This article outlines some general treatment guidelines which you may want to take into consideration when seeking treatment for depression and related mood disorders. The information below is not meant as an alternative to seeking professional help.
There are a wide variety of types of therapeutic approaches utilized for the treatment of depression. These range from cognitive behavioral therapy, to behavioral therapy, to interpersonal therapy, to rational emotive therapy, to family and psychodynamic approaches. Both individual and group modalities are commonly used, depending upon the severity of the depressive episode, the person's financial resources and the local resources which are available.
Cognitive-behavioral therapy is the most popular and commonly used therapy for depression treatment. Hundreds of research studies have been conducted which verify its safety and effectiveness in treating this disorder. Aaron T. Beck is considered the father of this technique and he has authored books and studies supporting cognitive-behavioral therapy. It consists of simple techniques which focus on the negative thought patterns, called cognitive distortions, which the depressed person may habitually use.
Therapy begins by establishing a supportive environment for the patient. Educating the patient about how depression may be caused by cognitive distortions is the next step. The types of faulty thinking are discussed (e.g., "all or nothing thinking," "misattribution of blame," "overgeneralization," etc.) and the patient is encouraged to begin noting his or her thoughts as they occur throughout the day. This is done so that the individual may understand how common and often these thoughts are occurring.
In cognitive-behavioral therapy, emphasis is placed on discussing the thoughts and the behaviors associated with depression rather than the emotions themselves. The rationale for this is that it is believed that by changing thoughts and behaviors the emotions will also change. Because of this approach, cognitive-behavioral therapy is short-term (usually under two dozen sessions) and works best for people experiencing a quite a bit of distress related to their depression. Individuals who are able to approach a problem from a unique perspective and who are more cognitively-oriented will to do best with this approach.
Interpersonal therapy is another short-term therapy used in the treatment of depression. The focus of this treatment approach is usually on an individual's social relationships and how to improve them. It is thought that good, stable social support is essential to a person's overall well-being. When relationships are unhealthy, a person suffers from this. This therapy seeks to improve a person's relationship skills, communication skills, expression of emotions, and assertiveness. It is usually conducted on an individual basis but can also be used in a group therapy setting.
Most individual approaches will emphasize the importance of the patient being actively involved in his own recovery. Patients are usually encouraged to do homework assignments between sessions. If the patient is not yet able to participate actively in therapy, then the therapist may provide a supportive environment until medication begins to improve the patient's state of mind
Psychoanalytic or psychodynamic approaches in the treatment of depression have little research to support their use at this time. Although some therapists may make use of psychodynamic theory to help conceptualize an individual's personality, there is much debate as to whether this is an effective treatment for depression.
Family or couples therapy should be considered when the individual's depression is directly affecting family relationships. Such therapy focuses on the interpersonal relationships shared among family members and seeks to ensure effective communication. The roles played by various family members in the patient's depression may be examined. Education about depression in general way may also be a part of family therapy.
Hospitalization of an individual may become necessary when it is deemed that a patient has become a danger to himself or others.
Care should be taken with regards to the hospitalization procedure. When possible, the patient's informed consent should be obtained and the patient encouraged to check him or herself in. Hospitalization is usually until the patient becomes fully stabilized and the therapeutic effects of an antidepressant begin to take hold (3 to 4 weeks).
Because suicide is the most dangerous outcome of depression, suicidal ideation should be assessed during regular intervals throughout therapy. The beginning stages of medication are especially crucial. Often, as the medication begins to take effect, they will be at higher risk for acting on suicidal impulses. Patient's should be monitored closely during the initial weeks of drug therapy.