Guide

Yes. Depression can almost always be cured if detected, diagnosed and treated in time. However, one needs to be careful because it can recur. Depression is a serious and complex illness. It cannot be wished away by the depressed person. It requires the attention of a professional who may recommend different medicines and therapies. Once again a word of caution. While we mention below some of the drugs that are used in treating depression, you should not attempt any self-medication nor try to procure them from some source and administer them to someone who has been diagnosed as depressed. Follow the advice of your doctor/specialist/ therapist who will have drawn-up a special plan for your recovery.

Role of Doctor / Specialist / Medicines

On completion of the diagnosis, the specialist, either a physician / psychiatrist / psychologist / counsellor etc. will draw up a plan for complete recovery. They may recommend a brief period of hospitalisation, psychotherapy and counselling. Treatment of depression also includes medication to aid faster recovery.

Tricyclic Antidepressants :

This type of drug acts by increasing the availability of the chemical messengers norepinephrine and serotonin in the brain. This class of drugs was discovered in 1950s. The popular drugs in this category are amitriptyline, imipramine and dothiepin.

Selective Serotonin Reuptake Inhibitors (SSRIs) :

The medicines that fall in this category are a relatively newer discovery. The SSRIs act to increase serotonin levels at the gaps between the brain cells (synapses) by reducing the level of its reuptake. This results in more serotonin being made available for the nerve impulse transmission in the brain. The effect of the SSRIs is mainly on the serotonin and not on the norepinephrine or other neuro-transmitters like in the case of tricyclics.

Monoamine Oxidase Inhibitors (MAOIs) :

These drugs are not very commonly used because of their serious side-effects. Generally they are used in treating depression with less common features like phobias. It is believed that the MAOIs work by inhibiting the enzyme monoamine oxidase. This monoamine oxidase is responsible for breaking down monoamines like serotonin and norepinephrine in the cells. The result is that enough neuro-transmitter is then available to restore mood and lift depression.

Hospitalisation :

Generally hospitalisation is recommended at the start of the therapy. This is to prevent any bodily harm either to self or to others. Besides, hospitalisation provides an opportunity for the doctor to closely monitor the patients response to drugs and adjust the doses.

Besides these medicines and hospitalisation treatment of depression may also
include some of the following:

Electro Convulsive Therapy (ECT) :

In few cases, where depression deepens despite medicines and psychotherapy, a person may be administered electrical shocks. Today this therapy is not as crude as it was in the past. Following ECT, the depressed person may be continued on medications and psychotherapy.

Psychotherapy or Talk Therapy :

• Cognitive Behavioural Therapy: The therapist helps a person recognise ones own negative thought patterns and helps replace them with positive thoughts.
• Interpersonal Therapy: Here the therapist helps the depressed person review their interaction with other people and help bring about a change so that they can deal with other people and/or situations more effectively.
• Psychodynamic Therapy: In this the therapist helps the depressed person look within to uncover and understand the emotional conflicts that may be the cause of depression. This is a long-term therapy and involves seeking solutions for unresolved problems from childhood.

Relatives and friends play a very important role in a depressed persons return to normalcy. After correct diagnosis and initiation of appropriate therapy, the depressed person needs encouragement to continue with the treatment. It is a long term therapy so if there is no substantial difference then it may be necessary to seek alternate treatment till there is improvement in the condition. It also involves taking appointments with the therapist, accompanying the depressed person to the sessions, monitor the intake of medicines etc.

Relatives and friends are also called upon to offer emotional support and companionship. Though care must be exercised to avoid building up of any unnecessary dependence. This involves mature understanding, patience and affection. The depressed person should be offered hope. The depressed person may make remarks about the futility of continuing to live and may express desire to commit suicide. Such statements should be taken seriously and reported to the therapist as soon as possible.

The depressed person needs to be taken out of the 'depressing' ambience. They should be invited to participate in joyful activities, go to movies, long walks etc. It is quite likely that such invitations may meet with refusals. Nevertheless, with gentle insistence and persuasion they may relent. Depressed people need to once again get involved in activities that were known to be of interest to them. Hobbies, sports, cultural or religious functions. The depressed person needs company. But making too many demands on the person can increase their feeling of failure.

Avoid accusing the depressed person of either faking the illness or of laziness. Certainly do not expect the depressed person to snap out of the illness. Eventually with proper care, treatment, medicines, warmth, emotional support and understanding from friends and relatives, a depressed person will come out of it and return to a normal life.

Role of alternate therapies

There are many alternate therapies that are being advocated for the treatment of depression with varied degrees of success-claims. These processes help in recovery but are not curative. Not all of them have been put to proper rigorous scientific tests. It is firmly advised that any of these therapies be attempted only under professional supervision.

Aroma Therapy :

In this kind of alternate therapy, essential oils extracted from flowers, fruits, roots, plants, are used for their healing properties. The aroma therapist selects the oils according to the physical and emotional state of the patient. Essential oils may be blended with other oils and massaged into the skin or mixed with bath water. Sometimes patients may be instructed to inhale them.

It is believed that Lavender oil has a calming effect while neroli is considered good for the mood. However care must be exercised as some of these essential oils can give allergic reactions.

Music Therapy :

This is based on the belief that music has the ability to change moods and arouse emotions. Therefore with the careful selection of music, the therapist (who is greatly aided by the patient) selects the appropriate music to bring back pleasant memories of the past. The therapy may involve singing, playing of musical instruments or just listening to it.

Relaxation Therapy - Yoga

The origins of yoga go back to antiquity. The men who devised such techniques have been described as scientists. Their study covered the detailed working of the body and mind. They set out to find ways of gaining voluntary control over most of the bodily functions. Both, voluntary as well as involuntary. They devised exercises to influence not only the physiological processes such as metabolism, digestion, elimination, respiration, circulation, the functioning of the glands and the nervous system but also the very quality and the level of consciousness itself.