By: Sam Ernst and Karmel Choi

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Depression is one of the most common, costly, and disabling mental disorders worldwide.  In the United States (US) alone, an estimated 16.6% of people will have experienced an episode of depression at some point in their lives. In any single year, over 16 million US adults will be affected. People with depression experience diminished interest or pleasure in activities as well as changes in how they think, feel, and behave, all of which causes significant distress and functional impairment.

There are many different approaches to treating depression.  A plan for treatment will depend on the severity of the disorder, a person’s responsiveness to treatment, and resources available. More often, these treatment approaches are used in parallel with one another – such as taking medication and receiving psychotherapy.

Psychotherapy

Many people participate in psychotherapy, or “talk therapy”, and work with a therapist to build better coping and problem-solving skills, change maladaptive behavioral patterns, and work through mental health and other life problems. There are a range of different types of therapy that one can participate in, including, but not limited to:

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  • Cognitive behavioral therapy (CBT)
  • Psychodynamic therapy
  • Interpersonal therapy
  • Family therapy

Read more here: https://www.nami.org/Learn-More/Treatment/Psychotherapy

 

 

 

 

Psychopharmacology

Medications such as antidepressants, mood stabilizers, and antipsychotic medications are used to treat depressive symptoms. There are many different types of antidepressants with varying mechanisms of action, and the major classes of antidepressants include:

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  • Selective serotonin reuptake inhibitors: SSRIs
    • Examples: fluoxetine (Prozac), escitalopram (Lexapro), sertraline (Zoloft), etc.
  • Serotonin-norepinephrine reuptake inhibitors: SNRIs
    • Examples: venlafaxine (Effexor), duloxetine (Cymbalta), etc.
  • Tricyclic antidepressants (TCAs)
    • Examples: amitriptyline (Elavil), desipramine (Norpramin), etc.
  • Monoamine oxidase inhibitors (MAOIs)
    • Examples: phenelzine (Nardil), selegiline (Emsam), etc.
  • Atypical agents
    • Examples: bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), etc.

Read more here: https://www.rxlist.com/the_comprehensive_list_of_antidepressants/drugs-condition.htm

 

Light Therapy

Light therapy uses a light box to attempt to regulate melatonin (a hormone) by exposing a person to light. Light therapy is often used to treat seasonable affective disorder (SAD) – a type of depression that occurs at a certain time of the year, usually in the winter or fall.

You can read more about light therapy here: https://www.mayoclinic.org/tests-procedures/light-therapy/about/pac-20384604

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Brain stimulation

For extreme cases of depression, where other psychotherapies and/or medications have not been effective, depression can be treated with noninvasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS), or invasive brain stimulation, where a device is implanted into brain for deep brain stimulation (DBS). Another type of procedure used is Electroconvulsive therapy (ECT), which is a treatment that uses a brief electric stimulus to produce generalized seizures. All of these treatments modulate neural activity with the hope of inducing changes that will lessen depressive symptoms. 

Helpful additions to treatment: Exercise, yoga, and mindfulness

Aerobic exercise is known to have a positive effect on cognition in both general and clinical populations, and exercise is increasingly being acknowledged as a promising addition to treatment for depression to help boost mood and improve cognitive performance. Additionally, yoga, meditation, and other practices such as mindfulness have also been shown to improve depressive symptoms.

There are many different types of treatments available for depression; however, it is best to talk with your doctor first before deciding on a course of action that is right for you.

 

Resources at MGH:

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