Treatment of Major Depressive Disorder
Psychotherapy, medication, and electroconvulsive therapy represent the three most common methods of treating depression. If you are under 18, then psychotherapy is the treatment of choice. Electroconvulsive therapy is only used as a last resort when other treatment attempts have failed.
If your depression in more complex and chronic, then a combination of medication and psychotherapy may be most useful. In these cases, I can coordinate care with your Psychiatrist of family doctor. I recommend seeking an assessment from a mental health professional prior to starting any psychotropic medication. In addition, I recommend that you seek monitoring from a mental health professional when taking any psychotropic medication.
If you are under 18, according to the National Institute for Health and Clinical Excellence, medication should only be used in conjunction with a psychological therapy, such as Cognitive Behavioral Therapy (CBT). Successful psychotherapy appears to reduce the recurrence of depression even after it has been terminated or replaced by occasional booster sessions.
According to research, the most effective form of psychotherapy for depression is CBT, which teaches you to challenge self-defeating, but enduring ways of thinking (cognitions) and change counter-productive behaviors. Research beginning in the mid-1990s suggested that CBT performs as well or better than antidepressants if you are afflicted with moderate to severe depression. CBT is particularly beneficial in preventing relapse.
Working together, the first stage of therapy typically involves behavioral interventions (i.e., increasing social support, sleep hygeine, diet and exercise, stress management, etc.) to enhance safety and relieve symptoms. Pharmacological interventions can take 6-8 weeks to begin to provide relief.
Once we establish safety and begin to see symptoms stabilize, we can begin to identify and challenge thoughts and beliefs (i.e., thoughts of hopelessness, powerlessness, inability, etc.) that negatively influence mood. This helps to prevent future episodes and to minimize the symptoms when episodes do recur.
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