Depression: A Misunderstood Disease by Stephanie Mallet - HTML preview

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Support Groups

Medications and therapy alone cannot always deliver desired

results.

You can form or join support groups with people suffering from

similar depression episodes. Spending time with such people,

sharing each other’s concerns, problems and doubts can make you

feel better equipped to handle your own concerns.

Lifestyle Changes

Doctors suggest various lifestyle changes in conjunction with regular

medications to combat unipolar depression. Such lifestyle changes

include maintaining a brisk exercise schedule for a minimum of

thirty minutes daily, quitting smoking, alcohol and drugs, and

adhering to a disciplined lifestyle.

Adopting these changes after completing your regular treatment for

depression can lower the chance of a relapse significantly.

Although treatment options do usually deliver desired results, there

may be insufficient response in some cases.

Doctors and psychotherapists could then suggest a change of

treatment option. Normally doctors watch you over a period of two

to three months of treatment.

If results are unsatisfactory, you could shift to another course of

treatment or you could take a second opinion of another doctor.

But, do not tax yourself too much. Any medication or treatment

option needs time to turn things around and help you to get back to

your earlier balanced life.

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21. Unipolar Depression Medications - Antidepressants

Antidepressants are one type of pill that doctors prescribe to help

unipolar depression. These pills do not guarantee immediate relief

but they can put you on the path to recovery.

Antidepressants help your brain to achieve a proper chemical

balance by regulating neurotransmitters.

Natural neurotransmitters, like norepinephrine and serotonin, are

essential for normal brain functioning and control of routine

activities like eating, sleeping and thinking.

Antidepressants increase the availability of these brain chemicals

and thereby help to relieve you of your unipolar depression.

A normal course of treatment through antidepressants spreads over

four to six months. Doctors decide on the necessary duration of

antidepressants according to the severity and complexity of your

unipolar depression.

Antidepressants include selective serotonin reuptake inhibitors

(SSRIs), tricyclics, and others antidepressants like mirtazapine,

bupropion, nefazodone, trazodone, and venlafaxine.

SSRIs include drugs like fluoxetine, citalopram, escitalopram,

paroxetine, and sertraline. These antidepressants act only on the

neurotransmitter serotonin of your brain. These may cause a few

side-effects like nausea, dry mouth, insomnia, nervousness,

headache, fatigue, sexual problems and diarrhea.

Tricyclics are effective antidepressants. They take effect on both

neurotransmitters like serotonin and norepinephrine and other body

chemicals. Side effects of this antidepressant may include

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constipation, tiredness, blurred vision, dry mouth, difficulty

urinating, impaired thinking and worsening of glaucoma. They could

also affect your blood pressure and heart beat.

Antidepressants can affect the effectiveness of other medications

you may be taking. Some could cause adverse reactions.

Certain antidepressants could trigger serious reactions with certain

beverages and foods.

Sometimes antidepressants could trigger over-stimulation of

serotonin receptors. It could result in mental confusion,

hyperactivity, shivering, fever, sweating, poor coordination, diarrhea

and seizures. There should always be a gap of more than two weeks

before changing to a new antidepressant.

Although antidepressants are effective medications for unipolar

depression, proper treatment requires that they be combined with

counseling sessions.

Different people react differently to antidepressants. No single

medication can prove effective for all. Therefore, doctors test the

suitability of the medication before prescribing it for your long-term

use.

Sometimes, doctors may prescribe you to be on certain mild

antidepressants for life.

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22. Electroconvulsive Therapy (ECT)

Electroconvulsive therapy (ECT) is a recommended form of

treatment for patients with severe unipolar depression. Psychiatrists

prescribe this treatment usually after other medications and

therapies do not deliver the desired effect. This therapy has a

success rate of 80%.

ECT can be administered during a hospital stay or you can undergo

treatment and return home. A normal course includes three sittings

per week with a maximum of twelve treatment sessions.

ECT involves use of controlled electric current of 0.9 ampere to

induce a shock to your brain. Passing such a current could cause an

artificial seizure. Psychiatrists administer you a general anesthesia

before start of treatment.

Anesthesia induces you into a sleep-like state. You are also given a

muscular relaxant. Doctors watch your vital functions closely.

Although the electric current causes your brain to experience a

seizure for one or two seconds, specific medicines control its effect

on your body.

You awaken five to ten minutes after the treatment. It takes little

time for you to recover completely.

Common side effects of ECT may include nausea, temporary short-

term memory loss, headache and muscle aches. In some cases, it

could cause changes in heart rhythms and blood pressure.

Doctors keep a watch for these and administer treatment

immediately if necessary. After completing all the sittings of a full

course of ECT treatment, psychiatrists could put you on

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antidepressants to achieve long-term relief from unipolar

depression.

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23. Eye Movement Desensitization

Reprocessing (EMDR)

Eye Movement and Desensitization Reprocessing (EMDR) technique

is a relatively new concept for treating unipolar depression. Dr.

Francine Shapiro, a psychologist at the Mental Research Institute in

Palo Alto, California created this technique in 1987. It involves use

of rapid eye movements with proper guidance to cure emotional

causes of unipolar depression.

Normally, people with unipolar depression exhibit varied and intense

feelings of anxiety, depression, obsessions, flashbacks, panic

attacks, nightmares and restlessness together with severe disorders

like sleep disturbances, eating disorders and, in extreme cases,

suicidal intentions.

EMDR may help you to combat these problems and overcome your

unipolar depression.

EMDR works by coordinating specific parts of your brain. Once any

traumatic event occurs, it remains registered in a specific part of

your brain permanently. The entire picture remains in a frozen

frame. Often you experience emotional upsets when these thoughts,

feelings, sounds and upsets are triggered due to any cause.

However, in another part of your brain, you always try your best to

resolve and forget these happenings. The absence of proper

coordination between these brain parts causes depression. EMDR

through fast eye movements and effective counseling tactics helps

to resolve this deficiency.

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EMDR treatment focuses on using your past happenings and your

present condition to make way for your future. The treatment

process first focuses on your position and condition at the time of

the emotional upset. This is the root cause of your problem.

Next, the treatment tries to solve your emotional upsets in the past

by attending to your present symptoms. This starts a specific

healing process, which tries to put right your emotional quotient and

prepares you to face a brighter future.

EMDR treatment involves various processes within the treatment

plan. These processes consist of preparation and assessment phases

according to individual requirements.

Then, you need to concentrate your eye movements on a moving

object for fifteen to thirty seconds, while focusing on specific

memories of your past. This coordinates your brain and eye

functioning.

You may experience different feelings and responses during the

process. Allowing things to move along while you concentrate

without questioning the correctness or incorrectness of anything can

improve the working and responses of your brain.

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24. Psychotherapy

Psychotherapy is one of the most common treatment options for

unipolar depression.

It is also popular as talking therapy, where a patient talks and

discusses problems with licensed and trained psychotherapist to find

relief from most symptoms of depression.

Depression problems could also be hereditary.

Sometimes various chemical imbalances in your brain could trigger

depression symptoms and manifest in deep behavioral problems.

Need for Psychotherapy

Often, a major event like death, trauma, accident, divorce or loss of

a job could cause severe disruptions in your emotional setup. This

translates into depression.

It is essential to analyze the root cause for your unipolar depression

to be able to suggest suitable remedies and prescribe necessary

treatment.

Psychotherapy treatments help you get back your control over your

life so that you are able to enjoy the basic pleasures in your life.

Psychotherapy treatments teach you various problem-solving skills

and coping techniques.

Types of Psychotherapy Treatments

Psychotherapy treatments can be in different modules:

Individual treatments include just you and your psychotherapist.

Group treatments include a small group of patients. Each of them

could discuss their individual problems, share experiences and

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provide solace. This makes each feel that they are not the only ones

suffering from depression problems.

Couple treatments involve you and your spouse or partner. This

helps the other person understand why you are suffering from

depression and how best to provide help and comfort during difficult

times.

Family treatments involve all family members together to learn how

to deal effectively with depression problems of a family member.

Choice of Suitable Psychotherapy Treatment

Your psychotherapist is the best person to judge and analyze the

best treatment suitable for your condition.

Different approaches to psychotherapy include:

Psychodynamic therapy

This therapy could last for a long period, even spreading over years.

This therapy starts with the assumption that your depression

problems are due to certain unresolved conflicts in childhood.

Your therapy, therefore, aims to help you understand and deal

better with such childhood experiences and overcome all negative

feeling associated with those past events.

Interpersonal therapy

This therapy treatment deals with your poor relationships with

friends and family members and depression that is the result of

such poor relationships.

This therapy aims at improving your communication skills so that

you are able to communicate better with other people. This

treatment normally lasts for three to four months.

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Cognitive behavioral therapy

This therapy aims at fixing your wrong self-assumptions. You

develop depressive thoughts as you feel you are inferior to others

and cannot stand on the same level with others in your age group

or community.

Your therapist tries to establish the correct ways of thinking and

removes wrong and irrelevant assumptions about yourself that form

the base for your depression problems.

Useful Therapy Tip

Analyzing the root cause of your depression problem could start

your psychotherapy treatment. However, you should be consistent

and try to put in the necessary effort and time so that your

treatments deliver desired results.

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25. Choosing a Psychotherapist

A psychotherapist is a trained medical professional. This

professional can treat and offer remedial measures for your

behavioral disorders.

When choosing a psychotherapist, you have to consider your

comfort zone.

You should be able to talk and deal freely with your psychotherapist.

Therapists use various techniques to treat your behavioral

symptoms. You can therefore choose a male or a female

psychotherapist according to your preferences and ability to

communicate easily.

Similarly, you could choose a therapist who can converse in a

language you feel most comfortable with.

While discussing your depression problems with your

psychotherapist, you can inquire in to their education qualifications

and suitable treatment options.

You have to be honest while discussing your problems with your

psychotherapist. Holding back information cannot get you

anywhere. It will only compound your problems.

Psychotherapists have different levels of education and professional

qualifications. A psychiatrist is a doctor who specializes in

psychiatry.

Psychiatry is a specialized branch of study of depression problems

and remedial measures. Psychiatrists can prescribe relevant

medications for behavioral problems.

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A psychiatric nurse practitioner has a master’s level nursing degree

with a state license. Such a nurse should have thirty hours of formal

training in mental health conditions and be capable of suggesting

necessary medications.

Normally, these nurses work with a psychotherapist to analyze your

behavioral problems and review your medical condition from time to

time.

A clinical psychologist should have a doctorate degree, relevant

state license and supervised experience in dealing with depression

patients.

A psychologist cannot prescribe medications, as a psychologist is

not a medical doctor. Normally, psychologists work with a

psychiatrist nurse practitioner or psychiatrist to discuss your

depression problems and suggest suitable medications.

A licensed counselor or therapist has a master’s degree in

counseling and clinical psychology. Further, such a person has

relevant experience and he should pass a state exam to receive the

relevant license. A licensed counselor or therapist has training in

different psychotherapy techniques.

Understanding the different categories of psychotherapists can help

you choose the one who meets your requirements and suits your

preferences.

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26. Experimental Therapies

Experimental therapies are treatment procedures for depression

problems, which doctors are uncertain over their effectiveness and

safety because there has not yet been enough data produced. These

therapies are not in regular use by doctors for treating depression

problems.

Experimental therapies include vagus nerve stimulation, hormone

replacement therapy in women, and transcranial magnetic

stimulation.

Vagus nerve stimulation uses electrical pulses to stimulate the

vagus nerve, the main nerve that controls depression and moods.

This therapy involves implantation of a tiny device in your chest,

connected to electrodes for necessary stimulation. This treatment is

common among epileptic patients. Doctors may use this treatment

in depression patients if no more common treatment techniques are

yielding any benefits.

Hormone replacement therapy in women can provide relief to

various mood changes taking place during menstrual periods,

perimenopause and post menopause. These periods involve drastic

changes in hormone levels that may cause severe depression and

other problems like hot flashes and night sweats.

Transcranial magnetic stimulation is also popularly known as

repetitive transcranial magnetic stimulation. This technique involves

placing an electromagnet on the head to induce electrical currents

within your brain. These induced currents may change and stimulate

better activity within the brain. This may alleviate depression. This

technique is claimed to have few side effects. This technique is a

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relatively new concept and studies are still ongoing to understand

its long-term benefits and effects.

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27. Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is a technique that makes

use of a powerful electromagnet to change brain activities. This is a

non-invasive technique.

Doctors place an electromagnet on your scalp. This induces an

electromagnetic current in the underlying cortical neurons. This

affects functioning of the cortical neurons.

Varying intensities and changing frequencies of this electromagnet

can produce currents of different intensities. These are claimed to

correct excessive or low stimulation levels within the brain. This

technique may become very useful in treating patients with

depression.

Side effects of TMS are claimed to be very few and rare. In some

cases, it could cause epileptic seizures. These side effects may be

more common in patients with a family history of epileptic seizures.

Each TMS session could last for half an hour. You can undergo daily

sessions for a fortnight.

Depressed individuals have low brain activity. The electromagnetic

pulses help stimulate and increase brain activity. It may be easier

for some patients to tolerate TMS than other forms of treatment for

depression.

TMS technique is claimed to score better over other forms of

depression treatments like ECT and VNS. Its supporters say that

this treatment not only improves depression in people, it also

improves the quality of different parts of brain thereby stimulating

better memory and reasoning abilities.

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TMS is claimed to be very successful in patients with post-trauma

depression, schizophrenia, speech problems, brain hyperactivity

problems and other problems associated with regional hypo-

metabolism.

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28. Vagus Nerve Stimulation (VNS)

Vagus nerve stimulation (VNS) is a system that gives intermittent

stimulations to the vagus nerve in the brain for thirty seconds at

five-minute intervals.

This consists of an implantable pulse generator, lead, and an

external programming system. Implantation of a vagus nerve

stimulation device takes about an hour.

Surgeons make a small incision in your neck and collarbone to

implant this battery-operated device. A flexible and insulated plastic

tube with electrodes is also placed under the skin near to the vagus

nerve.

The generator delivers electric shocks to your vagus nerve. These

restrict emotional disturbances.

Your brain has many nerve cells that communicate with electric

currents. Imbalances in regular electrical activity in the brain may

cause emotional problems.

These electric shocks through stimulation of the vagus nerve may

restrict these imbalances and control your emotional episodes.

VNS is more popular in treating people with partial seizures. The

vagus nerve is one of the twelve cranial nerves in brain. This nerve

not only coordinates body and mind movements, it also affects

mood levels in your brain.

So, stimulating this nerve may regulate and bring changes in mood

dysfunctions.

A VNS device is claimed to be a better alternative to

Electroconvulsive therapy.

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Risks and possible complications due to VNS include difficulty in

swallowing, hoarseness, injury to carotid artery, and possible

chances of infection at the place of implantation of the device.

Depressio

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