Treatment Options

If you’re having thoughts about harming yourself or someone else, get yourself to the emergency department of a local hospital.

The first step in treating depression is diagnosing the illness. It’s important for you to understand and recognize the symptoms.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, if you have at least 5 of the following symptoms present during the same 2-week period, and your symptoms represent a change from previous functioning, you’re suffering from a major depression. The symptoms cannot be due to a medical condition, drugs or bereavement:

• Depressed mood
• Diminished interest or pleasure in activities
• Significant appetite/weight loss or gain
• Insomnia or hypersomnia
• Feelings of worthlessness or excessive guilt
• Diminished ability to think or concentrate
• Recurrent thoughts of death or suicide

If you are experiencing a depression, it’s critical for you to get treated. The following healthcare professionals can help:

Psychiatrists
Medical doctors who specialize in psychiatric disorders. They can prescribe antidepressants.

Psychologists
Trained professionals ( Ph.D. or Psy.D.) who specialize in counselling and mental health issues.

Doctors
Many doctors (general practitioners) are trained in psychotherapy. They can prescribe antidepressants.

Psychiatric nurses
Nurses who specialize in psychiatric disorders.

Social workers
Qualified professionals (MSW or BSW). Some of them specialize in mental health issues, and many of them are trained in psychotherapy.

Treatment Plan

Healthcare professionals will develop a treatment plan with you. If you don’t understand or agree with the treatment suggestions, get a second opinion. Here are some recognized treatments for depression (in alphabetical order):

Antidepressant Drugs

Most psychiatrists and doctors will prescribe medication. One of the newer types of antidepressant drugs are called selective serotonin reuptake inhibitors (SSRIs e.g., Paxil, Prozac, Luvox, Zoloft). Make sure you’re aware of the common and dangerous side effects of any antidepressant medication that you decide to take.

Brain Surgery

Brain surgery is seldom used, but can be effective. It is now possible for surgeons to stimulate a certain section of the brain, known as area 25, through a brain pacemaker to eliminate depressive symptoms. Another extremely rare method is to burn away tissue in a targeted area of the brain by using radio and x-ray guided probes.

Electroconvulsive Therapy

Electroconvulsive therapy (ECT), otherwise known as shock treatment, has been effective at eliminating depressive symptoms among individuals who have not responded well to other treatments. Before anesthesia was used, there were reportings of individuals sustaining fractures of their limbs or vertebrae during ECT treatment. This is no longer an issue. Short-term memory loss is a side-effect of ECT treatment.  

Healthy Eating

It's important to eat well balanced, nutritious meals. You may also want to take a vitamin B supplement. Deficiencies in the B complex of vitamins (especially folic acid, thiamine, riboflavin, niacin and B6) contribute to depression. It’s also important to avoid drinking alcohol, even if you think it makes you feel good. Alcohol is a depressant and can make an existing depression worse.

Light Therapy

The use of bright lights to relieve the symptoms of a particular type of depression known as seasonal affective disorder (SAD) has become common. This inexpensive treatment involves sitting in front of bright lights (10,000 lux), with your eyes 16 inches from the lights, for 30 to 60 minutes a day during the darkest months of the year.

Natural Supplements

A well known herbal treatment for depression is St. John’s Wort. German researchers have found that St. John’s Wort was more effective than placebo and as effective as antidepressant drugs in treating mild to moderate depression. Japanese researchers discovered that omega-3 oils can be an effective treatment for depression. S-adenosylmethionine (SAM-e), an amino acid that acts as a catalyst in manufacturing joint cartilage and the maintenance of neural cell membrane function, has also been shown to effectively reduce depressive symptoms.

Physical Activity

Most people are aware that exercise increases the production of endorphins among individuals, which reduces pain and induces euphoria. This is particularly true for less physically fit individuals. However, there is also evidence that physical activity (e.g., walking, aerobics, strength training) increases the availability of serotonin at receptor sites in the brain. Evidence suggests that exercise, and the subsequent increase in physical fitness, alters serotonin levels in the brain, which reduces depressive symptoms and increases mood and feelings of well being.

Psychotherapy

Psychotherapy and counselling, which encompass a wide range of psychological strategies that promote recovery, has been shown to be as effective as antidepressant drugs for treating mild and moderate depression. One of the more recent and successful therapies is cognitive behavioural therapy (CBT), which is designed to help you change how you think (cognitive) and what you do (behaviour). Unlike traditional psychotherapy, it focuses on "here and now" problems and difficulties, instead of focusing on the causes of your distress or symptoms in the past. CBT looks for ways to improve your state of mind now.

Transcranial-Magnetic Stimulation

With Transcranial-Magnetic Stimulation (TMS), electrical activity in the patient’s brain is influenced by a targeted, pulsed magnetic field. It is a painless, non-invasive procedure that does not require anesthesia. TMS is used to treat depression by inducing a current in the DLPFC (left dorso lateral pre-frontal cortex) with stimulation by a magnetic field. The stimulations are short but intense, lasting less than a millisecond. The penetration itself holds little energy. Several studies have suggested that TMS regulates beta adreno-receptors and increases dopamine and serotonin levels. Patients suffering from depression that also have anxiety components can receive a reduction in anxiety levels, simply as a result of the treatment protocol used in the treatment for depression. However, in some cases, the desired therapeutic benefit is not fully achieved from depression treatment protocols alone. In this case, supplementary right-sided treatment for anxiety can be provided.

Vagal Nerve Stimulation

The vagal nerve regulates gastrointestinal function in the body. It runs down part of the length of the spinal canal, culminating in the abdominal end of the stomach. Some medical researchers have demonstrated that depressive symptoms in some patients disappear when the vagal nerve is stimulated by a small pacemaker.