There are a number of treatment options available to patients diagnosed with depression, bipolar disorder or related illnesses. The main treatments can be divided into three categories: Psychotherapy, Medication, and Neuromodulation.
Click here to view a video about treatment options from the MADI Resource Center at Massachusetts General Hospital
- Psychotherapy relies upon the interchange between an individual or group and a trained counselor to help bring about positive changes in thoughts, feelings and behaviors. Psychotherapy can take many forms: a therapist can work one-on-one with one individual, with a couple or family, or with a group of people who share common characteristics or challenges. The goal of psychotherapy is to help individuals address the issues that contribute to their depression, including resolving conflicts, improving family and work relationships, recovering from trauma or loss and learning how to deal with recurrent stresses.
- Medication (pharmacotherapy)
In recent years, more and better medications have been developed to treat depression and bipolar disorder. When administered properly, medications can help many people find relief from the symptoms of depression, usually with minimal or manageable side effects. In cases of moderate and severe depression, medications are often essential and even life-saving. Different classes of antidepressant medications are available to help minimize the severity of symptoms, and "mood stabilizing" medications are available to reduce the frequency of episodes of depression or mania. To achieve the desired outcome from medications, an adequate dosage over a sufficient period of time is required.
- Neuromodulation administers electrical or magnetic currents to stimulate the brain and alter (or "modulate") brain activity. There are a variety of neuromodulation methods currently in use to treat a range of brain illnesses, including depression, Parkinson's disease and tics. Neuromodulation techniques have been approved by the Food and Drug Administration for patients who have not found relief with other treatment approaches (a condition known as treatment resistant depression, or TRD).
Depression can be a complicated illness to diagnose, treat and manage. Working with an experienced healthcare provider, you can determine which treatment option or combination of options will best help you manage your illness. For example, for most people, combining medication with psychotherapy is the most effective approach, if that can be arranged. Over time, individuals and their healthcare providers may need to try more than one treatment strategy before arriving at a successful plan. Even treatment programs that show results initially may need to be revised over time. That's why it's important that you understand all of the options available to you, and that you actively participate in developing, maintaining and monitoring your treatment plan.
In addition to whatever course of treatment may be indicated for you, the self-care steps you take are equally important components of your plan. From good nutrition to healthy sleep habits to managing stress, there is much you can do to ensure you get the maximum benefit from your total treatment plan.
Options for Specific treatment for depression will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the depression
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disorder
- your opinion or preference
Generally, based on the outcome of evaluations, treatment for depressive disorders includes medication or psychotherapy, or a combination of the two.
You can also help yourself. Depressive disorders can make a person feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect. In the meantime, consider the following:
- Set realistic goals in light of the depression and assume a reasonable amount of responsibility.
- Break large tasks into small ones, set some priorities, and do what you can as you can.
- Try to be with other people and to confide in someone; it is usually better than being alone and secretive.
- Participate in activities that may make you feel better.
- Mild exercise, going to a movie, a ball game, or participating in religious, social, or other activities may help.
- Expect your mood to improve gradually, not immediately. Feeling better takes time.
- It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition - change jobs, get married or divorced - discuss it with others who know you well and have a more objective view of your situation.
- People rarely "snap out of" a depression. But they can feel a little better day-by-day.
- Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment.
- Let your family and friends help you.
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