People with a milder form of depression may benefit from psychotherapy alone, while those with more severe symptoms may get better results using antidepressants. A combination of both types of treatment is usually most helpful to people.
What is Evidence-Based Practice for Depression?
Evidence-based practice means the therapist takes three important things into consideration: their own expertise, the patient’s preferences and values, and scientific evidence to guide which treatments they use. Treatments that have research showing they are effective are called evidence-based treatments. Evidence-based treatments for major depression include:
- Cognitive Behavioral Therapy (CBT)
- Interpersonal Therapy
- Problem Solving Therapy
- Family Psychoeducation
- Assertive Community Treatment (ACT)
- Electroconvulsive Therapy (ECT)
Let’s take a look at what these treatments are and how they work.
For more information about antidepressant medications, read our post entitled Antidepressants: What You Should Know.
Cognitive Behavioral Therapy (CBT)
- Cognitive Behavioral Therapy (CBT) is a well-established treatment for people with depression that blends two types of therapies: cognitive therapy and behavioral therapy. Cognitive therapy focuses on identifying a person’s thoughts and beliefs so they can learn how those beliefs influence their mood and actions. CBT aims to change a person’s thinking to be more adaptive and healthier.
- Behavioral therapy focuses on a person’s actions and aims to change unhealthy behavior patterns.
With CBT, a person can focus on his or her current problems and how to solve them by:
- Learning how to identify and correct distorted thoughts or negative self-talk often associated with depressed feelings
- Recognizing and changing inaccurate beliefs
- Taking part in more rewarding and enjoyable activities to improve mood (behavioral activation)
- Relating to self and others in more positive ways
- Learning problem-solving skills
- Changing behaviors
Interpersonal Therapy is a short-term treatment which focuses on how depression impacts relationships, such as with family and friends. These relationships are believed to play a role in the onset of depression and in ongoing symptoms. In interpersonal therapy, the therapist and patient work together to improve one or two problems that occur in the patients’ interactions with others. The focus remains on these interpersonal problems throughout treatment. The idea is that depressive symptoms will improve if a person can make positive changes in their relationships and increase their social support.
Problem Solving Therapy
Problem Solving Therapy is a short-term, structured treatment based on the premise that problems of daily life can cause and maintain symptoms of depression. By learning to identify and work on these problems, depressive symptoms will improve. People in Problem Solving Therapy will set specific and realistic goals, and ideally gain a sense of control over their lives. This treatment is sometimes offered in primary care and community settings.
Mental illness affects the whole family. Family depression treatment can play an important role to help both the person with depression and his or her relatives. Family psychoeducation is one way families can work together towards recovery. The family and clinician meet together to discuss the problems they’re experiencing. Families also attend educational sessions where they learn basic facts about mental illness, coping skills, communication skills, problem-solving skills, and ways to work together toward recovery.
Assertive Community Treatment (ACT)
Assertive Community Treatment (ACT) is most effective for people with the greatest needs, such as a history of multiple hospitalizations. In ACT, the person receives treatment from a team of usually ten to twelve professionals. The team includes case managers, a psychiatrist, several nurses and social workers, vocational specialists, substance abuse treatment specialists, and peer specialists. The team provides coverage 24 hours a day, seven days a week, and utilizes small caseloads. There is usually one staff for every ten clients.
Services provided include case management, comprehensive treatment planning, crisis intervention, medication management, individual supportive therapy, substance abuse treatment, rehabilitation services (i.e. supported employment), and peer support.
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy (ECT) is a procedure used to treat severe or life-threatening depression. It is usually used when other treatments have not worked. It’s often given in combination with medication, psychotherapy, family therapy, and behavioral therapy.
It works by briefly sending electrical currents to the brain through electrodes placed on the head. The electrical current can last up to eight seconds, producing a short seizure. It is believed this brain stimulation helps relieve depression symptoms by altering brain chemicals, including neurotransmitters like serotonin and natural pain relievers called endorphins.
ECT depression treatment is usually done two to three times a week for two to three weeks. Maintenance treatments may be done one time each week, tapering down to one time each month. They may continue for several months to a year to reduce the risk of relapse.
Knowing the treatments available for depression can be valuable for those who are supporting a loved one through a depression diagnosis. It shows that you are invested in their well-being, and you can be a resource for your loved one when they want to talk about their options. It also helps you understand what your loved one is going through. Learning about depression, and the treatments available, is an investment in your relationship.
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