Sunday, February, 12, 2012

Major depression

Table of Contents

If you do not feel better with antidepressants and talk therapy, you may have treatment-resistant depression. Your doctor will often prescribe higher (but still safe) doses of an antidepressant, or a combination of medications. Lithium and thyroid hormone supplements also may be added to help the antidepressants work better.

St. John's wort is an herb sold without a prescription. It may help some people with mild depression. However, it can change the way other medicines work in your body, including antidepressants and birth control pills. Talk to your doctor before trying this herb.

CHANGES IN MEDICATIONS

Sometimes, medications that you take for another health problem can cause or worsen depression. Talk to your doctor about all the medicines you take. Your doctor may recommend changing your dose or switching to an alternative drug. Never stop taking your medications without first talkingt o your doctor.

Women being treated for depression who are pregnant or thinking about becoming pregnant should not stop taking antidepressants without first talking to their doctors.

TALK THERAPY

Talk therapy is counseling to talk about your feelings and thoughts, and help you learn how to deal with them.

Types of talk therapy include:

  • Cognitive behavioral therapy teaches you how to fight off negative thoughts. You will learn how to become more aware of your symptoms and how to spot things that make your depression worse. You'll also be taught problem-solving skills.
  • Psychotherapy can help you understand the issues that may be behind your thoughts and feelings.
  • Joining a support group of people who are sharing problems like yours can also help. Ask your therapist or doctor for a recommendation.

OTHER TREATMENTS FOR DEPRESSION

  • Electroconvulsive therapy (ECT) is the single most effective treatment for severe depression and it is generally safe. ECT may improve mood in those with severe depression or suicidal thoughts who don't get better with other treatments. It may also help treat depression in those who have psychotic symptoms.
  • Transcranial magnetic stimulation (TMS) uses pulses of energy to stimulate nerve cells in the brain that are believe to affect mood. There is some research to suggest that it can help relieve depression.
  • Light therapy may relieve depression symptoms in the winter time. However, it is usually not considered a first-line treatment.

Support Groups

You can often ease the stress of illness by joining a support group whose members share common experiences and problems.

See: Depression support group


Expectations (prognosis)

Review Date: 03/15/2011
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)