Guidelines For Treating Depression There are several different guidelines for treating depression published by the APA, CANMAT, BAP, NICE, and Texas Medication Algorithm Project. They suggest exercise, psychotherapy and antidepressant medication. The guidelines generally recommend the use of CBT or an SGA prior to beginning treatment and titrate up dosages according to the need. Patients who do not respond to monotherapy could benefit from augmentation with lithium, psychostimulants or SSRIs. 1. Diagnosis The first step in treatment of depression is getting a diagnosis. This is done through a discussion with your physician or mental health professional, and certain types of psychotherapy (talk therapy). Your GP will ask you about your symptoms and how they've affected your life in the last month. They'll also ask whether you've ever been a victim of thoughts of suicide or self-harm. Your GP will also take a look at your general health, family history and lifestyle to help decide whether you have depression or another mental health condition. It is important to be honest and open with your doctor so that they can get a true picture of how you're feeling. This will make it easier for them to identify the signs of depression. These symptoms can be used to rule out other diseases such as cancer or heart disease. Once your GP has determined that you might be suffering from depression, they'll rule out other conditions through tests. For instance blood tests can look for thyroid issues or anemia which could be the cause of your depression. They can also test your blood for vitamin deficiencies, or even alcohol and drugs, which can also mimic depression. If your GP has diagnosed depression the doctor will explain the causes and best treatment options. This might include psychotherapy or the combination of therapies and medication. The most effective medications for depression are antidepressants which alter the balance of chemicals in the brain. They can be taken either in the form of injections or orally and it can take a few weeks for them to start working. The drugs may also cause negative side effects like constipation and dry mouth. 2. Medication Many people can benefit from medication. Initially, your doctor may prescribe one or more antidepressants. If the initial treatment does not provide a satisfactory outcome, your doctor may recommend you try a different medication or to alter the dosage or time that you take it. It is crucial to take your medication on a regular basis to get the most benefit. Do not stop taking your medication without a doctor's consent. Based on your symptoms, a general antidepressant may be prescribed or an SSRI. An SSRI boosts the levels of serotonin, a chemical in the brain. Examples of SSRIs include citalopram (Celexa) as well as the escitalopram (Lexapro) and fluoxetine (Prozac). Your doctor might also prescribe a serotonin-norepinephrine reuptake inhibitor, or SNRI. SNRIs include duloxetine, (Cymbalta), and venlafaxine, (Effexor XR or Khedezla). If your doctor believes tetracyclics are more efficient than SSRIs or SNRIs, they may prescribe them. SSRIs and SNRIs are typically considered safe for use in children and adolescents. You should let your doctor know if you have any allergies or other health problems before starting medications. Some medications can result in side effects like an dry mouth or stomach that is upset. These side effects are typically mild and will go away by themselves in about a week. If you're taking medication do not drive or operate machinery until you feel relaxed and clearheaded. Certain depression-related symptoms, such as restlessness or difficulty sleeping, can be aggravated by alcohol or other recreational drugs. These substances should not be used because they can make depression more difficult to treat. If you continue to use them, particularly for a prolonged period of time, can also lead to more serious problems. 3. Psychotherapy Psychotherapy (also known as talk therapy) can assist you in dealing with issues that contribute to your depression. This type of treatment is long-term but has been shown to be effective in treating depression. Psychotherapy can be done in a variety of settings, including private clinics for therapists and hospitals, psychiatric clinics, and rehabilitation facilities. It is usually one-on-one, but it is also possible to do group therapy. Your therapy therapist will discuss your thoughts, feelings, behaviors, and relationships with you in a private and secure setting. During the first few sessions your therapist will begin to know you and will suggest a treatment program. This may include psychotherapy, medication, activity and exercises or other treatments like repetitive transcranial magnetic stimulation (rTMS) or electroconvulsive therapy (ECT). Some of these are short-term and are focused on specific issues. Interpersonal therapy (IPT), for example, helps people understand underlying issues such as unresolved grievance or conflicts with other people. Depression can be caused by a variety of reasons including loss and stress to unresolved traumas and abuse. They may require a longer-term therapy and other treatments. Cognitive behavioral therapy (CBT), also known as cognitive restructuring, assists people change their thinking patterns that trigger symptoms. It also helps improve the ability to cope and help them deal with the stresses and conflicts of life. Dialectical behavior therapy (DBT) incorporates elements of CBT with mindfulness techniques which allow you to be aware and accept your emotions. Sometimes, psychological treatment can help with acute, moderate or severe depression as effectively as antidepressants can. However, it takes longer to work and not everyone responds to it in the same way. It is important to attend your therapy sessions as well as to do your homework between sessions (like journaling or meditation). 4. Counseling It's important to find a treatment that works, whether your depression symptoms are not severe. This can include psychological therapy or counseling. Having an outside expert help with your feelings can have a profound impact on your life. It may be necessary to try various therapists before finding one that you like However, the effort is worth it. There are several types of psychotherapy. However the majority of them involve talking about your issues and finding strategies to combat depression. You may also find it helpful to talk about your experiences with other people who are going through similar struggles. Group counseling is offered at medical clinics, hospitals, therapists' offices, and even over the phone using online telehealth services. Counseling for depression aims to reduce negative thoughts and behaviors that contribute to the condition. For example, a therapist may coach you on ways to manage stress to improve your mood. You can be taught to recognize irrational thinking and challenge the preconceived notions that make you feel depressed. It is possible to use EMDR to let go of painful or traumatic experiences that could be contributing to depression. Other therapies such as cognitive behavioral therapy or behavioural activation can be used to help you recognize your patterns of behavior and make changes. For instance, behavioural therapy could be beneficial if depression causes you to avoid social activities. The aim is to encourage you to participate in more social activities and to identify how your actions influence your mood. In general, these strategies are employed in conjunction with medications. You can locate a certified counselor in your region by asking your physician to refer you, or by calling a community mental health center. 5. Exercise Exercise is a well-established method to reduce and treat depression. It's not a standard treatment. https://www.iampsychiatry.com/depression-treatment and medication are more frequently used. However, a growing body of research suggests that exercising can be as effective at treating depression as talking therapies and antidepressants, and perhaps even better. A meta-analysis of over 150 studies showed that it was more effective than psychotherapy or drugs by themselves. The research revealed that, on average those with depression who exercised improved their symptoms by five points using one measure and 6.5 points using another that is clinically significant. The results were the same whether they exercised in a few minutes or for an hour per day. Exercise is an excellent alternative to psychotherapy or medications, which are not suitable for all. Exercise can help keep our bodies fit and aid in preventing other mental health issues such as anxiety. Exercise is not stigmatized like drugs or talking therapy. Exercise is accessible to all and is cost-effective and can be a empowering approach. But it's still a challenge to study exercise as a medicine, because it can be difficult to determine the impact of things like how much people typically exercise and the other medications they are taking. More research is needed to determine the most effective type, frequency, and duration of exercise for treating and combating depression. To aid patients suffering from depression, doctors are prescribing more exercise as part of their treatment plans. This is known as a "green prescription' and it involves writing a fitness program in accordance with the needs of the patient and encouraging them to be active by maintaining regular face-to-face or telephone contact with a trained fitness professional like an exercise physiotherapist or physical educator.