Depression is a common and serious mental health condition that affects millions of people worldwide. The World Health Organization (WHO) estimates that about 280 million people globally suffer from depression, and the prevalence of the condition has been steadily increasing in recent years (1). WHO also says that Depression is the leading reason for disability throughout the world (1).
Depression may present itself as sleeping too much or sleeping too little, large, or little appetite, moodiness, talking about suicide, withdrawing from persons, losing interest in usual activities, and low self-esteem, especially when these affect your daily life (2).
Other uncommon symptoms may include great fatigue, substance abuse, changes in cognitive functions, and pain.
Depression is a crippling illness that can significantly affect your capacity for daily functioning. Depression can significantly impact your ability to function in your daily life, including your ability to work, socialize, and care for yourself.
However, there are effective treatments available for depression, including therapy and medication. In this article, the role of therapy and medication in the treatment of depression will be explained.
Therapy for Depression
Therapy is an essential component of the treatment of depression.
Talking to a licensed psychologist about your beliefs, feelings, and actions is referred to as therapy, sometimes known as psychotherapy or talk therapy.
Several types of therapy are effective in treating your depression, including cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy.
1. Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy (CBT) is a form of therapy that focuses on changing negative thoughts and behaviors that contribute to your depression. CBT is based on the idea that negative thoughts and beliefs can lead to negative behaviors and emotions.
In CBT, the therapist works with you to identify negative thoughts and beliefs. CBT is effective in treating depression, and it is often used in combination with medication.
CBT is typically conducted over 12-16 weeks. Sessions may occur once or twice a week.
2. Interpersonal Therapy (IPT)
Interpersonal therapy (IPT) is a form of therapy against depression, that uses the improvement of communication and relationships.
IPT is based on the idea that your depression is often caused by problems in relationships, and that improving these relationships can help alleviate depression. In IPT, the therapist works with you to identify problematic relationships and develop strategies for improving them. IPT is effective in treating depression, particularly if you experience interpersonal problems.
It aids you in recognizing and resolving relationship-related problems like disagreements, losses, and transitions. IPT normally lasts for 12 to 16 weeks, with sessions taking place once or twice each week.
3. Psychodynamic Therapy
Psychodynamic therapy is a form of therapy that focuses on exploring your unconscious mind to gain insight into the underlying causes of your depression. Psychodynamic therapy is based on the idea that your depression is often caused by unresolved conflicts or traumatic experiences.
Compared to other types of therapy, psychodynamic therapy involves a longer course of treatment because sessions are frequently scheduled weekly over a lengthy period. It allows your therapist to form a close, trusting relationship with you and engage in in-depth discussion, which promotes deeper understanding and personal development. The length of the course of treatment should be decided on an individual basis.
In psychodynamic therapy, the therapist works with you to explore these conflicts and experiences and develop strategies for resolving them and coping with them.
Psychodynamic therapy is effective in treating depression, particularly if you have a history of trauma or abuse. A meta-analysis of 23 studies found that psychodynamic therapy was more effective than no treatment and as effective as CBT and medication in the treatment of depression (3).
While therapy is considered to be very good for treating depression, some disadvantages come with therapy. These include needed time dedication. You may not be available to commit to both short and long-term therapy. Another major disadvantage is that therapy can be very expensive, you may not afford it. The experts in this field of therapy may also be scarce and not easily accessible.
The Role of Medication in the Treatment of Depression
Medication is another essential component of the treatment of depression. Several types of medication are effective in treating depression, including selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).
A. Selective Serotonin Reuptake Inhibitors
Selective serotonin reuptake inhibitors (also called SSRIs) are a type of medication that is commonly used to treat depression. They function by preventing your brain’s reuptake of the neurotransmitter serotonin (4).
SSRIs serve to regulate mood and lessen depressive symptoms by increasing the amount of serotonin accessible in the brain by blocking the reuptake. SSRIs work by increasing the levels of serotonin in the brain.
Serotonin is a neurotransmitter, a chemical messenger that transmits signals between nerve cells (neurons) in your brain and nervous system. It is sometimes called the “feel-good” neurotransmitter because it is associated with feelings of happiness, well-being, and satisfaction.
SSRIs are the most commonly prescribed antidepressants in the United States and are generally considered safe and effective (5). Some commonly prescribed SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and escitalopram (Lexapro).
While SSRIs generally, can be well tolerated by you, they do have the potential to cause side effects. Nausea, diarrhea, dizziness, headaches, and sexual dysfunction, such as decreased libido and difficulty achieving orgasm, are common side effects. These side effects can be temporary and improve with time, but they can also be persistent and frustrating for you.
SSRIs can pose more serious risks such as suicide tendencies in children, adolescents, and young adults. If you are taking SSRIs, you should be monitored closely for these signs. You should also report them.
B. Serotonin-Norepinephrine Reuptake Inhibitors
Serotonin-norepinephrine reuptake inhibitors (also called SNRIs) are a type of medication that is similar to SSRIs. SNRIs work by increasing the levels of serotonin and norepinephrine in your brain.
Norepinephrine is a chemical messenger that helps regulate mood. SNRIs are medications that can treat depression by affecting norepinephrine and other neurotransmitters in the brain. They are generally effective and well-tolerated.
SNRIs can cause side effects, some of which are more common than others. These include nausea, headache, dizziness, vertigo, insomnia, sleep disturbances, elevated blood pressure, decreased appetite, sweating, sexual dysfunction, and skin rashes.
You should discuss their risks and benefits with your healthcare provider and report any side effects promptly.
C. Tricyclic Antidepressants (TCAs)
A class of drugs known as tricyclic antidepressants (TCAs) is used to treat depression as well as other mental health issues like anxiety disorders and obsessive-compulsive disorder. TCAs function by preventing serotonin and norepinephrine from being reabsorbed in your brain, hence raising the levels of these neurotransmitters.
Increased levels of these neurotransmitters can aid in reducing depressive symptoms like sadness, hopelessness, and fatigue. TCAs have been demonstrated to be useful in the treatment of depression, especially if you have not responded to conventional antidepressants.
TCAs are associated with more side effects than newer antidepressants, such as dry mouth, blurred vision, constipation, and difficulty urinating, and can be dangerous in overdose. Ensure to follow your doctor’s prescriptions.
D. Monoamine Oxidase Inhibitors (MAOIs)
MAOIs are a type of medication used to treat depression, anxiety disorders, and other mental health conditions. MAOIs work by inhibiting the enzyme monoamine oxidase, which breaks down the neurotransmitter serotonin, norepinephrine, and dopamine in the brain. This causes an increase in the levels of these neurotransmitters, which can help to reduce depression symptoms.
MAOIs are effective in treating depression, particularly in people who have not responded to other types of antidepressants. However, MAOIs are associated with significant side effects and interactions with certain foods and medications, which can limit their use. You must ensure to comply with all your doctor’s rules for the maximum function of your drugs and adhere to a strict dietary regimen and avoid certain foods and medications.
MAOIs can cause a hypertensive crisis, dizziness, drowsiness, dry mouth, constipation, and sexual dysfunction. They can also interact with other medications, leading to a life-threatening condition known as serotonin syndrome. Ensure you inform your doctor of any other medications you’re on.
MAOIs are generally not prescribed as a first-line treatment for depression but are reserved for cases where other treatments have failed or for people with specific medical conditions.
Even though medication is useful in treating depression, it has some drawbacks. The potential for side effects is one of the key restrictions. An antidepressant’s typical adverse effects include nausea, headaches, sleeplessness, and sexual dysfunction. Particularly with younger people, more severe adverse effects including suicidal thoughts or acts can manifest. Those who are taking medicine for depression need to be regularly watched, especially at the beginning of treatment.
Another limitation of medication is the risk of dependence and withdrawal. Some antidepressant medications can be addictive, and individuals may experience withdrawal symptoms if they stop taking them suddenly. It is essential to work closely with a healthcare provider when starting or stopping medication for depression.
Additionally, medication may not work for everyone. Some individuals may not respond well to medication, and it may take several weeks or months to see an improvement in symptoms. In some cases, individuals may need to try several different medications before finding one that works for them (6).
Combination Therapy
In some cases, combination therapy, which involves the use of both therapy and medication, may be more effective in treating depression than either therapy or medication alone. Combination therapy is particularly effective for individuals with severe or treatment-resistant depression. However, the use of combination therapy requires careful monitoring and management to ensure that patients receive the optimal dose of medication and therapy.
Overall, both therapy and medication have a role in the treatment of depression. Therapy can help individuals gain insight into their thoughts and behaviors and develop new coping strategies. Medication can help regulate neurotransmitters in the brain and alleviate symptoms of depression. However, both treatments have limitations, and it is essential to work closely with a mental health professional to determine the best course of treatment for each individual.
It is also important to note that therapy and medication are not the only treatments available for depression. There are several other treatments that individuals may find helpful, such as exercise, mindfulness practices, and alternative therapies like acupuncture or herbal supplements. It is essential to work with a healthcare provider to determine the best course of treatment for each individual’s unique needs and preferences.
Conclusion
In conclusion, depression is a mental health condition that affects people of all ages, genders, and backgrounds. It is a serious condition with serious consequences for an individual’s ability to function in daily life, including work, relationships, and personal well-being. The good news is that depression can be effectively treated.
Therapy is one of the most effective depression treatments. Therapy can take many forms, including cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy. CBT is a type of therapy that assists patients in identifying and changing negative thoughts and behaviors that contribute to depression. IPT focuses on improving communication and relationships with others, whereas psychodynamic therapy helps patients gain insight into the underlying causes of depression.
Medication can also be effective in treating depression. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs) can increase the levels of neurotransmitters in the brain that are associated with mood regulation.
In many cases, a combination of therapy and medication can be more effective in treating severe or treatment-resistant depression. Medications such as antidepressants can help alleviate the symptoms of depression by regulating the levels of neurotransmitters in the brain that affect mood, while therapy can help individuals develop coping skills and change negative thought patterns that contribute to their depression.
However, it is essential to note that medication and therapy should be carefully monitored and managed to ensure that patients receive the optimal dose of treatment. This is especially important in cases where patients have a history of adverse reactions to medication or have coexisting medical conditions.
Some medications used to treat depression may have potential side effects, and the effectiveness of the medication can depend on various factors such as the patient’s age, weight, and overall health. Therefore, patients should be closely monitored by their healthcare provider to ensure that the medication is working correctly and that side effects are managed appropriately.
If you or someone you know is experiencing depression symptoms, you must seek professional help. A mental health professional can assist in determining the best treatment plan for your needs. Individuals suffering from depression can significantly improve their symptoms and quality of life with the right treatment and support.
References
(1) World Health Organization. (2021). Depression. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/depression
(2) Mayo Clinic Staff. (2022, October 14). Depression (major depressive disorder) – Symptoms
and causes. Mayo Clinic https://www.mayoclinic.org/diseasesconditions/depression/symptoms-causes/syc-20356007#:~:text=Also%20called%20major%20depressive%20disorder
(3) Driessen, E., Cuijpers, P., Maat, S. de, Abbass, A. A., Jonghe, F. de, & Dekker, J. J. (2009). The efficacy of short-term psychodynamic psychotherapy for depression: a meta-analysis. In www.ncbi.nlm.nih.gov. Centre for Reviews and Dissemination (UK). https://www.ncbi.nlm.nih.gov/books/NBK76814Driessen, E., Cuijpers, P., Maat, S. de, Abbass, A. A., Jonghe, F. de, & Dekker, J. J. (2009). The efficacy of short-term psychodynamic psychotherapy for depression: a meta-analysis. In www.ncbi.nlm.nih.gov. Centre for Reviews and Dissemination (UK). https://www.ncbi.nlm.nih.gov/books/NBK76814
(4) NHS Inform. (2023, February 23). Selective serotonin reuptake inhibitors (SSRIs). Www.nhsinform.scot. https://www.nhsinform.scot/tests-and-treatments/medicines-and-medical-aids/types-of-medicine/selective-serotonin-reuptake-inhibitors-ssris#:~:text=After%20carrying%20a%20message%2C%20serotonin
(5) Mayo Clinic Staff. (2019, September 17). The most commonly prescribed type of antidepressant. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825#:~:text=Selective%20serotonin%20reuptake%20inhibitors%20(SSRIs)%20are%20the%20most%20commonly%20prescribed
(6) Informed Health. (2020, June 18). Depression: How Effective Are Antidepressants? Nih.gov; Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK361016/
