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A female therapist counselling another woman

6 Evidence Based Ways to Treat Depression

Depression can be a persistent and debilitating condition. Here are 6 evidence based ways to treat it.

Even though you may feel hopeless when suffering with depression, the good news is that there are a number of safe and proven treatments that can be tried. However, it’s important to remember that most of them do take time to work. So whatever approach a person chooses, it’s important to remain consistent for a period of time in order to experience an improvement.

Self Help

Mild depression may not necessarily require the involvement of a health professional. Often simple lifestyle changes can make a dramatic change and lift a person out of a mild depression. Useful strategies involve improving sleep hygiene, eating a nutritious wholefood diet with less processed foods and less sugar, practicing relaxation either through meditation or yoga, listening to music, artistic creativity and exercise. Lifestyle modifications can complement all other treatments for depression as well as be incredibly helpful for people at any stage of depression.

Talking Therapies

These are a type of treatment where a person with depression speaks with a trained therapist, either a counsellor or psychologist. Studies have shown that a minimum of 8 sessions are needed to notice a change. For mild to moderate depression, talk therapies can be as effective as medication. There are four main types of talk therapy.

  1. Cognitive Behavioural Therapy where you learn to notice your own negative thoughts or behaviours and are taught how to intercept them and replace them with positive thoughts and behaviours.
  2. Interpersonal Therapy where you work on improving your relationship with people in your life by learning to reflect on your own reactions as well as how to communicate better.
  3. Psychodynamic Therapy where you explore your past to unveil very deep emotions and identify past experiences that are influencing the way you feel and behave now.
  4. Counselling is where you talk about your problems with a trained counsellor and work together to find solutions. Types of counselling include grief counselling, family counselling, couples’ counselling, financial counselling and relationship counselling.
St Johns Wort flowers and capsules

Antidepressants

Medications have been found to be effective in treating moderate or severe depression. It is recommended that they are used in conjunction with talking therapies and lifestyle changes for best results. Antidepressant treatments have come a long way in the past few decades with fewer side effects and reduced physical dependence. The most commonly used anti-depressants are:

Selective Serotonin Reuptake Inhibitors (SSRI). These medications include well-known names like Prozac, Zoloft and Lexapro and are generally the first line treatment offered to patients. SSRIs increase serotonin availability in the brain. Serotonin is a feel good chemical, higher available levels result in an improved mood. People with depression have been found to have lower serotonin levels and additionally, trauma is known to result in reduced production of serotonin.

Serotonin and Noradrenalin Reuptake Inhibitors (SNRIs). Examples of SNRIs include Effexor, Pristique and Cymbalta. These drugs are can be used if a person is not responding to and SSRI. They increase bioavailability of both serotonin and another neurotransmitter called noradrenalin in the brain. Increasing noradrenalin levels as well as serotonin, can have an added effect in managing depression as well as anxiety.

There are other, older medication types which aren’t used as often anymore due to the increased risk of side effects. They are reserved for use in patients with who have not responded to SSRIs or SNRIs, or in patients with more uncommon forms of depression.

All antidepressant medications take 4 to 6 weeks before a patient notices that they are working. It is quite common to experience side effects like nausea, headaches and increased anxiety in the first week or two after starting SSRIs or SNRIs. It is much easier to come off SSRIs and SNRIs than other treatments but you should always work together with your doctor on weaning off medication.

Supplements

St John’s Wort. This is a plant that has been used for decades in the treatment of depression. It works in a similar way to SSRIs and SNRIs increasing the availability of serotonin, dopamine and noradrenalin in the brain. You don’t need a doctor to prescribe it but St John’s Wort can interact with a number of other prescription medications so it’s important to let your healthcare professional know that you are taking it.

SAMe. S-Adenosyl methionine is a compound that is found naturally in the body and increases serotonin levels in the brain. Supplements have been found to have a positive effect on depression and anxiety.

While there are a number of other supplements available for depression such as 5HTP, ginseng and fish oil, studies haven’t been conclusive as to whether they actually work.

Woman looking sad holding her hands to her head

Electroconvulsive Therapy (ECT)

ECT may be considered by a psychiatrist for people with severe depression which is not responding to other treatments. A small electric current is applied to the brain triggering a mild seizure. It is thought that seizure activity may increase connectivity between nerves in the brain and perhaps increases levels of neurotransmitters like serotonin and dopamine which have a positive effect on mood.

Transcranial Magnetic Stimulation (TMS)

TMS is a newer treatment that has been found to be very effective in improving depression. A coil is placed around the patient’s head and a magnetic pulse is delivered to the part of the brain that is involved in depression, stimulating the neurons in that area. This stimulated activity has been shown to lead to positive changes in mood.

 

If you think you might be suffering, talk to your healthcare professional about how they can help you. In Australia you can also visit Beyond Blue or in the UK Mind.

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