The severity and type of depression dictate the treatment option available for patients. A patient diagnosed with mild depression can wait for symptoms to subside. If the symptoms persist, the patient can exercise or join a self-help group to assist in managing depression. Patients with moderate depression can join a talking therapy such as counseling and cognitive behavioral therapy (CBT). Individuals diagnosed with severe depression should seek treatment options such as antidepressants, combination therapy, and mental health teams.
There are various types of antidepressants available in the market that alleviate symptoms such as sadness, hopelessness, and mood swings. Antidepressants target the brain circuit system by modulating three vital hormones to uplift one’s mood. These chemical messengers include norepinephrine, dopamine, and serotonin. Selective serotonin reuptake inhibitors (SSRIs) include citalopram, fluoxetine, escitalopram, paroxetine, venlafaxine, duloxetine, and sertraline.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) interfere with brain circuits by modulating norepinephrine and serotonin. SNRIs in the market include duloxetine, desvenlafaxine, levomilnacipran, and venlafaxine. Both SNRIs and SSRIs increase the serotonin concentrations in the brain, thereby elevating patients’ moods. Fluoxetine can be administered to children under the legal age following the prescription of a physician.
Tricyclic antidepressants (TCAs) elevate the serotonin levels and norepinephrine in the brain, thus elevating depression patients’ moods. TCAs include imipramine and amitriptyline. Monoamine oxidase inhibitors (MAOIs) include isocarboxazid, phenelzine, and selegiline. MAOI are among the first antidepressant types developed and have close interactions with like decongestants and food such as cheese
Brain stimulation is used in severe depression that is unresponsive to conventional treatment. The therapy passes electromagnetic currents to specific areas in the brain to alleviate the manifestations of depression. For example, transcranial magnetic stimulation has become more available as an alternative option for treating depression. Other brain stimulatory therapies include electroconvulsive therapy (ECT) and transcranial direct current stimulations (TDCS).
Transcranial magnetic stimulation (TMS) is achieved by sending stimulatory signals to the prefrontal cortex nerve cells to manage moods. During a TMS therapy, an electromagnetic coil is placed on the scalp of the patient, creating a magnetic field that fires electric currents in the brain nerves. ECT is a painless and brief electric shock sent to the brain through the scalp of the patient. Brain stimulation therapies such as tDCS deliver a small current via two electrodes on the patient’s head and improve their moods.
Talking therapies are treatment options available for depression patients and include CBT, interpersonal therapy (IPT), psychodynamic psychotherapy, and counseling. Psychodynamic psychotherapy assists patients to become open about their feelings and find patterns that create the problem. Counseling aids the patient in understanding the problems they face and find solutions for them. A counselor provides guidance and solutions to patients undergoing depression.
IPT targets the relationships of the patient with others and problems that might stem from it. These problems in relationships include communication challenges and bereavement. CBT assists the patient in understanding their behavior and thoughts that might affect their actions. Furthermore, CBT uses critical past events that will shift the patients thinking, feelings and behavior, eliminating negative thoughts and elevate moods.
St John’s wort
Hypericin is also known as St John’s wort is used to treat moderate and mild depression. Like the antidepressants, patients must watch out for drug-drug interaction that can cause serious adverse effects. Patients diagnosed with depression and taking hypericin should avoid taking with anti-convulsants, contraceptives, and anticoagulants concurrently. Furthermore, lactating and pregnant women should avoid the use of hypericin.
Lithium is administered as either lithium carbonate or lithium citrate as one of the last resort medications to treating severe depression. Lithium is co-administered with other depression treatment options to improve and stabilize the mood for patients. Lithium salts should be used with care because high concentrations are toxic. Furthermore, patients on lithium salts should avoid consuming low-salt diets since they can trigger lithium toxicity.