Clinical Practice Guidelines for Treating Depression

Depression is a serious mental illness characterized by feelings of sadness, hopelessness or worthlessness that are persistent enough to disrupt an individual's well-being and ability to function in daily life. It is a common condition and typically requires medical treatment if it is to improve. Fortunately, clinical guidelines for treating depression are well-established.

Understanding Depression

• According to the National Institute of Mental Health, the most common forms of depression are major depressive disorder and dysthymic disorder (dysthymia). If you experience major depression, your symptoms are typically strong enough to severely disrupt your daily routines and disable your normal abilities to function. Although you may only experience a bout of severe depression once in your lifetime, it is likely that your symptoms will repeat at various times. If you have dysthymia, your symptoms will generally be less severe, but may still disrupt your sense of well-being or functional abilities. You may also experience occasional bouts of major depression.

  Additional forms of depression include postpartum depression,major depression in the aftermath of childbirth; seasonal affective disorder, depression associated with prolonged lack of sunlight; and psychotic depression, depression combined with hallucinations or other forms of psychosis. You may also experience depression in combination with other disorders or illnesses, including anxiety disorders and alcohol or substance abuse, as well as diabetes, stroke, cancer and a number of other common conditions.

Medications

• Even if your depression symptoms are highly disruptive, there is a good chance that medication will improve your condition. Treatment often begins with a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Examples here include sertraline (Zoloft), fluoxetine (Prozac) and citalopram (Celexa). Another treatment option is a group of medications called selective norepinephrine reuptake inhibitors (SNRIs), with examples including duloxetine (Cymbalta) and venlafaxine (Effexor). Additional medication options include monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants. Typically, these compounds produce more side effects than SSRIs or SNRIs, but this may not be true for you. Work with your doctor to find the medication that works best for you, and be aware that it may take some time before the most appropriate option is discovered.

  Be aware that antidepressant medications may actually worsen your depression symptoms and trigger suicidal thoughts or behaviors. This is especially true for adolescents and children, but also potentially applies to adults. To avoid this possibility, monitor your behavior and report any changes to your doctor as soon as they occur. Do the same if you notice these types of changes in your child.

Psycotherapy

• Psychotherapy is also an important part of depression treatment, and if your symptoms are mild or moderate, it may be preferable to medications. Depending on your needs, your doctor may recommend cognitive-behavior therapy or interpersonal therapy. In cognitive therapy, you will learn new ways of thinking and behaving to avoid worsening your depression symptoms. In interpersonal therapy, you will learn how to cope with relationship stresses that cause or worsen your symptoms.

  Consult your psychiatrist or psychotherapist to learn more about depression and its current treatment guidelines.