About Treating Depression

Depending on the severity and course of the illness, treatment of depression usually involves antidepressant therapy, psychotherapy, or both.

Depressive illness is often recurrent, so it is important for the treating clinician to keep in mind the long-term nature of the illness when choosing the mode of treatment. People who experience one episode of depression have a 50% chance that the illness will recur, those who experience two episodes have a 70% chance, and those who experience three episodes have a 90% chance.

Despite the recurrent nature of depression, depression is a highly treatable illness. The available therapeutic options are successful in 60-80% of all patients, so patients who receive treatment have a good chance of achieving remission. In treating clinical depression, or Major Depressive Disorder (MDD), health care providers must strive to not only achieve full symptomatic remission, but also to improve the quality of life and to prevent relapse and recurrence.

Effective treatment of depression consists of three basic phases:

1. The acute phase consists of the first six to twelve weeks of treatment where the goal of treatment is to remove all the symptoms of depression until wellness is achieved.
2. Continuing treatment even after the symptoms disappear is important to prevent relapse (the return of an episode of depression). Continuation therapy typically lasts approximately twelve months past the initial treatment.
3. Finally, for individuals who have experienced multiple episodes of depression (recurrent depression), maintaining the effective dose of the medication is usually indicated. Maintenance phase treatment begins approximately one year after the start of treatment and may last as long as a lifetime. The goal of this phase is to prevent recurrence (another episode) of depression. With maintenance treatment, the chances of staying well are also extremely good.

All phases of treatment should include patient education and input, long term planning, and the selection of appropriate treatments. Ultimately, the goals of treatment are to completely remove all symptoms of depression, restore psychosocial functioning to the previous level, and to prevent relapse and recurrence.

Treatment for depression works gradually. With medicine, most depressed patients report some benefits within 3-4 weeks; psychotherapy alone often takes longer. There is a good chance that the first treatment will work; however, if the treatment is not effective after a certain amount of time, the treatment plan should be changed or adjusted.

There are many treatments to try and not every treatment works for every individual. Even after one treatment does not work for an individual, there is a very good chance that another treatment will. Finding the right medication and dosage is likely to involve a period of trial and adjustment.

[TOP]