Psychotherapy
This approach is based on developing a
trusting, safe and understanding environment for you to talk
through your thoughts and feelings with the help of a trained
counsellor. By
sharing your experiences either on a one to one basis or
perhaps in a group therapy session with people in a similar
situation or with similar feelings, can allow you the necessary
emotional support you need to enable you to cope. This
type of treatment lends itself well to mild and moderate
types of depression sometimes alongside medication.
Cognitive Behavioural Therapy
Sometimes negative thoughts and ideas or the way you think
about things can contribute to feelings of depression. This
type of therapy helps you to look at these in detail in order
to change the way you think about them, so that you change
your behaviour accordingly. By focussing on specific difficulties
that are happening in your life now, new ways of coping and
dealing with situations can be identified. It is particularly
helpful for anxiety related and panic disorders and disorders
affecting behaviour, for example, obsessive compulsive disorder
and eating disorders, amongst others.
Anti-depressant medication
Persistent depression may require the use of anti-depressants
for a period of time. Just like all treatments, they are
not an overnight fix and can take anything up to several
weeks for the effect of the medication to be felt, and just
like all medications they can carry side effects.
There are many kinds of anti-depressants available but the
four main types fall into the categories of:
• Tricyclics – including Anafranil
• Selective Serotonin Reuptake Inhibitors – SSRIs
like Prozac
• Serotonin and Noradrenaline Reuptake Inhibitors – SNRIs
such as Endronax
• Monoamine Oxidase Inhibitors – for example,
Manerix and Nardil
Basically, they are all believed to work
by impacting on the activity of the chemicals in the brain
responsible for making us "feel good" such as Serotonin and Noradrenaline. The
most commonly prescribed anti-depressant drugs today fall
into the SSRI category as they appear to have fewer side
effects and are considered less dangerous than the others.
Lithium Carbonate has a mood stabilising effect and is sometimes
prescribed to people with severe depression; however, it
is dangerous if the levels in the blood become too high so
constant medical checks and blood tests are a necessity.
St John's Wort is a herbal remedy that has gained a lot of
recognition in recent years for being effective in cases
of mild to moderate depression and anxiety and is already
widely used in Germany. It appears to work in much
the same way as Prozac by inhibiting the reuptake of Serotonin
in the brain.
Electro Convulsive Therapy
The National Institute for Health and Clinical Excellence
(NICE), recommend that ECT is only used "for the treatment
of severe depressive illness, a prolonged or severe episode
of mania, or catatonia" but certain conditions apply including
one that other forms of treatment have proved ineffective.
It is a controversial procedure that involves placing electrodes
on the head and administering a short electrical shock to
the brain. The person receiving ECT is given an anaesthetic
and muscle relaxants beforehand. It is usually given in twice
weekly sessions over a period of several weeks and possibly
monthly after that to prevent a relapse. The most common
and distressing side effect reported is long term and/or
short term memory loss.
Experimental Treatments
Vagal Nerve Stimulation is a treatment that is used in cases
of Epilepsy but has also been found to be effective in the
treatment of severe depression. Although still classed
as experimental, in 2005 it was approved by the FDA in the
USA for severe treatment-resistant depression. One
of the main differences with this type of treatment and others
is that it takes quite some time for the effect to be noticed,
up to a year or even two years in some cases, however, the
indications are that those receiving the treatment appear
to stay better for longer. A nerve stimulator similar
to a heart pace maker, is placed in the chest where it delivers
regular electrical impulses to the Vagal nerve in the neck,
which in turns stimulates the brain. No one really understands
why it appears to be effective or exactly how it works but
research by Dr.Charles Conway, assistant professor of psychiatry
at Saint Louis University School of Medicine, who led a four
year research project into Vagal Nerve Stimulation from 2000
to 2004, found that it appears to produce the same type of
effect in the brain as ECT, but that the effect doesn't seem
to wear off as it does with ECT. More research is required.
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