Treating major depression is a challenge, but with the right combination of approaches, it is quite possible. I provide therapy for major depression, which typically involves a combination of methods tailored to the individual’s needs. This post goes over the primary ways I treat major depressive disorder, followed by a fictitious example. Of course, every client’s needs are unique, so you may want to do other research, such as reading my therapy blog posts about my other treatment approaches, and for specific concerns such as seasonal affective disorder treatment.
If you would like to discuss your own needs or the needs of a loved one, please feel free to contact me or schedule a consultation anytime.
Methods for Treating Major Depression
The following are the basic methods used in combination to treat major depressive disorder:
Psychotherapy for Major Depression
These are the more common forms of therapy for treating major depression
– Cognitive Behavioral Therapy (CBT) focuses on identifying and changing negative thought patterns and behaviors. CBT is often the first line of treatment for major depression because it is focused and proven, and results can come quickly. I often start with cognitive-behavioral therapy while looking to mix in other techniques depending on each client’s needs and goals.
Interpersonal Therapy (IPT) addresses problems in personal relationships and social functioning. This is a good example of how I add a new method based on the individual’s unique needs when treating major depression. When it appears that social issues are either causing or maintaining the depressive state, IPT is an excellent add-on.
Dialectical Behavior Therapy (DBT) is a form of CBT that emphasizes psychosocial aspects to treat major depressive disorder. It is often used for individuals with severe symptoms. DBT is also a good add-on when social issues are involved and when a person may need more than one weekly session.
– Psychodynamic Therapy explores unconscious feelings and thoughts and how they influence current behavior. I use Psychodynamic approaches when the roots of the current depressive state reach into the past and when developing new insights into these roots may help speed treatment.
Other approaches can also be helpful, depending on what is causing your symptoms. These include existential psychotherapy and narrative therapy. In an integrated practice like mine, we will continually explore new methods and techniques that could be helpful as add-ons.
Treating Major Depression with Medications
It is a personal choice whether to pursue medication treatment, and I am happy to advise those who request it. Otherwise, I can provide information about the psychiatrists I trust to take a balanced approach. The types of medications commonly used to treat major depressive disorder include:
– Selective Serotonin Reuptake Inhibitors (SSRIs) include fluoxetine (Prozac) and sertraline (Zoloft). These are often the first ones that people try, given that doctors like that they have few side effects, have been mostly proven safe, and do what they set out to do. I cannot give specific advice or guidance about these or any medications.
– Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) include venlafaxine (Effexor) and duloxetine (Cymbalta). Many people try these if SSRIs do not work.
– Atypical Antidepressants include bupropion (Wellbutrin) and mirtazapine (Remeron). Some people respond well to these, but again, you need to consult with a doctor who can review your history and needs and give you more specific advice.
Lifestyle Modifications to Treat Major Depressive Disorder
Outside of therapy, there are many things you can do as an adjunct to address your symptoms. For example:
– Regular physical activity can improve mood and reduce symptoms of depression. While exercise may not provide a cure, it can help as part of a comprehensive and multi-faceted approach.
– Balanced nutrition supports overall mental health. This is particularly true if an unhealthy diet reduces energy and motivation.
– Socializing to a comfortable degree can help lift depressive moods, especially if you are avoiding your normal degree of going out and being with and around people.
– Maintaining a regular sleep schedule is crucial. Sleeping too much or too little can affect your mood.
Mindfulness and Relaxation Techniques
These techniques may not get to the root of the problem that is causing the depression, but some find that they address symptoms:
– Mindfulness-Based Cognitive Therapy (MBCT) combines mindfulness strategies with cognitive therapy. I like to mix mindfulness exercises to help people avoid automatic and irrational thoughts and find times of peacefulness and contentment. They also help people focus on the exceptions and extend them – the times that bring happiness.
– Meditation and Yoga can help reduce stress and improve mood. These techniques are not my specialty, but I know good apps, virtual providers, and exercises to provide interested people. Many people benefit greatly from these methods.
Treating Major Depression: Alternatives
There are some other ways of treating major depression, including:
– Light Therapy can be especially useful for Seasonal Affective Disorder (SAD). You can buy a reasonably inexpensive light to use for treating major depression at online retailers. They are easy to use
– Acupuncture can be beneficial for symptom relief. Many people have used acupuncture for a variety of mental health conditions with reported positive results. This is not an area of expertise for me.
Some noninvasive procedures use magnetic fields to stimulate nerve cells in the brain. They are often used when other treatments have failed.
New treatments are continuously being researched, including the use of ketamine and psychedelics. I stay informed about emerging therapies and am happy to discuss all your options. When an area is outside my expertise, I can refer you to someone who can help.
Therapy for Major Depression: Example
Here’s an example of how I might provide therapy for major depression. This fictitious example gives a general idea of how my practice works.
Jane is 38 and has been suffering from major depressive disorder for the past 10 years. She has tried multiple antidepressants, including SSRIs and SNRIs, without significant improvement. She has also tried cognitive behavioral therapy (CBT) with limited success.
Therapy for Major Depression: Planning
We start with a comprehensive assessment of Jane’s diagnosis, treatment history, and overall health. We’ll review what has worked and what hasn’t, as well as her current stressors and challenges. We’ll talk about her support network and daily schedule. We might discuss when she feels at her best and her worst. The end result will be a comprehensive treatment plan with meaningful, measurable, and clear goals.
Psychotherapy for Major Depression
Our major goals of this individual therapy for treatment-resistant depression are reducing Jane’s symptoms’ intensity, helping her develop coping strategies, and helping her see and tap into her strengths. We’ll combine cognitive-behavioral therapy with narrative therapy to help her develop new and more positive ways of thinking about her life and to re-write her feelings about how things will go. We’ll also use an interpersonal approach since some of her symptoms stem from concerns about her social life and self-esteem. Thus, we plan weekly sessions focusing on unconscious conflicts, negative and automatic thoughts, and current relational dynamics.
Lifestyle and Holistic Approaches
To support her overall well-being and enhance treatment efficacy, she got regular physical exercise, such as a daily 30-minute walk or yoga. I also teach mindfulness meditation practices to reduce stress and improve emotional regulation. She also made an appointment with a Nutritionist to design a balanced diet rich in omega-3 fatty acids, vitamins, and minerals.
Ongoing Therapy for Major Depression
We meet regularly and introduce new techniques and methods as needed. I sometimes measure her depressive symptoms using standardized scales such as the Beck Inventory. We will adjust the treatment plan based on her response and any emerging issues. The goal of therapy for major depression is to bring her relief, help her develop a toolkit of coping strategies, and eliminate some of what was maintaining her symptoms. This exploration might include exploring underlying emotional conflicts and how they relate to her depressive symptoms and addressing automatic negative thought patterns.
After eight weeks of this combined approach, Jane reports significant mood and daily functioning improvement. She continues with regular psychotherapy to pursue even greater improvement and to address some longer-standing issues now that the severity of her symptoms has lessened.
This multimodal approach aims to address both the biological and psychological aspects of depression, providing Jane with a comprehensive and individualized treatment plan. Jane feels she no longer needs therapy for major depression, though she is considering returning to work on some less urgent issues that may help her avoid a relapse.
Treating Major Depression in My Practice
In my integrated practice, I treat major depressive disorder, including treatment-resistant depression, using many of the same techniques I use with less severe depression and related issues such as existential crises and life transitions. Often, clients who come in with a major episode stay in treatment to work on some less severe but still meaningful issues after the depressive symptoms subside a bit. The approach I use to treat major depressive disorder involves urgency, and it is treated as a time-limited intervention to get you relief from severe symptoms.
I sometimes treat major depressive disorder with a family therapy or couples treatment approach, where others who are important to the client join in treatment at times if the client feels that this would be helpful. There are also groups I can refer you to. Treating major depression can be effective virtually or in person, and I offer both.
Questions about Treating Major Depression?
This post was designed to provide an overview and answer some general questions, but every client is unique, so you may want to learn more. If you have any questions about how I treat major depressive disorder, therapy for treatment-resistant depression, or what a therapy course might look like for you or a loved one, please feel free to contact me or schedule a consultation.
