Recovery from Depression

Depression can range from mild to severe, brief episodes lasting a few days to chronic lasting over many years. For milder forms of depression, recovery can come in the form of:

  • Good self-care: diet, exercise, meditation, play
  • Social support
  • Support groups
  • Behavioral activation
  • Self-help books 

Depression and exercise

  • Extensive literature showing benefits
  • Higher energy activity & weight lifting may be superior to moderate exercise
  • Several studies show yoga can reduce depressive symptoms & lead to remission from depression
  • Consult physician if in doubt about safety of exercise

Bibliotherapy (self-help books)      

  • Can be very effective
  • Comparable to CBT provided by therapists in some studies
  • Suggestions:
    Feeling Good by Burns
    Mind Over Mood by Greenberger & Padesky
    The Mindfulness & Acceptance Workbook for Depression by Strosahl & Robinson

For more severe depression, recovery starts with good assessment from a professional:

  • Medical evaluation to rule out possible underlying causes (medical disorders, drug side effects, etc.)
  • Mental health evaluation to develop treatment plan

Goals for depression treatment:

  • Frequent contact with professional team to continuously re-evaluate and improve treatment.
  • Fostering open communication of treatment preferences.
  • Generally, (but not always) correct underlying problems causing depression first
  • Avoid worsening of symptoms (e.g. stopping substances that worsen depression)
  • Minimize (or utilize) side effects of treatment
  • Treat aggressively: Remission of all depressive symptoms is the goal because research shows that when we do this, people function better and stay better longer.

How well do treatments for depression work?

  • Unfortunately, only half of Americans experiencing an episode of major depression receive treatment
  • However for those who do, 80% -90% of people that seek treatment for depression are treated successfully using therapy and/or medication. (TAPS study)

There are several types of psychotherapy (talk therapy) that have shown to be effective for depression:

  • Most evidence:
    • Cognitive behavioral therapies (CBT): changing thoughts & behaviors
    • Interpersonal therapy (IPT): relationships, role transitions, grieving
  • Some evidence for:
    • Psychodynamic therapy: unconscious drives & defenses
    • Behavioral activation therapy
    • Problem solving therapy
    • Social skills training

Non-directive/supportive therapies are shown to be the least effective.


Medications
Although there are several classes of medications which have shown to be effective for depression, all medications carry certain, potential risks and side effects which should be thoroughly discussed with a physician before starting. Any side effects or problems experienced after starting medication for depression should be discussed with one’s physician immediately. Medications for depression generally should not be stopped abruptly without consulting the prescribing provider as significant withdrawal symptoms could occur.

Light Therapy: Different forms of light therapy (phototherapy) have also shown to effective in treating both seasonal and non-seasonally related depression.

Nutritional supplements: Omega-3 fatty acids, SAM-E and St. John’s Wort have also been shown to be effective for some with depression. Because of potential medical risks of these supplements, one should consult their physician before starting them.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Light Therapy
Different forms of light therapy (phototherapy) have also shown to effective in treating both seasonal and non-seasonally related depression.


Bibliotherapy (self-help books)      
Self-help books

  • Can be very effective
  • Comparable to CBT provided by therapists in some studies

Recommendations:
Feeling Good by Burns

Mind Over Mood by Greenberger & Padesky
The Mindfulness and Acceptance Workbook for Depression by Strosahl & Robinson

For more severe depression, recovery starts with good assessment from a professional:

  • Medical evaluation to rule out possible underlying causes (medical disorders, drug side effects, etc.)
  • Mental health evaluation to develop treatment plan

Goals for depression treatment:

  • Frequent contact with professional team to continuously re-evaluate and improve treatment.
  • Fostering open communication of treatment preferences.
  • Generally, (but not always) correct underlying problems causing depression first
  • Avoid worsening of symptoms (e.g. stopping substances that worsen depression)
  • Minimize (or utilize) side effects of treatment
  • Treat aggressively: Remission of all depressive symptoms is the goal because research shows that when we do this, people function better and stay better longer.

How well do treatments for depression work?

  • Unfortunately, only half of Americans experiencing an episode of major depression receive treatment.
  • However for those who do, 80% -90% of people that seek treatment for depression are treated successfully using therapy and/or medication. (TAPS study)

There are several types of psychotherapy (talk therapy) that have shown to be effective for depression:

Most evidence:

  • Cognitive behavioral therapies (CBT): changing thoughts & behaviors
  • Interpersonal therapy (IPT): relationships, role transitions, grieving

Some evidence for:

  • Psychodynamic therapy: unconscious drives & defenses
  • Behavioral activation therapy
  • Problem solving therapy
  • Social skills training

Non-directive/supportive therapies are least effective.

 

Nutritional supplements
Omega-3 fatty acids, SAM-E and St. John’s Wort have also been shown to be effective for some with depression. Because of potential medical risks of these supplements, one should consult their physician before starting them.

 

 

 

 

 

 

 

 

 

 

 

 

 

 


At times when depression is severe or does not respond to standard interventions, more invasive interventions may be tried:

  • Electroconvulsive Therapy (ECT)
  • Transmagnetic Stimulation(TMS)
  • Deep brain stimulation

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