Treatment For Major Depression

Although major depression is a serious and sometimes devastating mental illness, in most cases it can be effectively treated. Most of the patients who receive treatment for major depression are able to return to their normal lives and feelings.

The type of treatment is chosen taking into account the severity and particularities of each situation. There are three basic types of treatment for major depression:

• medication
• psychotherapy
• electroconvulsive therapy

Medication

An important factor that can lead to depression is the imbalance in serotonin, dopamine, norepinephrine and other neurotransmitters. Antidepressants are prescribed to correct these imbalances. There are four groups of antidepressants commonly used as a treatment for major depression.

Tricyclics

These antidepressants are widely used in treating major depression. They improve the patient's mood, correct sleep disorders and re-establish a normal appetite level, but require 3-4 weeks to give some results.

Tricyclics include desipramine (Norpramine), nortriptyline (Pamelor, Aventyl), amitriptyline (Elavil, Amititril, protriptyline (Vivactyl), imipramine (Imavate, Antipress,  Tofranil) and doxepine (Sinequan).

Monoamine Oxidase Inhibitors (MAOIs)

These medications are often effective for patients who do not respond to other treatments or suffer from “atypical” depression, with symptoms such as anxiety, irritability, excessive sleeping, hypochondria and phobic characteristics. They include tranylcypromine sulfate (Parnate) and phenelzine (Nardil).

Selective Serotonin Reputake Inhibitors (SSRIs)

SSRIs are a treatment for major depression that acts on serotonin. They have fewer side effects than tricyclics or MAOIs. SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), escitalopram (Lexapro) and citalopram (Celexa).

Serotonin and Norepinephrine Reputake Inhibitors (SNRIs)

SNRIs have been proved very effective for patients taking antidepressant medicines for the first time who had not responded to other treatments for major depression. They also have fewer side effects than tricycles and MAOIs. SNRIs include medicines such as Venlafaxine (Effexor).

Bupropion (Wellbutrin)

This is a newer medicine against major depression, acting on dopamine and norepinephrine. It also has fewer side effects.

Patients taking medication treatment for major depression, as well as their families, have to be cautious, especially during the first days. Energy level and the capacity to make decisions may return sooner than the mood actually improves, so there is a high risk for suicide.

Psychological Therapy
 
There are various types of psychotherapy, such as cognitive-behavioral therapy and interpersonal therapy, which have proved very efficient in dealing with depression symptoms.

However, whereas mild to moderate depression can be cured with psychotherapy alone, a treatment for major depression usually includes medication as well.

Cognitive-behavioral Therapy

This type of therapy helps changing the patient's negative thinking and behavior that leads to depression, teaching him how to change behavioral patterns that are causing their illness.

Interpersonal Therapy

This form of psychotherapy focuses on improving the patient's relationships and helping him or her adjust to new lifestyles and roles that may have caused  the depression.

Electroconvulsive Therapy

This is a highly effective depression treatment in situations where medication, psychotherapy and the two combined gave little or no results or were two slowly in reducing serious symptoms, such as suicidal thoughts or psychosis. It is also a good option for those who cannot take medications.