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Clinical Depression Treatments Depression is treated by psychotherapy and medication. Medication can alleviate a variety of symptoms, but it is not an answer to the problem. Talk therapy is a type of cognitive behavioral therapy, which is focused on the identification and change of negative thoughts. Interpersonal psychotherapy is a treatment that focuses on relationships and problems which may cause depression. Other treatments, like ECT or vagus nerve stimulator are also sometimes used. Medication The treatment for depression in clinical cases is usually by psychotherapy (talk therapy) and medication. Antidepressants are the most popular medications prescribed for patients suffering from clinical depression and can also be antipsychotics or mood stabilizers. It is important to realize that these medications may take time to start working, so don't lose hope if you're not feeling better immediately. It may take a few months or more for you to start feeling better, especially if your symptoms are serious. Some people aren't able to respond to antidepressants or might experience undesirable side effects, such as weight gain, dry mouth, dizziness, or shakiness. It's important to tell your doctor of any adverse effects you experience and also to speak with the doctor about changing your dose or trying a different medication. Finding an effective medication may be a matter of trial and error. The first step in getting treatment is to schedule an appointment with your physician or mental health professional. They'll ask about your symptoms, such as when they started and how long they've been. They'll also inquire about other factors in the way of your mood, like alcohol or stress. They will probably perform an examination of your body to rule out any medical issues. A doctor can diagnose depression by examining your symptoms and medical history. They can help you to comprehend what's going on and offer advice and support. They'll also refer you an expert in mental health if they think you need it. Psychological treatments can improve depression symptoms and prevent the recurrence of depression. They include cognitive behavioral therapy (CBT) and interpersonal therapy, both of which are tested to be effective in treating depression. Both treatments involve one-on-one sessions with a trained therapist. They can be received in person or through telehealth. Other treatments for depression in clinical settings include electroconvulsive therapy (ECT) and vagus nerve stimulator. ECT involves the passing of electrical currents through your brain, affecting the function and effect of neurotransmitters to alleviate depression. Esketamine is a different option. It is FDA-approved and is for adults who aren't improving with other medications or are at the risk of suicide. Psychotherapy (talk therapy) Psychotherapy is a form of therapy for talking that can aid in treating clinical depression. Studies have shown that psychotherapy is usually more effective than medication alone. It involves speaking with an expert in mental health like a psychologist or social worker. It helps people change their negative thoughts, feelings and behaviours. Psychotherapy is available in many forms. Cognitive behavioral therapy (CBT) and interpersonal therapy are the two most popular. Talk therapy can be conducted in a one-on-one meeting with a professional, or it could be conducted in groups. Group therapy is usually less expensive than individual sessions. Some people may also find it less intimidating. However, it could take longer to see results. It is essential to seek treatment as soon as possible if you are suffering from depression. Early treatment can help prevent the symptoms from getting worse. Treatment can also prevent the condition from returning. Speak to depression treatment strategies about the best treatment for you. Before diagnosing depression, it's important to rule other medical illnesses out. A physical exam and blood tests can aid. The doctor will ask questions about your symptoms, and how they impact your life. The mental health professional will use a standard list of criteria, known as the Diagnostic and Statistical Manual of Mental Disorders or DSM-5, to determine if you suffer from depression. Prescription antidepressants may help by altering the brain's chemicals. They can be prescribed to treat mild, moderate or severe depression. It could take some time and trial and error to find the right medicine and dose for you. Antidepressants can trigger undesirable side effects, but they usually improve with time. Some people suffer from severe, life-threatening depression that isn't responding to medications. Electroconvulsive Therapy, or ECT, is very helpful in these situations. In ECT, a mild electric current flows through your brain and causes an instant seizure. It is highly effective, however, it is not recommended as the first treatment. It is usually reserved for patients who have tried other treatments but have not seen any improvement. Light therapy A light therapy device emits bright light to offset a lack of sunlight that may cause seasonal affective disorder (SAD). This is often used in conjunction with antidepressant medications. Light therapy can be effective for SAD as well as non-seasonal depression. However it is most effective when it is initiated in the fall or early winter, before symptoms start, and continues until spring. The treatment typically lasts for 30 minutes each day however, you can alter the amount of time needed. Some people may experience more discomfort while others may experience rapid improvements. If symptoms get progressively worse or you're feeling suicidal, contact 911 or your local emergency department. Clinical depression is characterized by extreme sadness or despair. Other signs include difficulty sleeping (insomnia) and fatigue or low energy, difficulty speaking and thinking and weight loss or gain, and sometimes psychomotor disturbance. Light therapy can cause mania in those with bipolar disorder. They should consult a psychiatrist before trying it. Psychological treatments, also known as talking therapies, have been proven to be beneficial for depression. Cognitive behavioral therapy is one of many kinds of psychotherapy. It helps you to modify your negative thinking patterns and improve your coping capabilities. Other psychotherapies, like psychodynamic psychotherapy, assist you to explore your past experiences and examine how they may be affecting your present. Brain stimulation therapy, while less popular as treatment for depression, can be an alternative when other treatments are unsuccessful. It involves sending small electric currents through the brain to trigger brief seizures which alter the balance of chemicals and ease your symptoms. This treatment is usually used after someone has been treated with psychotherapy and medication. However, it can be utilized earlier if the depression is life-threatening or severe and is not responding to medications. Psychiatrists may also recommend lifestyle changes, like more physical activity and sleep changes to alleviate symptoms. They may also suggest social and family support. Some people find it helpful to express their feelings to family members and trusted friends, while others prefer to seek for support from peers. Vagus nerve stimulation Vagus nerve stimulation is a depression treatment that has been approved by the FDA for use in patients suffering from refractory unipolar or bipolar depression. It is a surgically implanted device that sends impulses from the neck through the vagus nerve, which targets the locus cereruleus and dorsal raphe nuclei within the brain stem. It can be used as an alternative to psychotherapy and antidepressants. The FDA recommends that it be used in conjunction with other treatment options. The device has been proven to improve depression by stimulating the locus cereruleus. This is an area of the brain that regulates the ability to impulsively. It also boosts the release of norepinephrine, dopamine, and other neurotransmitters that are believed to be the reason for depression relief. It is important to remember that the device can only be prescribed by psychiatrists who have been trained in its use. Numerous studies have shown that VNS improves the efficacy of antidepressants and may augment the effects of psychotherapy in patients with treatment-resistant depression. A recent registry study found that adjunctive VNS significantly improved the quality of life for depression compared to pharmacotherapy alone in a sample of treatment-resistant patients. The registry is the most comprehensive naturalistic research to date, and it provides additional evidence that VNS can be a successful treatment for this difficult-to-treat disorder. VNS is believed to act directly on the limbic system of the brain, and studies have demonstrated that it influences monoamine activity in the forebrain. VNS, for example, is associated with increased gamma aminobutryric (GABA), activity in LC and decreased noradrenergic activations in the cingulate-retrosplenial cortex. 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, patients receiving VNS demonstrated a deactivation correlated with the VNS in the medial prefrontal cortex, the left superior temporal gyrus, and the right insula. Additionally, the insula showed a dynamic response to depression severity as deactivation caused by VNS increased over time as reflected by a decrease in depressive symptoms. The study's authors propose that this dynamic response to depression is consistent with the role of the insula in vicero-autonomic function and pain control.