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Medical treatment
Moderate and severe depression patients, especially if they are thinking of harming themselves or committing suicide, need to consider medication.
Tricyclic Antidepressants: Antidepressants work by blocking the reabsorption of serotonin, allowing serotonin to keep releasing and binding to receptor sites again and again, which release hormones that have mood-lifting effects and increase motivation. To prevent addiction, it takes several days or weeks for antidepressants to work, followed by four or nine months of continuation treatment. The period of medical treatment depends on the symptoms and risks of another depressive episode. After the first few weeks of antidepressant intake, possible side effects of antidepressants include a dry mouth, headaches, decreased sex drive, and feeling faint and restlessness arises. Different people react differently to medication, so the doctor adjusts the dose and treatment if necessary. Toward the end of the treatment, the doses were reduced. When people stop taking antidepressants, they have trouble sleeping and feel restless. As a reminder, stopping taking antidepressants without a doctor's consultation increases the risk of depression returning.
Herbal product: Herbal medicines are used to treat mild depression, St John's Wort (Hypericum perforatum L.) has been shown to influence the reuptake of neurotransmitters, such as norepinephrine, dopamine, and serotonin. It is important to consult a doctor before taking St. John’s wort as there are a wide variety of products on the market, with different extract ingredients and doses.
Psychotherapy
Cognitive behavioral therapy (CBT): CBT breaks down depression's psychological symptoms such as continual self-doubt and feeling of guilt by utilizing cognitive therapy (CT) and behavioral therapy (BT). CT is based on the idea that challenges are not caused by things but by cognitive vulnerability and personality vulnerability, which is the importance that people attach to them. So changing the way people see things can be an important step. BT is to identify destructive patterns of behavior and work at them and change them. CBT lets the patients be aware of their own thoughts, attitudes, and expectations, making it possible to identify false and change them.
Psychoanalytic approaches: Psychoanalytic approaches include analytical psychotherapy and methods based on depth psychology, depending on acute negative life events that are unresolved. The aim is to identify and work through it by talking to a therapist.
Systemic therapy: Systemic therapy improves interpersonal vulnerability, in terms of relationships between family, friends, or work. These relationships can play a vital role in the cause or impacts of depression as mentioned previously. The therapy tries to improve communication with others, embracing the patient to fit in the society, forming a more social bond and social reward.
Physiotherapy
Relaxation techniques and yoga: Evidence has shown that progressive muscle relaxation, autogenic training, muscle therapy, and yoga, etc relaxation techniques can relieve non-mild to moderate depression. But there isn’t effective research proving the neurology behind it.
Sport and exercise: Nordic walking, jogging, cycling, swimming, or hiking are recommended for the relief of depression. Exercise reduces the stress hormone cortisol and pumps the release of dopamine and endorphins that regulate our mood. Yet, little research has shown a clear relationship between physical activity and the impact of depression.
Light therapy: Light therapy, known as phototherapy, is used to treat the seasonal affective disorder (SAD), which is a depression that affects patients during months without sunlight. In circumstances of shortage of natural bright daylight, Light therapy involves sitting in front of artificial light for about half an hour every morning.
Sleep deprivation therapy This treatment involves temporarily depriving the patient of sleep by staying awake for a whole night, and going to sleep the following night, as mentioned in physical symptoms, sleep deprivation may prompt the production of serotonin and dopamine. Sleep deprivation therapy only aims to improve the symptoms temporarily.
Electroconvulsive therapy (ECT): Electroconvulsive therapy is carried out in a hospital. Electrodes are placed on the patient’s head and a short burst of electric current is passed through the brain, inducing a seizure. The patient can’t feel anything because the procedure is carried out under general anesthesia. Electroconvulsive therapy is only considered for people with severe depression if other treatments haven't helped and need permission from a counseled doctor. ECT brings about neuroplastic changes at synapses (synaptogenesis) and neurons (neurogenesis), improving the connection between neurons, and prompting the binding of neurotransmitters. Also, ECT increases BDNF levels, a brain-derived neurotrophic factor, that plays an important role in the maintenance and survival of neurons.
