Clinical depression is not just a feeling of sadness that many of us experience after the loss of a loved one, divorce, loss of employment, or other type of loss. It is a physical illness that lasts for at least two weeks, and could even last for a period of months or years. Unlike sadness where a person is able to go on with their lives, clinical depression may be totally devastated and unable to go on. They feel hopeless and overwhelmed by their circumstances. For more about the symptoms and causes of this illness at How to Diagnose Clinical Depression. Since bipolar disorder also deals with depression, you may want to read How to Diagnose Bipolar Disorder and How to Treat Bipolar Disorder.

This article on How to Treat Clinical Depression will discuss and explore the many options available for treatment, such as psychotherapy, medications, and alternative therapy. While medications may help, treatment is often more successful with a combination of treatments. In some cases, medications are not even necessary. The side effects of some of these medications will be examined. It is important to get some type of treatment, however, because it will only get worse if you do not seek help.

How does psychotherapy help?

Talking to a supportive therapist can help ease some of your pain and help you get through the feelings of hopelessness you may have. Unfortunately, some people may need more than just supportive therapy. If a therapist is not well trained, therapy may go on for a long period of time without any marked improvement. If you do not change the way you look at things, depression will continue.http://www.psychologyinfo.com/depression/treatment.htm

What is cognitive therapy, and how can it help?

“First, remember that we cannot present cognitive psychotherapy in one web page, or in a few paragraphs. But, the essence of cognitive therapy is the assumption that irrational thoughts and beliefs, overgeneralization of negative events, a pessimistic outlook on life, a tendency to focus on problems and failures, and negative self assessment, as well as other cognitive distortions, promote the development of psychological problems, especially depression. Psychologists use cognitive therapy to help you identify and understand how these cognitive distortions affect your life. Cognitive therapy helps you to change, so that these issues will not rule your life. If you are feeling overburdened, that life is not working for you, and you don't know what to do next, talk to someone who can help, consult a psychologist.”http://www.psychologyinfo.com/depression/cognitive.htm

What other types of therapy might be helpful?

Behavioral therapy may be necessary to help you learn better coping skills. You may also need to learn how to solve problems, how to communicate, and how to manage stress. If you have relationship problems, you may need interpersonal therapy to learn better relationship skills.http://www.psychologyinfo.com/depression/treatment.htm

How long will therapy take?

Treatment varies. The majority of people seem to find relief and improvement with between 20 to 30 sessions. These sessions are usually an hour long and are scheduled once a week. If your depression is mild you may need fewer sessions, and if it is strong, you may need more sessions.http://www.psychologyinfo.com/depression/treatment.htm

What about Electroconvulsive therapy (ECT)?

This type of therapy passes an electrical current through the brain causing controlled seizures. This is mainly used in people with severe depression or those with a high risk for suicide that did not respond to medication. It is very effective in relieving depression. Some people will continue to have maintenance ECT treatments, some will continue on with medications, while still others will combine the two treatments. Usually six to ten treatments are involved. While the patient is under anesthesia, an electrical current is passed through the brain for a period of 20 to 90 seconds. Recovery time is approximately 5 to 10 minutes. This treatment may be done as an outpatient procedure. It does have short-term memory loss as a side effect. http://www.medicinenet.com/depression/page6.htm

Most cases of depression except for bipolar depression or severe depression may not need medication. It is not a cure and will only help to control some of the symptoms. Taking a pill will not make your problems disappear. Sometimes medication is necessary because symptoms such as lack of concentration, fatigue, or sleep and appetite problems, and may hinder your efforts to make life changes. In severe depression suicidal ideation or thoughts of death may require medication, as well as psychotherapy. The decision whether or not to take medication should be a collaborative decision between your doctor, your psychologist and you. The benefits should be considered, as well as the risks that are involved. Your medication should be supervised by your treating doctor or a psychiatrist, which would also include medications you might be taking for another illness.http://www.psychologyinfo.com/depression/treatment.htm

Antidepressants:

Though antidepressants are not a cure for depression, they may help alleviate some of the symptoms and allow them to move forward with their life and get the most out of psychotherapy. If they are in too much pain to talk to a therapist, antidepressants can help them deal with the pain and open up to therapy. The amount of relief they provide varies from individual to individual and what problems they are dealing with. The goal is to help the individual feel like they did before they became depressed.

It is important to be informed about the medications you are taking. Never self-medicate because it can be very dangerous. The management of your medications should be left to a professional to reduce risk from side effects or any complications that may occur. How long you may have to take them depends on your disorder. Some disorders require long term use, while others may be for a short period of time. How much you will need to take may depend on many factors including size, age, gender, other illnesses, diet, and habits which can affect the effect medications have. Dosages should be monitored and may have to be adjusted. Most medications take from a week to three weeks before any results are realized. If you have no change in your symptoms by the end of six weeks, medication may need to be changed. You may have to experiment with several different medications before the right one is found.http://www.psychologyinfo.com/depression/medication.htm

There are many different types of antidepressants, such as:

- Tricyclic antidepressants which are used in treating major depressions (e.g., Anafranil, Elavil, Vivactil);

- Monoamine oxidase inhibitors (MAOIs) which are used for atypical depressions like panic attacks, anxiety and phobias;

- Selective serotonin reuptake inhibitors (SSRIs) which work on the neurotransmitter serotonin (e.g., Paxil, Zoloft, and Prozac);

- Two newer antidepressants with fewer side effects which affect the neurotransmitters serotonin and norepinephrine (e.g., Effexor and Serzone); and

- Another new antidepressant Wellbutrin which affects both norepinephrine and dopamine.http://www.psychologyinfo.com/depression/medication.htm

- Tetracyclic antidepressants (TCAs) are similar in action to tricyclics, but their structure has four chemical rings. Examples of tetracyclics include maprotiline (Ludiomil) and mirtazapine (Remeron). ref> http://www.medicinenet.com/depression/page6.htm</ref>

- Stimulants such as Ritalin or Dexedrine are used mainly for depression that has been resistant to other medications. They are often used in combination of mood stabilizers, antipsychotics, or the thyroid hormone. http://www.medicinenet.com/depression/page6.htm

Side Effects of Antidepressants:

Tricyclic Antidepressants may cause side effects include drowsiness, anxiety, restlessness, complication of heart problems, dizziness, weight gain, constipation, sweating, problems with urinating, decrease in sexual desire and ability, weakness, twitching muscles, fatigue, and dry mouth. Because of these side effects, medication should be monitored by a medical doctor or a psychiatrist. Some people may not have side effects or may only experience them for a short period of time, while others experience them the entire time they are on the medication. There may also be drug interactions which need to be monitored such as thyroid medication, high blood pressure medications, birth control pills, sleeping pills, antipsychotic drugs, alcohol, tobacco, aspirin, vitamin C, and diuretics. An overdose of these tricyclics could result in death within a short time after ingestion and require immediate medical treatment. http://www.psychologyinfo.com/depression/medication.htm

SSRI Antidepressants may cause side effects such as headaches and gastrointestinal problems. Other side effects may include sleeplessness, agitation and anxiety. When switching to an MAOI, a period of two weeks to a month should elapse before taking the new medication because of problems with interaction between the two.http://www.psychologyinfo.com/depression/medication.htm

Monoamine Oxidase Inhibitors (MAOIs) may cause dizziness and rapid heartbeat. They may also interact with aged cheese, MSG, red wines, allergy medications, insulin, narcotics, and tobacco. It may take several hours for the symptoms to appear but they include elevated blood pressure, vomiting, nausea, headache, confusion, seizures, psychotic symtpoms, stroke or coma. It is important for the person to get a list of restricted foods from their doctor or pharmacist.http://www.psychologyinfo.com/depression/medication.htm

Tetracyclic Antidepressants are usually well tolerated and safe for use. However, if an overdose occurs they can cause serious disturbances of heart rhythms which can be life threatening. They can also block nerves that control the gut motion, visual focus, and production of saliva. Dry mouth, constipation, blurred vision and dizziness can also occur. People with seizure disorders or previous strokes should not take TCAs. http://www.medicinenet.com/depression/page6.htm

Stimulants are seldom used alone and are potentially addictive drugs because of the high they produce.

Special Concerns:

The elderly, pregnant women and children have special concerns when taking these medications. Collaboration with the doctor, psychiatrist and individual is extremely important. Pregnant women should not take lithium or benzodiazepines during the first trimester of pregnancy. Nursing mothers must be aware that medications could pass to their infant when breast feeding. Women taking birth control should let their doctor know, because estrogen can cause a change in the effect of the medication.http://www.psychologyinfo.com/depression/medication.htm

Some of the major problems with antidepressant medication are:

- They do not correct the behaviors that contribute to depression;
- They only reduce symptoms instead of helping the body to rectify disorders;
- Severe side effects can create major problems; and
- There are some people drugs cannot help.

There are many natural techniques that can help to eliminate depression. You can get back your “feel good factor”. Here are a few of them.

Brainswitching uses mental exercises to switch depression from the subcortex, which is the emotional part of the brain, to the neocortex, which has no capacity for depression. Try this exercise: When you are feeling down or feel depression setting in, start thinking positive thoughts and get your mind concentrated on something else. Instead of sending depressive thoughts to your subcortex, you will block them with positive thoughts. “This technique will increase the neuronal activity in the neocortex and decrease it in the subcortex, thus correcting the chemical imbalance that feeds depression.”http://depressiontreatmenthelp.org/

Omega-3 fatty acids help to overcome depression because they help with the connection of neurons in the brain. Eating foods with Omega-3 fatty acids two or three times a week help to significantly reduce thoughts of depression or hostility. They also help with other illnesses such as arthritis, ADHD, diabetes and high blood pressure.”http://depressiontreatmenthelp.org/

Aerobic exercise for a half an hour three times a week can help to relieve stress. It also helps with memory and thought processing. When jogging, endorphins are released which can elevate your mood. It also helps your brain release more serotonin. Low levels of serotonin are often found in people suffering from clinical depression. Exercise increases neurogenesis the same way antidepressant medications do.http://depressiontreatmenthelp.org/

Sleep patterns that are improper can cause depression or be the result of depression. Our body needs to produce serotonin to keep up our energy in the daytime and it needs melatonin to help up sleep at night. If our body clock or Circadian Rhythm starts producing the wrong hormone at the wrong time, this can cause a disruption in our moods and has been tied to depression. In order to fix our body clock, we need to go out in the sunlight at least 30 minutes per day, eliminate activities before bedtime that increase our adrenaline, go to bed at the same time each night, and have a dedicated room for sleeping. “Incorporating these natural steps in your daily life will not only help you overcome depression but also improve the general quality of your life.”http://depressiontreatmenthelp.org/

The content on this page is for information purposes only and is not a substitute for professional medical advice. Speak with a qualified heath care professional to ensure that you have the most accurate information regarding any mental health diagnosis.