Treating Depression: Would We Tolerate Complexity?
When it comes to treating depression we're confronted with a few problems. Some of these relate to the range and effectiveness of treatments available and some relate to the people on the receiving end of treatment. Depression is a complex disease to treat and some suggest it requires a more complex response than is generally available. But even if such a 'complex' treatment package were available, what is the likelihood of its success?
The more complex a treatment becomes the greater the chances are a patient will not fully adhere to it. We know this as fact as even people with the most chronic and potentially life-threatening diseases are prone to ignoring or in some way modifying their treatment to the point where it becomes ineffective.
Anyone reading these Shareposts must have been struck by the fact that an array of advice, tips and treatments for depression is on offer. Interestingly, at least to my knowledge, there is really no information to tell us the effects of more complex forms of treatment. Is this because it is perceived as impractical? Perhaps it isn't really clear how best these should cluster? So what we often find is the so-called 'well-rounded' package of treatments includes something plucked from one of three general areas. First, we have antidepressant medication. Secondly, we have psychological interventions. Thirdly, we have lifestyle. Under each of these general categories there are very many options or variations.
Treatments are often fairly limited and the vast majority are not truly tailored to individual lives and circumstances. In fairness, health services are not really set up to provide a bespoke service lasting as long as the patient needs it. If you're rich, well maybe you get a better deal, or you can at least make different choices so far as treatments are concerned.
So the situation we currently employ has a focus on diminishing the most damaging symptoms of depression. Yet we know that many of the less overt but still obvious symptoms can continue well beyond the offical number required to make a diagnosis of clinical depression. This suggests the main goal of treatment is to diminish some of the major symptoms of depression, despite the knowledge that the chances of relapse are actually quite high.
We're left with a bit of a conundrum. There certainly appears to be scope for investigating the effects of more complex treatments, but what are the limits in terms of cost and acceptability. Even with what we know today, how many people prone to depression take regular exercise and eat a well balanced diet? These are simple activities known to influence mood, yet are often passed over. Are they too much effort, or too demanding? I don't know how complex a treatment plan might have to become and no doubt this would vary from person to person. In the midst of all this there may be an irony that an overly complex treatment package could result in the lowering of mood!