The treatment of a depression is based on two main pillars: psychotropic drugs and psychotherapy.
At the onset of a treatment, a thorough and empathic medical consultation should always take place, which will allow the physician to elaborate a therapy plan for the patient. In the case of a milder form of depression, medication and psychotherapy are usually used in about equal proportions, even though psychotherapy can sometimes prove to reach better results. In the case of a medium or stronger depression, a medication treatment is usually indicated during the initial phase. Ideally, a medication-based treatment used in combination with a psychotherapeutic follow-up should be privileged.
Treatment of depression with antidepressants
Certainly, taking antidepressants cannot fundamentally change the life of a depressive person from one day to the other. However, a medication-based treatment often constitutes the pre-condition for a patient to be able to tackle the actual problems. Indeed, when the lack of hope and motivation subsides, difficulties that had first appeared impossible to overcome now seem comparable to problems that have a more ubiquitous character and to which a solution can be found.
The standard approach is based on a combination of medical consultation or psychotherapy and antidepressants. Other therapeutic measures such as body-related therapies, physical activity, dietary change and alternative medicine can also provide an important support.
The treatment of depression can be divided in three fields:
- acute treatment
- continuing treatment
- relapse prevention
Medication-based acute treatment
In order for a treatment to be successful, it is essential to inform the doctor of all effects and side effects induced by the medication. The patient should never change the medication – or the dosage – without consulting the physician.
Generally speaking, the medication decided upon for treating a depression should also be taken over several months. A regular intake is necessary – not only when the symptoms are present – as several weeks can go by before an improvement is perceptible. The treatment can include various medications and active substances.
Since the positive effect of the medication can subside after the treatment has ended, the physician may sometimes advise taking the medication over a longer period of time.
Should a medication not bring the desired effects or cause unpleasant side effects, it is worthwhile trying a different, more compatible antidepressant.
Further treatment possibilities
In order to insure a lasting recovery, the WHO (World Health Organisation) recommends taking antidepressants for a further 6 months after the end of a depression.
The WHO recommends a preventive treatment in the following situations:
- when more than one severe episode of a depressive illness has already been diagnosed
- when one ore more episodes of a depressive illness have been diagnosed over the last 5 years
Source: Consensus Statement WHO, Journal of Affective Disorders 17, 197-8
Text: Helga Grafe 09/2015
Translation from German: MyH 06/2016