Depression Help

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Depression Help

By The Fix staff 01/21/15
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Help with Depression

Depression in all its forms directly affects more than 350 million people worldwide, according to the World Health Organization. More than 16 million depression sufferers are adult Americans, reports the National Institute of Mental Health (NIMH). Add the effects on loved ones and friends, and the real impact is quite high.

Depression, like most mental illnesses, is not just "all in your head." The sadness, hopelessness, sense of worthlessness, and dark thoughts may be invisible, but they're very real to the person dealing with them.

Obstacles to Help

You would think people would want relief from feeling badly, but there are a number of reasons why this doesn't happen:

  1. Denying the symptoms – "I don't have depression. I just have a case of the blues."
  2. Discounting the symptoms – "So I'm depressed. Not a big deal; it'll clear up by itself."
  3. Geographic distance from help – This is a real problem, especially in rural and remote areas, where the doctor is in the next town, but the next town is more than 100 miles away.
  4. Not knowing the symptoms – Many people do not understand the consequences of untreated depression. When a depressed person attempts or commits suicide, though, the consequences become tragically real.
  5. Self-medicating – Depression is a serious mental illness. A depressed person can turn to substances like alcohol or drugs – sometimes both – to relieve the sense of misery they are feeling. "This is nothing a good party and some serious drinking won't cure."
  6. Stigma of mental illness – Many people are inclined to think mental illness is not real or is not as serious as physical conditions. Even after more than a century, mental health issues are, for the most part, taken more lightly than physical issues. People don't wish to be thought of as weak in the head or mentally off-balance.

Kinds of Help Available

Psychotherapy combined with medication is the preferred treatment plan of most mental health professionals when working with a person who has been diagnosed with any kind of depression. If the side effects prevent a person from using medications for their depression, psychotherapy alone can be pursued.

Non-medication help

An individual can get relief from depression by non-pharmaceutical means. Psychotherapy alone requires that the depressed person be diligent about attending sessions, doing any homework assigned, and practicing the therapeutic techniques presented in sessions. Eating programs (which may include vitamin and mineral supplements), exercise regimens, and sleep routines may also be included as part of the treatment plan.

Conventional Therapies

  1. Cognitive Behavioral Therapy (CBT) – helps a client/patient examine the relationships between thoughts, feelings and behaviors. CBT encourages a person not to believe everything they think and to challenge assumptions they may have held as truths for a long time.
  2. Interpersonal Therapy – a relatively brief type of therapy that encourages the patient to regain control of mood and functioning. This usually lasts only 12-16 weeks.
  3. Psychodynamic Therapy – also called Insight-Oriented Therapy, allows the client to examine unresolved issues that were experienced in past relationships and now show up in the present.

Unconventional Therapies

  1. Acupuncture – The Chinese practice of putting very fine needles into the body at specific points to manipulate the body's flow of energy shows promise as a treatment for depression.
  2. Equine-Assisted Psychotherapy (E-AP) – This is a form of therapy that engages horses as co-therapists. A horse is a 1,200 pound mirror and picks up on the emotions an individual is really experiencing and not what that person wants others to think they are feeling. A person can fool another person, even a therapist, for a while, but not a horse, even for a moment. Therapists and Equine Specialists observe the interactions between horse(s) and client(s) and only get involved when safety issues arise. Horses are honest, so they are powerful messengers. More information about E-AP can be found at their site.
  3. Movement Therapy (DMT) – Dance/movement therapy, as defined by the American Dance Therapy Association, http://www.adta.org/, uses movement to "further the emotional, cognitive, physical and social integration of the individual." Through movement, DMT can help individuals with a wide range of psychological disorders achieve greater self-expression.
  4. Music Therapy – Music Therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals. The professional organization, the American Music Therapy Association, can help you find a music therapist in your area.
  5. Play Therapy – Usually used with children, this therapy is particularly effective with anyone who is nonverbal or reluctant to speak to a therapist. The therapist observes the client in play mode, which eventually becomes unguarded and an honest form of expression for the client.

Self-help

  1. Books – Many books and workbooks are available for an individual to work through their issues without the need to speak with a therapist. Sometimes, therapists assign certain books (reading them is called bibliotherapy) as homework to help a client/patient better understand certain concepts.
  2. Herbal remedies – Herbs do not require a prescription but can be an alternative to conventional medications and can deliver quite effective results over time.
  3. Support groups – For a depressed person, getting reassurance that they are not alone in their depression and that others are willing to share what they know in order to help, can go a long way toward relieving feelings of situational depression.
  4. Meditation – According to the National Center for Complementary and Alternative Medicine, a 2014 systematic review and meta-analysis of 47 trials and 3,515 participants found that mindful meditation programs had moderate evidence of improved depression. For some, moderate is enough.
  5. Stress and Relaxation Techniques – These techniques can be used as part of a treatment program for phobias or a panic disorder. Relaxation techniques are also used to relieve anxiety for people in stressful situations, such as certain medical procedures or social situations.
  6. Tai Chi and Yoga – These are two Eastern disciplines that have specific movements for specific reasons. Focusing on postures and poses, along with the meditation, and breathing exercises both disciplines require, helps a person become more centered, balanced, and mindful of their emotional states. These disciplines can also do triple duty by providing a form of physical exercise, a way of staying in the here-and-now, and for relaxation to help maintain a calmer frame of mind.

Medication help

All medications have side effects, even something as familiar as aspirin. The trick is to be able to balance the medication's benefits with the side effects it can cause. There are a great many medications available that are designed to treat depression:

  1. Monoamine Oxidase Inhibitors (MAOIs) – These are the oldest antidepressants still available. Those approved by the Food and Drug Administration (FDA) to treat depression are Isocarboxazid (Marplan), Phenelzine (Nardil), Selegiline (Emsam), and Tranylcypromine (Parnate). They are still around because for some people, they are the only medication that works. Newer medications have taken their places in most instances, mostly because when they are combined with tyramine-containing foods (e.g., cheeses, red wine) MAOIs cause dangerously high blood pressure problems. Other common side effects include dry mouth, nausea, diarrhea or constipation, headache, drowsiness, insomnia, dizziness or lightheadedness.
  2. Selective Serotonin-Reuptake Inhibitors (SSRIs) – This is a fairly new group of antidepressants. They work by preventing (inhibiting) the body from re-absorbing (re-uptaking) the available serotonin in the brain. They are considered an effective treatment for all depressive disorders, if the side effects can be tolerated. Citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) generally have fewer side effects when compared with tricyclic antidepressants. Some common side effects include disruptions in sleep patterns (insomnia or sleepiness), difficulties with sexual performance, and weight gain.
  3. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) – These medications work in practically the same way as SSRIs and are also considered first-choice options when prescribing for mood issues. Venlafaxine (Effexor) and duloxetine (Cymbalta) help to elevate sad moods, smooth out highs and lows on moods, and help relieve actual physical pain. They can be used for other disorders as well, such as bipolar disorder and some kinds of chronic pain.
  4. Tricyclic Antidepressants – These are a class of older medications. They are quite effective when used for depression, but they are not as safe. Amitriptyline (Elavil), imipramine (Tofranil), and nortriptyline (Pamelor) can have more serious side effects than SSRIs and SNRIs, such as blood pressure drop upon standing, constipation, urinary retention, dry mouth, blurry vision, tinnitus, and irregular heartbeat.
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