and rehabilitation facilities. It is typically conducted one-on-one but group therapy is also a possibility. Your therapist will ask questions about your thoughts, feelings, and relationships, and discuss them with you in a secure and confidential setting. During the initial sessions your therapist will get to know you better and recommends a treatment program. This can include psychotherapy, medication, activity and exercises or other treatments like repetitive transcranial magnet stimulation (rTMS), or electroconvulsive therapy (ECT). Some are short-term and they concentrate on specific issues. For example, interpersonal therapy (IPT) helps people to understand the root causes of problems, such as conflicts over unresolved grief or conflicts with significant others. Depression can manifest in various ways, ranging from stress to loss and unresolved traumas. These may require longer-term therapy and other treatments. Cognitive behavioral therapy (CBT) is also referred to as cognitive restructuring, aids people to alter their thinking patterns that cause symptoms. It also enhances resilience and helps people deal with the stresses and challenges of daily life. Dialectical Behavior Therapy (DBT) blends CBT elements with mindfulness techniques to help you accept and observe your emotions. Psychotherapy can often ease acute moderate to severe depression just as antidepressants can. However, it can take longer to effect results and not everyone responds to it in the same way. It is important to attend your therapy sessions and to complete your homework between sessions (like journaling or meditating). 4. Counseling It is crucial to find the right treatment, whether your depression symptoms are not severe. Often, that includes psychotherapy or counseling. A professional outside of your life helping with your issues can have a profound impact on your life. You may need to try several therapists before you find one that clicks with you however, the process is worth it. There are several types of psychotherapy. However the majority of them involve discussing your problems and developing strategies to manage depression. It can also be helpful to talk about your experiences with other people who are experiencing similar problems. Group counseling is available at hospitals, medical clinics and therapists' office. It can also be conducted via phone using online telehealth services. Counseling for depression aims to change negative thoughts and behaviors which cause depression. A therapist may help, for instance, instruct you on how to manage stress in order to improve your mood. You can learn to recognize irrational thinking and challenge the preconceived notions that make you feel down. You could try EMDR (eye movement desensitization and processing) to help you get rid of traumatizing or painful memories that may contribute to depression. Other therapies, such as cognitive behavioral therapy or behavioural activation therapy, can be used to assist you in identifying and make changes in your behaviour patterns. For example, behavioural therapy can be beneficial if depression makes you avoid social activities. The goal is to encourage you to take part in more social activities and to identify the way your actions impact your mood. Generally, these methods are employed in conjunction with medications. You can locate a certified counselor in your area by asking your doctor to refer you or by calling the community mental health center. 5. Exercise Exercise is a well-established method to prevent and treat depression. It's not a standard treatment. Psychotherapy and medication are more frequently used. However, a growing body research suggests that exercising can be as effective at treating depression as psychotherapy and antidepressants, and perhaps even more effective. In fact, it's more effective than either psychotherapy or drugs by itself according to a meta-analysis of more than 150 studies. The research revealed that, on average, those suffering from depression who exercised improved their symptoms by five points with one measure and 6.5 points using another that is clinically significant. The results were the same regardless of whether they exercised for just only a few minutes or an hour per day. Exercise can also be an effective alternative to medication or psychotherapy, which may not be suitable for all. Exercise can also help keep us physically fit and may aid in preventing mental health issues like anxiety. Exercise isn't stigmatized as drugs or talking therapy. Exercise is accessible to all and is cost-effective and can be a empowering method. But it's still a challenge to research the effects of exercise on a person due to the fact that it's difficult to control for factors such as how often people normally exercise and other medications they may be taking. More research is needed to determine the best kind, frequency and duration of exercise to treat and preventative treatment for depression. To help patients with depression, doctors are prescribing exercise as a part of their treatment plans. The "green prescription" is a program designed to encourage patients to get active by contacting a fitness expert regularly by phone or face-toface.