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    Depression overview

: Treatment

The most helpful treatment is a combination of psychotherapy and medication. A medication from a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) is often prescribed first. These medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro). They are not without problems, but they are fairly easy to take and relatively safe compared with previous generations of antidepressants. SSRIs are known to cause problems with sexual functioning, some nausea, and an increase in anxiety in the early stages of treatment. Other effective antidepressants include bupropion (Wellbutrin), venlafaxine (Effexor), mirtazapine (Remeron), and duloxetine (Cymbalta). Two older classes of antidepressants, tricyclic antidepressants and monoamine oxidase inhibitors, are also still in use. They are as effective as the newer ones and can be very useful when someone has not responded well to other treatments. It usually takes at least two to six weeks of taking an antidepressant to see improvement. It may take several attempts to find the medication that works best. Once the right medication is found, it may take up to a few months to find a proper dose and for the full positive effect to be seen. Sometimes, two different antidepressants are used together. Or a mood stabilizer, such as lithium (sold under several brand names) or valproic acid (Depakene, Depakote), is added. If psychotic symptoms are present, a doctor may prescribe an antipsychotic medication. These include haloperidol (Haldol), risperidone (Risperdal), ziprasidone (Geodon), aripiprazole (Abilify), and olanzapine (Zyprexa). A number of different psychotherapy techniques have been demonstrated to be helpful, depending on the causes of the depression, the availability of family and other social support, and an individual's personal style and preference. A technique called cognitive behavioral therapy can help a depressed person recognize negative thinking and teach techniques for controlling symptoms. Other types of therapy, including psychodynamic, insight-oriented, and interpersonal psychotherapy, can help depressed people to sort out conflicts in important relationships or explore the history behind symptoms. If you suffer from depression, you will benefit from learning all you can about the illness. You can also make use of any support networks that may be available in your community. Electroconvulsive therapy (ECT) can be a lifesaving option. In ECT, an electrical impulse is applied to the person's scalp and passes through to the brain, causing a seizure. The patient is under anesthesia for the entire procedure and is monitored carefully. Medication is given before the procedure to prevent any outward signs of convulsions, which helps to prevent injury. Improvement is seen gradually over a period of days to weeks after the treatment. ECT is the quickest and most effective treatment for the most severe forms of depression, and in most people, it is not any more risky than other antidepressant treatments. Repetitive transcranial magnetic stimulation (rTMS) is another treatment for depression that is becoming more common. rTMS uses magnetic fields to alter brain function, possibly improving connections between neurons and changing how regions of the brain interact to influence mood.