Depression:Part II

Treating Depression:

The American Psychiatric Association estimates that 80 to 90 percent of all depression can be treated. The first step is an accurate diagnosis. Along with a physical and lab tests to rule out causes such as reduced thyroid activity, a complete psychiatric history should be taken. And because depression and other major psychiatric problems are side effects of many medications, a good work-up will also include a review of the patient's medications and any illicit drug use.

Once a diagnosis is made, the basic medications used for depression today are:
Tricyclic antidepressants such as Elavil, Tofranil, and Pamelor are prescribed for patients who are in despair, feeling helpless, and unable to feel pleasure.

Serotonin uptake inhibitors such as Prozac, Paxil, and Effexor, all prescribed for uncomplicated depression.

Monoamine Oxidase (mao) Inhibitors like Nardil and Parnate: These medications are usually used when depressive symptoms are accompanied by symptoms of an anxiety disorder.

Lithium: This is the most effective drug for manic depression. However, it can also be used to prevent recurring episodes of depression.

When one of these medications is prescribed, follow-up and continued medical supervision are critical. Blood tests and other metabolic studies are often performed on a regular basis to determine the effect of the drug on the patient. This can be a drawn-out process, because most drugs for depression don't relieve symptoms instantly. Often it takes four to six weeks for a medication to become effective.

Other forms of therapy for depression include interpersonal psychotherapy to help broken relationships, cognitive behavioral therapy to help reverse the patient's negative view of himself and the world, and traditional psychoanalysis. Electroconvulsive therapy--known as ECT or shock therapy--has been used effectively in patients who cannot tolerate the side effects of today's medications, who cannot wait for the medications to work, or who are unable to take drugs for other reasons. While controversial, ECT has proved to be a good treatment option.

Next: In-patient Treatment