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Guidelines For Treating Depression The APA, CANMAT BAP NICE and Texas Medication Algorithm Project have released a number of guidelines for treating depression. They recommend exercise, psychotherapy and antidepressant drugs. In general, the guidelines suggest the use of CBT or an SGA before starting on medications and titrate dosages as needed. Supplementation with psychostimulants, lithium SSRIs or SNRIs or TMAPs can be beneficial in patients who are not responding to monotherapy. 1. Diagnosis A diagnosis is the first step towards treating depression. This can be done by having a conversation with a mental health professional or a doctor, as well as some forms of talk therapy. Your GP will ask about your symptoms, and how they have affected your life in the past month. They'll also want to know whether you've had any thoughts of self-harm or suicide. Iam Psychiatry will also look at your general health, family history, and lifestyle to help decide whether you have depression or another mental health issue. You must be honest and open with your doctor so they get a full picture of how you're feeling. This will make it easier for them to recognize the signs of depression. These symptoms can be used to rule out other illnesses like cancer or heart disease. Once your GP has decided that you may have depression, they'll rule out the possibility of other ailments with tests. For example, blood tests can check for thyroid issues or anemia that might be causing your depression. They will also test your blood to look for deficiencies in vitamins, alcohol and drugs that mimic depression. If your GP discovers you have depression, they'll discuss the reasons behind it and the best way to treat it. This could involve psychotherapy, or a combination of therapy and medication. Antidepressants are among the most effective medication to treat depression. They work by changing the balance of chemical substances within the brain. They can be administered either orally or via injections and can take up to several weeks before they begin to take effect. They may also cause adverse effects, such as dry mouth and constipation. 2. Medication Many people can benefit from medication. Your doctor might initially prescribe one or more antidepressants. If the initial treatment does not yield a satisfactory result your doctor might suggest you try a different medication or that you change the dose or duration at which you take it. To get the most benefits of your medication, it's essential to take it regularly. Don't stop taking your medication without doctor's consent. Based on the severity of your symptoms, you may be prescribed an antidepressant that is general in nature or an SSRI. An SSRI increases the amount of serotonin, which is a chemical found in the brain. Examples of SSRIs include citalopram (Celexa) and Escitalopram (Lexapro) and fluoxetine (Prozac). Your doctor might also prescribe a serotonin-norepinephrine reuptake inhibitor, or SNRI. SNRIs include duloxetine (Cymbalta), and venlafaxine (Effexor XR or Khedezla). Other antidepressants, such as tetracyclics, may be prescribed if a doctor believes that these medications would be more efficient than an SSRI or an SNRI. SSRIs and SNRIs are typically considered safe for use in adolescents and children. You should let your doctor know whether you suffer from any allergies or other health problems before starting treatment. Medication can trigger side effects such as stomach upset or dry mouth. Generally, these are mild and will go away on their own within two or three weeks. If you're taking medication, do not drive or operate machinery until you feel alert and clearheaded. The use of alcohol and other recreational drugs can exacerbate depression symptoms, such as insomnia or restlessness. These substances are not recommended for use because they can make depression difficult to treat. Continued use, especially for a long time can result in more serious problems. 3. Psychotherapy Psychotherapy, also known as talk therapy, can help you address issues that are contributing to your depression. This type of treatment may be long-lasting, but it has been proven effective for many people with depression. Psychotherapy can be done in a variety of settings including private therapists' offices, hospitals, clinics for psychiatry, and rehabilitation facilities. It is usually done one-on-one but group therapy is also a possibility. Your therapy therapist will discuss your thoughts, feelings and behaviors as well as your relationships with you in a confidential and secure setting. During the first few sessions, your therapist will get to know you better and recommend a treatment plan. This can include psychotherapy, medication, activity and exercises or other treatments like repetitive transcranial magnet stimulation (rTMS) or electroconvulsive therapy (ECT). Some of them are short-term and focus on specific issues. Interpersonal therapy (IPT) for instance, helps people understand underlying issues like unresolved grievances or conflicts with other people. Depression can be triggered by a range of factors, from stress and loss to unresolved traumas and abuse. These may require more intensive therapy as well as other forms of treatment. Cognitive behavioral therapy (CBT) is also referred to as cognitive restructuring, helps people to alter their thinking patterns that cause symptoms. It also helps improve the ability to cope and help them deal with the stresses and tensions of life. Dialectical behavior therapy (DBT) incorporates elements of CBT with mindfulness techniques, that help you to observe and accept your emotions. Often, psychological treatment can help with acute, moderate or severe depression in the same way that antidepressants can. It can take longer for it to be effective and not everyone responds in the same manner. It is essential to continue to attend therapy sessions and complete your homework (like journaling or meditative) between sessions. 4. Counseling Whether your depression symptoms are severe or mild, it's important to find treatment that helps. Often, that includes psychotherapy or counseling. A professional outside can change your life. It may take several therapy sessions to find one who is a good fit for you. However, it's worth the effort. There are many types of psychotherapy. However the majority of them involve talking about your issues and finding strategies to combat depression. It can also be beneficial to share your experiences with a group of others who are experiencing similar issues. Group counseling is available at medical clinics, hospitals, therapists' offices, and even on your phone through online Telehealth services. Counseling for depression is designed to change negative thoughts and behaviors that contribute to the disorder. For instance, a therapist might coach you on ways to manage stress to help improve your mood. You might be taught to recognize thoughts that are not rational and challenge preconceptions that make you feel depressed. It is possible to use EMDR to let go of painful or traumatic experiences that could be contributing to depression. Other treatments, such as cognitive behavioral therapy or behavioural activation can be used to help you identify your behavior patterns and make adjustments. For example, behavioural therapy can be useful if depression makes you withdraw from social activity. The aim is to motivate you to participate in more social activities and to identify the ways in which your actions affect your mood. In general, these strategies are utilized in conjunction with medication. Ask your doctor for a referral, or call the local mental health center in your community to locate a therapist who is certified. 5. Exercise Exercise is a proven method to prevent and treat depression. But it's rarely considered a treatment of choice as psychotherapy and medication being more popular. However, a growing body of research suggests that exercising can be as effective in treating depression as talk therapies and antidepressants, perhaps even better. In fact it's more effective than either psychotherapy or medication by itself, according to a meta-analysis involving more than 150 studies. The research found that people with depression who exercised saw their symptoms improve by an average of five points on one measure and 6.5 points on another, which is clinically important. And the results were significant regardless of whether they exercised for just an hour or so, or more than an hour per day. Exercise is also a good alternative to medication or psychotherapy, but it may not be suitable for everyone. Additionally, it comes with the benefit of keeping us physically healthy and helping to ward off other mental health problems like anxiety. Exercise isn't viewed as a stigmatizing practice like drugs or talking therapy. Exercise is available to everyone, comes with few costs and can be an empowering approach. It's still hard to study the effects of exercise on health because it is difficult for researchers to control variables such as how much people exercise normally as well as any other medications they might be taking. More research is needed to determine the best type, frequency and length of exercise for treating and combating depression. To aid patients suffering from depression, GPs are prescribing exercise as a part of their treatment plans. The 'green prescription,' is a program that aims to encourage patients to get active by contacting a fitness expert frequently via phone or face-to-face.