Recent Developments in Depression Treatments

Depression cure involves a multidimensional approach since numerous factors are responsible for it. Initially depression was not recognized overtly but it was attributed to other-worldly phenomenon. In ancient societies it was primarily associated with religion and magic. People tended to find theological explanations for the symptoms of depression. In the absence of concrete evidence and knowledge, majority of the people believed in those explanations.

After the emergence of psychology there was a paradigm shift and people found a more scientific and objective explanation of the above phenomena. Psychological roots of depression were uncovered. People started to understand the actual cause behind depression. But curing depression was a major challenge until early twentieth century.

Recently there are two primary modes of treatment available namely – Medication and Psychotherapy. Apart from these two, significant changes in lifestyle also serve the purpose to a great extent. The combination of the above two therapies with influential changes in lifestyle produces beneficial results. Now let us consider the above therapies comprehensively.

1. Medication: - Until recently biological basis of depression has been nullified but recent developments of MRIs, CT Scan and other technical advancements have highlighted the importance of biological roots in causing depression.

1. Psychotherapy: - Sometimes hospitalization is also employed to reduce the risk of any future damage. Partial hospitalization, in which an individual sleeps at his home but spends most of his time in hospital, is also employed depending upon the complexity of situation.

Medication usually provides symptomatic relief to the patient. Classical first line therapy involves the use of “Selective Serotonin Reuptake inhibitors (SSRIs)” such as “citalopram, Sertraline, Paroxetine and Fluoxetine”.

a)      SSRIsand- It is a family of antidepressants which is used to work by checking the reuptake of neurotransmitter serotonin by the presynaptic nerve. The drugs belonging to this family has fewer side effects than other drugs like tricyclics or MAOIs.

b)      Serotorin :- Norepinephrine   Reuptake inhibitors (SNRIs) :- This includes drugs like venlafaxine and duloxefine. It affects both norepinephrine and 5-HT.

c)      Norepinephrine   Reuptake inhibitors (NRIs) ;- This family of drugs influences concentration and motivation in a positive manner e.g. Reboxetive.

d)     Noradrenergic and Specific Serotonergic Antidepressants (NASSAs);- These drugs block presynaptic alpha-2 receptors thereby increasing the Serotonin and Norepinephrine neurotransmission. Moreover it also minimizes the Serotonin induced side effects.

e)        Tricyclic Antidepressants (TCAs):- TCAs blocks the reuptake of Serotonin and norephinephrine. This is the oldest drug family for the treatment of depression. Several side effects are accompanied to it but its potency is also very high facilitating in severe cases. Amitrrjptyline and Desipramine are some common examples.

f)       Monoamine Oxidase Inhibitor (MAOIs):- Only used when other medication is ineffective as it may be dangerous with certain fooditems e.g. Phenelzine.

g)      Psychotherapy:   Psychotherapy includes an extremely wide range of procedures and techniques which are as effective as medication.

The important psychotherapies are as follows:-

a)       Psychodynamic Therapies: These therapies define mental disorders arising basically due to hidden conflicts. It can be further classified into two classes:-

i)  Classical Psychoanalysis: In this method a ‘free association’ by patient helps the psychologist to pick out the hidden desires and eradicate them accordingly.

ii) Modern Psychodynamic Therapy: This thereby considers interpersonal relationship as a main cause of depression instead of inner conflicts.

b) Experiential Therapies: It primarily emphasized on the improper environmental setting as a cause for depression. This involves the following therapies:-

i)        Client-Centered Therapy: Provides unconditional positive regard to the patient.

ii)  Gestalt Therapy: Clients express themselves through games.

iii) Humanistic Therapy:  Considers a positive outlook of patient and nullifies the fact of constant inner conflicts.

1. Changes in Lifestyle: Required changes in lifestyle also provide a great help to the patient to recover from depression. Development of positive attitude and an attractive outlook itself degasify the depressed Psychological state.

Hence depression can be effectively treated at any stage by using a combination of the above therapies.