While depression, or major depressive disorder, is a condition that has likely existed throughout human history, depression-specific treatments are relatively new. For centuries, the medical world was not able to successfully distinguish between different kinds of mental illness. Once depression was isolated as a unique disorder, science was able to begin developing treatment options that treat typical depression symptoms. Today, there are a variety of treatments for depression that can be used in isolation or in combination with other treatments to relieve depression in patients.
Psychotherapy, a process originally developed by Sigmund Freud, is the oldest of the modern treatments for depression. This method for treating depression began in the late 1800s, around the time that depression was first recognized as a unique disorder. In general, psychotherapy refers to treating mental disorders by talking about the disorder and related problems with a medical professional. At first, health professionals believed that all depression was situational depression; in other words, all depression was the result of individuals responding to outside circumstances. Psychotherapy was aimed at helping individuals to identify those depressive factors and develop strategies to help them cope
Electroconvulsive therapy, also called electroshock therapy, was the second method to be used to treat major depressive disorder. Electroconvulsive therapy has also been used to treat a variety of other mental disorders, and was often used when no specific diagnosis had been made. Electroconvulsive therapy passes electrical current through a patient’s brain in sufficient amounts to alter the levels of neurotransmitters. The exact way in which this procedure relieves the symptoms of depression is not fully understood, but the procedure is considered to be highly effective, especially in severe cases. Despite its effectiveness, electroconvulsive therapy developed a largely negative reputation in its early years because of the high risk of negative side effects. High levels of electrical current were employed without anesthesia, and often resulted in intense confusion, significant memory loss, and even broken bones in addition to the discomfort of the procedure. Modern procedures now take place under anesthesia, and the levels of current are carefully managed to produce the greatest benefits with the fewest side effects. While temporary confusion often results, physical trauma is almost unheard of and memory loss is rare and usually temporary. Nevertheless, the relatively intense nature of electroconvulsive therapy when compared to other depression treatments means that the procedure is usually reserved for cases that have resisted other forms of treatment, or when patients are considered a significant suicide risk.
Various forms of medications have been used to treat depression since the 1950s, when it was realized that iproniazid-a medication originally used to treat tuberculosis-was able to relieve depression symptoms. There is now a wide range of depression-specific medications available to patients. These medications are classified into groups depending on the ways in which they act upon the brain to relieve depression symptoms. A combination of medication and psychotherapy is now considered to be the most effective form of depression treatment for most patients. The most widely prescribed antidepressants are selective serotonin reuptake inhibitors (SSRIs.) These medications are popular because they are considered to produce fewer short term and long-term side effects than other antidepressants. Brand-name medications in this class include Prozac, Celexa, Paxil, and Zoloft.
Patients who require hospitalization or residential treatment for their depression are likely to receive the same kinds of treatment as other patients-particularly counseling and medication. However, these patients will receive accelerated treatment such as multiple counseling sessions per day, in addition to consistent monitoring of their mental and physical health. This step may be necessary for patients who are no longer able to provide day-to-day care for themselves, or who are considered to be a danger to themselves. Medications such as SSRIs take several weeks to become effective, so 24-hour care may be necessary until the depression becomes manageable with medication.
Lifestyle changes to ease depression-particularly situation depression-can be an effective method of treatment. Typically, psychotherapy helps patients to identify factors in their lives that are contributing to their depression, such as stressful work environments, unhealthy relationships, and other stressors. Therapists can also help patients to identify possible solutions to these challenges to help them on the road to resolution and recovery.