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Psychotherapy and the treatment of depression

Often, psychotherapy – or “therapy,” as it’s more often called – is the first line of defense, the first kind of treatment suggested to people suffering with depression. Psychotherapy is designed to help you find recovery from depression by giving you the opportunity to talk to a mental health professional in a safe, secure and confidential space about how to identify and work through the factors and circumstances that may have brought on and/or are triggering depression or depressive episodes. It could be that you are suffering from chemical imbalances, or you might have had prolonged negative experiences you weren’t skilled at handling and have now affected that way you function on a day to day basis. It could be that depression runs through your family tree. Psychotherapy has been beneficial for millions, over decades, because it examines your past, helps you deal with your present, and gives you the tools and skills to handle what life throws your way in the future.


If you have a chronic illness, learn how it may affect your mood and depression.


How exactly does psychotherapy help depression?


Psychotherapy is considered the gold standard for people looking for help for depression. Talk therapy for depression is beneficial because it helps you understand your emotions and helps reframe the ideas and behaviors you might be exhibiting that either contribute to your depression or are prolonging it.  


It also helps you go back and discuss any kind of life events that might have brought on your depression. It could be that you had a death in the family; are a survivor of physical, sexual or emotional abuse; have had severe financial difficulty; been the victim of harassment; or are coming out of a bad marriage. You might have experienced an unpleasant childhood, and hadn’t realized it’s been affecting you in your adulthood now. A mental health professional will help you figure out what has been weighing on you.


Learn more about your triggers, and how to identify stress and anxiety.


Through various coping techniques and skills you’ll learn in psychotherapy, you’ll be able to better solve problems and see things in a new light. You’ll be able to gain a sense of control over your feelings and behaviors, and you’ll begin to enjoy life again.


Are there different types of therapy for depression? What are they?


There are various types of therapy to help those with depression. Talk therapy includes interpersonal therapy (IPT) and cognitive behavioral therapy (CBT). Other methods include herbal medication for depression and in more severe cases, hospitalization for depression.

The good news is that there is help for depression – over time, you’ll find the one that works for you.


Interpersonal therapy (IPT)


Interpersonal therapy (IPT) is a form of depression treatment, one that focuses on you and your relationships with your friends, family, coworkers and acquaintances. Those who are experts at interpersonal therapy report that IPT is based on the idea that it’s your personal relationships that are the core of your psychological problems and emotional pain.


That said, it’s not to say that depression is caused by relationships, or events surrounding a relationship. But depression can and does create various problems of varying degrees in the relationships we keep. In IPT, you will be guided on how to communicate better, and eventually figure out what the problems are in your relationships – and in your own behavior – that might be contributing to your depression.


While IPT has been reported as being as successful and effective as antidepressants, many psychiatrists will combine medication and IPT in the treatment of depression.


How does IPT work?


Patti, 48, remembers her first interpersonal therapy session well.


“It was like an interview,” she says. “My therapist sat with me and asked me what felt like a thousand questions. I know that sounds intimidating, but it was so helpful right away. Her questions weren’t jarring – it didn’t feel intrusive or anything. But what it did, in the space of an hour, was help pinpoint where my anxiety and sadness was coming from, right now.

“By the end of the session, we identified what was bothering me – well, the tip of the iceberg, anyway – and together, we had a treatment outlined for me.”


Patti’s treatment plan included three months of weekly hour-long sessions, even though she admits to having an extra hour here and there when she felt she needed it.


“What was different about IPT was that it wasn’t about my childhood, or some deep-seated issues. We covered that, mind you – but it’s not a session where I regress and I’m six years old again. It was more about my current state. It was more ‘I’m depressed right now. I’m experiencing this problems right now. My relationships are falling apart right now.’ IPT was amazing and life-changing for me because it focused on the now, which I found infinitely easier to handle, rather than examining my rearview mirror and feeling hopeless about not being able to change those circumstances in the past.”


With her therapist, Patti was able to master skills to help her handle her difficult emotions, and enabled her to be more positive and hopeful in her daily life and activities.


Cognitive behavioral therapy (CBT)


Cognitive behavioral therapy (CBT) for depression is one of the most popular types of psychotherapy today, and one of the most successful. It’s designed in a way that your therapist can help you figure out what your negative thought patterns are, as well as your negative behaviors, and then reframe them so you respond differently – positively – when faced with stressful, challenging or frustrating circumstances and situations.


Amanda, 35, is a firm believer in CBT. But she wasn’t always.


“When I first self-diagnosed with depression – I think I was 22, 23 – I tried to tackle it on my own. I read and read everything I could, and the one treatment that kept popping up was CBT. It got to the point that I was tired of seeing the acronym and felt like it was a BS term. I couldn’t wrap my head around how something that seemed so simple could help, or even work. Like, how do you simplify someone’s sadness so much that you can tell them, ‘Hey, if you just change your actions, you can change your feelings. If you can see yourself differently, you can get rid of your depression.’”


When Amanda decided to seek professional help, she found a therapist who was compassionate, gentle, and firm – and who was also an expert on CBT methods.


“She explained that because of its popularity, the term CBT gets used a lot, and for good reason. It helps you focus and recognize how your thoughts really do impact your feelings and your behaviors. In CBT you figure out how  to experiment with new behaviors, train yourself to have new, positive thoughts, and relate to your experiences differently.


“It sounds super simple, and it is, but it’s not easy. That said, I’m a huge advocate of CBT because it works.”


As Amanda explained, your therapist will guide you through techniques and skills that you can take home with you; you can practice these new methods and master them as you move through your treatment plan and into your future.


Alternative treatments: herbal medication for depression


When self-described free spirit Sarah began to first feel symptoms of depression, she turned to her uncle, an herbalist, for help.


“In our house, we eat very clean – everything is organic, we don’t eat meat, we try to source from our garden as often as possible. I don’t judge what others choose to do; I respect everyone’s lifestyles and the way they want to live.


“Depression was a surprising diagnosis for me. I meditate; I’m mindful. I see the good in everyone and feel hopeful most of the time, no matter how sad or grave a situation might present itself to be. So when I started feeling really low, lethargic, and just generally slow… when I started crying over nothing… when I was just devastated over what should have been minute, trivial stuff, I knew I had some kind of imbalance and I needed to fix it.”


Read more about medication and depression, and how it can help you with your treatment.


These are some of the herbal medications Sarah was recommended. It’s important to note, however, that supplements such as these are not monitored or approved by the FDA in the same way that prescription medications are. It’s suggested that you do your research before choosing a supplement, always purchase from a reputable company, and if possible, seek the advice of a medical doctor to ensure that they won’t interact with any of your current medications.


DHEA. DHEA is also referred to as dehydroepiandrosterone, which is a hormone your body produces. When the levels of DHEA in your body change, you may experience symptoms of depression. Many people report that DHEA is effective and well-tolerated, but side effects can be serious and include stomach upset, high blood pressure, skin thickening, fatigue, deepening of the voice of excessive facial hair growth in women, and changes in menstrual cycle.  


5-HTP. 5-hydroxytryptophan has been said to improve serotonin levels, which is a chemical in your brain that affects and improves your mood. Some have even reported that 5-HTP helps with weight loss because it makes you feel full; others have said it helps promote sleep by increase the production of melatonin (which helps you get your shut-eye). However, side effects include diarrhea, nausea, cramping, gas, bloating, vomiting, heartburn and possible decrease in appetite. It may also contribute to or cause serotonin syndrome, which is a serious group of symptoms that occur after using serotonin drugs. These include sweating, tremors, agitation, high body temperature and diarrhea, among others.


St. John’s Wort. This widely available herbal supplement has been used for mild to moderate depression. It’s important to note that this particular supplement can interact negatively with medications like birth control pills and blood-thinning drugs. If you’re on other antidepressants, do not take St. John’s Wort.


Omega-3 fatty acids. Found in flaxseed, cold-water fish, walnuts and flax oil, as well as in some other foods, many people are turning to Omega-3 supplements as a generally safe treatment for depression symptoms. Some have reported a fishy aftertaste. Experts say that while more studies have to be done to determine whether this supplement can actually prevent or improve depression, there are considerable benefits to one’s heart health if he or she eats foods with Omega-3 fatty acids.


Hospitalization for depression


Roy was at his wit’s end. He had been watching his 17-year-old son, Nick, spiraling from the symptoms of his depression, withdrawing from his friends and family. His grades were dropping. He’d broken up with his girlfriend a few weeks before.


But one morning, troubled by the silence coming from Nick’s room, Roy decided to burst in. There, he found Nick crafting a noose out of a bed sheet – his baby boy was about to take his own life.


“I don’t know what sound came out of my mouth, but it felt like a nightmare I couldn’t wake up from,” says Roy, who still tears up when he remembers. “It was the single most frightening, sorrowful thing I’d ever experienced in my whole life. I was lucky… we were lucky… we caught him in time. What of all those parents who weren’t so lucky? Those kids who weren’t so lucky?”

Roy and his wife, Meredith, rushed their son to the hospital. Nick was in shock; he couldn’t speak. In the days after being admitted, he told his parents he didn’t even realize what was happening. It had been a haze, he said. He’d been sad and depressed, but it was almost an instantaneous decision, as opposed to a plan he’d been hatching for weeks or months.


“The hospital seemed the only place for him,” says Roy. “He needed supervision. He needed a safe place where he could be treated with as much intensity as the system could afford him. We needed him in 24 hour care until he was stabilized.”


If your symptoms are severe, and you are a danger to yourself or others, it’s suggested that you seek the help of a friend or a family member and check into the hospital. You will be evaluated by a psychiatrist and a treatment plan will be designed to meet your needs. You will likely meet with a number of mental health professionals, including doctors, social workers and other rehabilitation therapists. You will likely attend individual therapy and group therapy sessions, and will probably be prescribed medications.


Because you are checking yourself in, you can also check yourself out. However, if the hospital staff feels you are a danger to yourself or others, you may not be permitted to leave. You will be completely informed about your treatment and any tests hospital staff wishes to conduct. You can always refuse anything you feel are unnecessary or unsafe, although if your safety and the safety of those around you are at risk, hospital staff retains the right to enforce their recommendations and procedures.


No one has to know about your hospitalization. It is entirely up to you if you want to share your story with others. After you are discharged, you may be encouraged to seek treatment at an outpatient facility, or continue to check in with a therapist to make sure you stay on the road to recovery.


If you are interested in finding out more about psychotherapy and alternative forms of help for depression, visit www.hopetherapyandwellness.com

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