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Guidelines For Treating Depression There are many different guidelines for treating depression that have been published by the APA, CANMAT, BAP, NICE, and Texas Medication Algorithm Project. They suggest exercise, psychotherapy and antidepressant medication. The guidelines suggest that patients who don't respond to monotherapy should use CBT or SGA prior to beginning treatment and increase dosages as necessary. Augmentation with psychostimulants, lithium SSRIs or SNRIs or TMAPs could be beneficial for patients who are not responding to monotherapy. 1. Diagnosis A diagnosis is the first step in treating depression. This involves a conversation with a mental health professional or your doctor, and certain forms of therapy. Your GP will ask about your symptoms and how they've affected your life in the last month. They will also ask if you have ever had thoughts of self-harm or suicide. Your GP will also examine your general health, family history and lifestyle to help decide whether you have depression or another mental health condition. You must be honest and open with your doctor, so they can get a true picture of how you are feeling. This will make it easier for them to spot the symptoms of depression. These symptoms can be used to rule out other diseases such as cancer or heart disease. After your GP has concluded that you might be suffering from depression, they'll rule out the possibility of other illnesses through tests. Blood tests, for instance test thyroid or anemia-related issues which could be the cause of depression. They'll also test your blood for deficiencies in vitamins or the presence of alcohol and drugs that can mimic depression. If your GP has diagnosed depression the doctor will explain the cause and best treatment options. This could include psychotherapy or a combination of medications and therapies. The most effective drugs for depression are antidepressants which work by altering the balance of chemicals within the brain. They can be taken either orally or by injection and it could take several weeks before they start working. The drugs may also cause adverse effects, such as constipation and dry mouth. 2. Medication Many people can benefit from medication. with depression. At first, your doctor may prescribe antidepressants or a combination of them. If your initial treatment isn't producing a satisfactory response, your doctor might recommend that you try another medication or alter the dosage or time of day you take it. Regularly taking your medication is essential to reap the maximum benefits. Don't stop taking your medication without your doctor's consent. Depending on the severity of your symptoms, you may be given a prescription for a general antidepressant or an SSRI. An SSRI is an antidepressant that raises the levels of the chemical serotonin in the brain. SSRIs include citalopram, escitalopram, and fluoxetine. Your doctor might also prescribe a serotonin-norepinephrine reuptake inhibitor, or SNRI. SNRIs include duloxetine, (Cymbalta), and venlafaxine, (Effexor XR or Khedezla). Other antidepressants, such as tetracyclics can be prescribed if your doctor believes that these medications would be more effective than an SSRI or an SNRI. SSRIs and SNRIs are typically considered safe to use in adolescents and children. Before starting any medication, inform your doctor if there are any allergies or health problems. Some medications can cause side effects like an upset stomach or a dry mouth. In general, they are minor and go away by themselves in two or three weeks. Do not operate or drive machines if you're taking medication. Alcohol and other recreational drugs can exacerbate depression symptoms, such as sleeplessness or trouble sleeping. cognitive behavioral therapy for depression are not recommended for use because they can make depression more difficult to treat. If you continue to use them, especially for an extended period of time, may cause more serious issues. 3. Psychotherapy Psychotherapy, also referred to as talk therapy, can help you address issues that contribute to your depression. This type of treatment may be long-term, but it has been proven to be beneficial for many people suffering from depression. Psychotherapy can be done in a variety of settings, like private therapists' offices, hospitals, clinics for psychiatry, and rehabilitation facilities. It is usually done one-on-one but group therapy is also a possibility. Your therapist will inquire about your thoughts, feelings, and relationships, and discuss these with you in a secure and confidential environment. In the initial few sessions your therapist will begin to know you and suggest a treatment plan. This can include psychotherapy, medication as well as exercises and other treatments such as repetitive transcranial magnetic stimulation (rTMS), or electroconvulsive therapy (ECT). Some of them are short-term and focus on specific issues. For example IPT, or interpersonal therapy (IPT) helps people understand the root causes of problems, such as unresolved grief or conflicts with significant others. Depression can be caused by a variety of reasons including loss and stress to unresolved traumas or abuse. They may require more intense therapy or other treatments. Cognitive behavioral therapy (CBT), also known as cognitive restructuring, assists people to alter their thinking patterns, which cause symptoms. It also enhances coping skills and helps them to manage the stress and challenges of daily life. Dialectical behavior therapy (DBT) combines elements of CBT with mindfulness techniques that help you to observe and accept your emotions. Psychological therapy can be more effective than antidepressants in treating acute depression. It may take longer for it to be effective and not everyone responds in the same manner. It is important to attend your therapy sessions as well as to complete your homework between sessions (like journaling or meditating). 4. Counseling It is crucial to find the right treatment, regardless of whether your symptoms of depression are not severe. Most often, this means counseling or psychological therapy. A professional outside can transform your life. It may take several therapy sessions to find one who is a good fit for you. However, it's worth the effort. There are a variety of psychotherapy. However most involve discussing your concerns and finding strategies to combat depression. You may also find it helpful to talk about your experience with others who are experiencing similar problems. Group counseling is available at medical clinics, hospitals and therapists' offices. It can also be done on your phone through online telehealth services. Counseling for depression is designed at transforming negative thoughts and behaviors which cause depression. A therapist could help, for instance, instruct you on how to manage stress in order to improve your mood. You can be taught to recognize irrational thinking and challenge your preconceived notions that cause you feel down. You can try EMDR (eye movement desensitization and processing) to ease the burden of traumatizing or painful memories that might be contributing to your depression. Other therapies, like cognitive behavioral therapy or behavioural activation can be used to help you recognize your patterns of behavior and make adjustments. For instance the behavioural activation therapy is beneficial when depression causes you to withdraw from social activities. The aim is to encourage you to take part in more social activities and to determine the way your actions impact your mood. These strategies are usually employed as a complement to medication. Ask your doctor for a referral, or call the local mental health center in your community to locate a therapist who is certified. 5. Exercise The benefits of exercise in preventing and treating depression are well-established. It's not a typical treatment. Psychotherapy and medication are more commonly utilized. However, a growing body research suggests that exercise may be as effective in treating depression as talk therapies and antidepressants, perhaps even more effective. A meta-analysis of more than 150 studies showed that it was more effective than psychotherapy or medications by themselves. The research found that, on average people with depression who exercised improved their symptoms by five points using one measure and 6.5 points with another which is clinically significant. The results were similar whether they exercised a few minutes or an hour each day. Exercise is also a good alternative to medication or psychotherapy, but it may not be suitable for all. And it has the added bonus of keeping us physically fit and preventing other mental health problems, including anxiety. Additionally exercising doesn't carry the stigma that can be associated with taking drugs or going to talk therapy. It's accessible to everyone, comes with no expenses and is a very empowering approach. However, it's still difficult to research the effects of exercise on a person, because it can be difficult to determine the impact of things like how much people exercise regularly and other medications they are taking. More research is needed to determine the best kind, frequency and duration of exercise for treating and preventing depression. To help patients with depression, doctors are prescribing more exercise as part of their treatment plans. The green prescription is a program that encourages patients to get active by contacting a fitness expert regularly by phone or face-toface.