Depression should not be neglected. Although about one-third of patients with depression
recover spontaneously, early intervention with professional mental health
care can help avoid the continuation of the mental suffering of depression and increase
the chances of remission. Proper early treatment will help bring about
remission of the symptoms of depression in 60% to 80% of cases. Treatment also
decreases the risk of associated physical illnesses such as stroke, heart attack, and
The main options for treating depression and bipolar disorder are antidepressant
medications, psychotherapy, including cognitive behavioral therapy, and electroconvulsive
(shock) therapy. Antidepressant drugs are often the first choice for treatment
for depression. About one-third of people get full remission, one-third improve,
and one-third, especially older people with major depressive disorder, do not
respond to initial treatment. The effects of antidepressant drugs take 4 to 8 weeks to
become evident and up to 16 weeks for a full benefit. It is often necessary to switch
between various antidepressant drugs and classes of drugs to reach the best balance
between benefits and side effects.
Recently, new therapies for depression, including transcranial direct-current
stimulation and infusion of ketamine anesthesia or ketamine analogs is being
explored. Ketamine treatment is notable in that relief is immediate but not
long-lasting, and side effects such as confusion and hallucinations are significant. A
ketamine analog, esketamine, administered with a nasal spray 1 to 2 times a week,
is effective alone and for use as an adjunct to oral antidepressants. Although esketamine
may cause short term side effects, including high blood pressure, nausea,
dissociation, vertigo, and dizziness, it has been approved by the FDA for use under
carefully controlled conditions of medical supervision.
These treatment modalities can be used alone or in any combination. Light therapy
can be used to treat the depression caused by a seasonal affective disorder (SAD).
Some research studies have shown that for mild to moderate depression, combination
therapy using both medication and psychotherapy is more effective than either
therapy alone. Combination therapy may also prevent or delay recurrences of depression.
In addition, adopting a healthy lifestyle that helps deal with stress may
help prevent depression (e.g., staying socially connected, avoiding substance misuse,
getting exercise, etc.) and may hasten recovery from depression.
This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.