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Clinical Depression Treatments Depression is treated by medication and psychotherapy. Medication helps relieve many symptoms, but it is not an effective treatment. Talk therapy includes cognitive behavioral therapy, which focuses on finding and changing negative thoughts. Psychotherapy for interpersonal relationships is a method of treatment that focuses on the relationships and the issues that could cause depression. Other treatments may be used in addition, such as ECT and vagus nerve stimulation. Medication Clinical depression is often treated with a combination of psychotherapy (talk therapy) and medication. Antidepressants are the most popular medication prescribed for depression in clinical cases and, sometimes, antipsychotics or mood stabilizers. It is important to know that these medications can take some time to work so don't lose hope if you aren't feeling better immediately. It could take a few months, or even longer, for you to feel better. This is particularly true when your symptoms appear to be to be severe. Some people aren't responsive to antidepressants, or experience undesirable side effects like weight gain or dizziness or shakiness. It's crucial to inform your health care provider about any adverse effects you experience and also to speak with the doctor about changing your dose or attempting a different drug. cognitive behavioral therapy for depression I Am Psychiatry can take some trial and error to find the medication that is right for you. The first step to get treatment is to schedule an appointment with your physician or mental health professional. They will ask you about your symptoms and the time they started. They'll also inquire about any other factors which could be affecting your mood, such as stress and alcohol abuse. They'll likely need to conduct a physical exam to rule out medical issues. A doctor can diagnose depression by examining your symptoms and medical history. They can help you to know what's happening and provide support and advice. They'll also recommend you to a mental health specialist when they think you're in need of it. Psychological treatments can help alleviate symptoms of depression and prevent them from coming back. These include cognitive behavior therapy (CBT) and interpersonal therapy both of which have been tested to be effective in treating depression. Both therapies require one-on-one sessions with a trained therapist. They can be received in person or via the internet via telehealth. Other treatments for depression in clinical settings include electroconvulsive therapy (ECT) and vagus nerve stimulator. ECT involves passing electrical currents through your brain, which alter the function and effect of neurotransmitters to relieve depression. Esketamine is a different alternative. It is FDA-approved, and is recommended for people who aren't improving with other medications or at the risk of suicide. Psychotherapy (talk Therapy) Psychotherapy is a type of therapy that can be used to treat depression. Studies show that it's often more effective than medications alone. It involves speaking with a mental health expert, such as psychologist or a social worker. It helps people learn how to deal with negative emotions, thoughts and behaviors. Psychotherapy is available in many forms. Cognitive behavioral therapy (CBT) and interpersonal therapy are among the most frequent. Talk therapy can be conducted in a one-onone session with an therapy therapist, or it may be performed in groups. Group therapy is typically more affordable than individual sessions. It may also be less intimidating for certain people. It could take longer for the results to be observed. It is crucial to seek treatment as quickly as you can if suffering from depression. Early treatment can stop the symptoms from becoming worse. Treatment can also prevent the condition from returning. Consult your physician about the best treatment for you. It is important to rule out other medical conditions prior to making the diagnosis of depression. A physical examination and blood tests may assist. The doctor will also ask you questions about your symptoms and how they affect your life. The mental health professional uses the same set of criteria, referred to as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to determine whether depression is present. Antidepressants prescribed by doctors can help by altering the chemical composition of the brain. They can be used for mild, moderate, or severe depression. It could take some time and trial and error to discover the right dosage and medicine for you. Antidepressants can trigger unpleasant side effects, however they usually improve with time. Some people suffer from severe, life-threatening depression that isn't able to be treated with medications. In those cases electroconvulsive therapy or ECT can be extremely helpful. When you undergo ECT the mild electric current flows through your brain and causes an instant seizure. It is extremely effective, however, it is not recommended as the first treatment. It is reserved for those who are not improving after trying other treatments. Light therapy A light therapy device emits bright light to counteract a lack of sunlight that can trigger seasonal affective disorder (SAD). It is typically employed in conjunction with antidepressant medication. Research suggests that light therapy is effective for both SAD and nonseasonal depression, however, it is to be most effective when it is initiated in the fall or in the early winter before symptoms begin to show, then continued until spring. Treatment takes approximately 30 minutes each morning but you can modify it to your needs. Some people experience more discomfort during the treatment process However, they also notice a rapid improvement. If you are feeling suicidal or when your symptoms get worse you should dial 911. Clinical depression symptoms include intense feelings of sadness or hopelessness, losing interest in things that once brought joy, trouble sleeping (insomnia) and fatigue, low energy, difficulties talking and thinking, weight gain or weight loss, and sometimes psychomotor agitation (sped-up speech or movements). Bipolar disorder sufferers should not try light therapy without a psychiatrist's advice as it could trigger mania. Psychological treatments, also known as talking therapies, have been proven to be effective in treating depression. Cognitive behavioral therapy (CBT) is one of the most common forms of psychotherapy. it assists you in changing unhelpful patterns of thinking and enhance your coping skills. Other psychotherapies, such as psychodynamic psychotherapy, help you examine your past experiences and examine how they might be impacting you today. Brain stimulation therapy, though less popular as a treatment for depression could be a viable option in the event that other treatments are unsuccessful. It involves sending mild electrical currents through your brain, causing short seizures that reset the balance of chemicals and reduce the symptoms. The treatment is usually applied after the patient has tried psychotherapy or medication, but it is sometimes utilized earlier in serious life-threatening depression that do not respond to medicine. Psychiatrists can also recommend lifestyle changes, such as increased physical activity and changes in sleep patterns to alleviate symptoms. They may also suggest social and family support. Some people find it helpful to talk about their feelings with family members and friends who are trustworthy, while others find it more useful to seek support from a group of friends. Vagus nerve stimulation The FDA has approved vagus nerve stimulation as a depression treatment for patients with unipolar or bipolar depression that is refractory. It is a surgically-implanted device that transmits electrical impulses through the vagus to the locus cereruleus nuclei and dorsal Raphe Nuclei of the brain stem. It is a different treatment to antidepressants or psychotherapy. The FDA recommends the use of it in conjunction with other treatment options. The device has been demonstrated to reduce depression symptoms by stimulating the locus cereruleus which is a part of the brain that regulates impulsivity. It also boosts the release of norepinephrine, dopamine and other important neurotransmitters that are believed to be responsible for depression reduction. It is important to keep in mind that only psychiatrists who have been trained are able to prescribe the device. Several studies have demonstrated that VNS increases the effectiveness of antidepressants, and could also enhance the effects of psychotherapy in treatment-resistant depression. A recent registry study found that the use of adjunctive VNS significantly improved the quality of life for depression as compared to pharmacotherapy by itself in a population of patients who were resistant to treatment. The registry is the biggest naturalistic study to date, and gives further evidence that VNS is a viable treatment for this difficult-to-treat disorder. VNS appears to act directly on the limbic system of the brain, and studies have demonstrated that it affects monoamine activity in the forebrain. For example, VNS is associated with increased gamma-aminobutryric acid (GABA) activity in the LC and with decreased noradrenergic activity in the retrosplenial cingulate. Moreover, cerebral spinal fluid (CSF) studies in epilepsy patients treated with VNS show increases of homovanillic acid (HVA) and decreases of 5-hydroxyindoleacetic acid (5-HIAA), the major metabolites of dopamine and serotonin, respectively (Ben-Menachem et al, 1995; Naritoku et al, 1995). In one study, subjects receiving VNS were found to have a correlation between deactivation in the medial prefrontal cortex, the left superior temporal gyrus and right insula. The insula also showed an active response to depression severity and the degree of activation induced by VNS increasing in time as evident by the reduction in depression symptoms. The study's authors suggest this dynamic response to depression level is consistent with the role of the insula's vicero-autonomic function and the modulation of pain.