Depression Treatment: Finding One That Works

“Well, that’s depressing” is a statement often given without a second thought. Those without depression seldom pause to contemplate the context of their words. Depression is the most common mental disorder in the United States; however, the severity is too frequently minimized. Overwhelming sadness, sullen emptiness, anxiety, irritability, sleep disturbances, and a loss of interest in activities that once brought joy are a few of the many symptoms of depression. Whether your glum mood changes with the seasons or remains unrelenting, all hope is not lost. What depression treatment is available? Are depression treatments affordable? Finding a depression treatment that works is possible. There are numerous depression treatment options proven effective. Find out more in this article. 

Depression Treatment

Depression Treatment: Antidepressants

Depression is linked to many symptoms. When asked, those with depression cannot pinpoint why they feel sad. They just do. In some cases, depression treatment can be correcting a chemical imbalance or hormones.

Serotonin, dopamine, and norepinephrine are a trio of neurotransmitters responsible for stabilizing mood. A number of complex processes in the human body work to keep neurotransmitters within normal parameters. The slightest disruption can lead to a deficiency of neurotransmitters, interfere with the neurotransmitter receptor sites, or prevent the neurotransmitters from being manufactured at all. Antidepressants are designed to combat the unfavorable effects of depression.

Depression Treatment: Selective Serotonin Reuptake Inhibitors (SSRIs)

A common depression treatment is Selective Serotonin Reuptake Inhibitors that block the reabsorption of serotonin in the brain. This drug class is referred to as selective because it primarily targets serotonin, having little influence over neurotransmitters like dopamine.

Examples of SSRIs:

• Zoloft (sertraline)
• Celexa (fluvoxamine)
• Paxil (paroxetine)
• Prozac (fluoxetine)
• Luvox (fluvoxamine)
• Lexapro (escitalopram)
• Viibryd (vilazodone)

Physicians prescribe SSRIs as depression treatment more frequently than other antidepressants, as there are fewer side effects. Still, the following side effects have been reported: sexual dysfunction, trouble sleeping, nausea, vomiting, diarrhea, headaches, dry mouth, weight gain, and dizziness.

Depression Treatment: Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Another depression treatment is the Serotonin-Norepinephrine Reuptake Inhibitors that block both the reabsorption serotonin and norepinephrine. SNRIs are the treatment of choice for the depression comorbidities, chronic pain and Chronic Fatigue Syndrome (CFS).

Examples of SNRIs:

• Cymbalta (duloxetine)
• Effexor (venlafaxine)
• Fetzima (levomilnacipran)
• Pristiq (desvenlafaxine)
• Savella (milnacipran)

Side effects include sweating, nausea, dizziness, sexual dysfunction, fatigue, constipation, insomnia, anxiety, loss of appetite, and headaches.

Depression Treatment: Tricyclic Antidepressants (TCAs)

Founded in the 1950s, tricyclic antidepressants were one of the first approved depression treatments and antidepressants. TCAs facilitate depression treatment by blocking the reabsorption of serotonin and norepinephrine. TCAs affect several other neurotransmitters. They also block alpha-adrenergic, muscarinic M1, and histamine H1 receptors (making them notably effective for depression secondary to histamine driven conditions such as Mast Cell Activation Disorders).

Examples of TCAs:

• Sinequan (doxepin)
• Elavil (amitriptyline)
• Asendin (amoxapine)
• Norpramin (desipramine)
• Surmontil (trimipramine)
• Anafranil (clomipramine)
• Vivactil (protriptyline)
• Tofranil (imipramine)

TCAs are prescribed less frequently due to the extensive side effect profile. Common side effects are dizziness, tachycardia, urinary retention, memory impairment, delirium, constipation, and dry mouth. Orthostatic hypotension, seizures, bone fractures, sexual dysfunction, increased sweating, weight gain, and irregular heartbeats have been reported too.

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Depression Treatment: Monoamine Oxidase Inhibitors (MAOIs)

Monoamine Oxidase Inhibitors are another early class of antidepressants for depression treatment. They block the activity of monoamine oxidase—an enzyme that breaks down dopamine, serotonin, and norepinephrine. Preventing their breakdown increases the amounts of neurotransmitters available for the brain to use.

Examples of MAOIs:

• Parnate (tranylcypromine)
• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Emsam (selegiline)

Newer classes of antidepressants have since replaced MAOIs because of the high incidence of food and drug interactions. MAOIs may preserve much-needed neurotransmitters, but they also impede monoamine oxidase from removing excess tyramine from the body. Tyramine is an amino acid that regulates blood pressure and MAOIs present the risk for dangerously high levels.

While taking MAOIs, consuming foods and beverages containing tyramine can induce life-threatening cardiovascular events. Foods containing tyramine include cured meats, overripe fruits, soy products, wine, aged cheese, beans, beer, sourdough bread, and sauerkraut. Other side effects of MAOIs are sexual dysfunction, postural hypotension, and weight gain.

Antidepressants To Treat Depression

Depression Treatment: Atypical Antidepressants

Atypical antidepressants are newer medications that do not fit into the SSRI, SNRI, TCA, or MAOI categories. This depression treatment alters neurotransmitter levels. The neurotransmitter(s) affected varies. Medical professionals will prescribe an atypical antidepressant to patients who are unresponsive to medications in other classes or are experiencing unwanted side effects.

Examples of Atypical Antidepressants:

• Desyrel (trazodone)
• Wellbutrin (bupropion)
• Trintellix (vortioxetine)
• Remeron (mirtazapine)

The side effect profile of atypical antidepressants depends on the medication. Common side effects include dry mouth, dizziness, lightheadedness, and constipation.

An improvement of symptoms after taking antidepressants does not necessarily mean the depression was caused directly by a chemical imbalance. For example, ibuprofen relieves a headache and Tylenol reduces a fever, but neither medication cures the underlying source of those ailments.

It is important to remember that each patient’s experience with depression is unique. An effective antidepressant cocktail requires trial and error. The chosen antidepressant for depression treatment should be up to the discretion of a mutual decision between doctor and patient. Always heed your doctor’s warnings.

Depression Treatment: Psychotherapy

Depression is an immense mental burden you need not bear alone. Intervention from a professional is critical for depression treatment. While it is not pleasant to share your inner self with a stranger, communicating with a licensed therapist can aid you in expressing thoughts, correcting behavior, and uncovering experiences that contribute to your depression.

Psychotherapy is an umbrella term for a range of counseling therapies each characterized by a different technique. Psychotherapy is beyond a casual, advice-giving conversation. Its purpose runs deeper. The foundation of any psychotherapy begins with building a respectful client-counselor relationship. Psychotherapy treats multiple mental disorders, but there are types of psychotherapy best suited for treating depression.

 Depression Treatment: Cognitive Behavioral Therapy (CBT)

Typically for cases without an underlying medical cause, Cognitive Behavioral Therapy is the preferred therapy to treat depression. CBT is a long-term psychotherapy with a central focus on behavior. The therapist and client isolate behaviors that have a negative effect on the client’s depression and then implement problem-solving skills to overcome them. CBT also has an emphasis on mood and thought associated with negative behaviors. The therapy is tailored to the individual—reconditioning the client to have positive associations with new, effective behaviors.

Depression Treatment: Psychodynamic Psychotherapy

Psychodynamic therapy targets the unconscious mental and emotional aspects of depression. Its focus is on the unconscious attempts to recognize patterns in underlying thoughts, emotions, beliefs, and experiences that influence depression. Psychodynamic psychotherapy is especially helpful for the clients with depression following a childhood trauma.

Depression Treatment: Interpersonal Therapy (IPT)

Interpersonal therapy is a short-term psychotherapy that delves into the interpersonal issues causing depression. This includes unresolved grief, family conflicts, or social problems. IPT benefits depression treatment because the therapist teaches the client to convey emotions in a healthy manner rather than ways that exacerbate depression symptoms.

Depression Treatment: Group Psychotherapy

Depression is isolating, and its vice grip pulls you away from the people you love if you let it. One way to deal with of depression treatment is group therapy. Group therapy is a form of psychotherapy that discredits the voice of depression when it says nobody else understands. The support from others offered through group psychotherapy is undoubtedly valuable for depression treatment. Group therapy has advantages like cultivating social skills, new perspectives, and solace in speaking to others with similar issues. With multiple counselors supervising the group, sufferers realize there are others who understand the lonely retreat into the darkness of depression. Together, they can discover the light.

Depression Treatment: Lifestyle Changes

Perhaps the discussion of pharmaceuticals is intimidating. Antidepressants carry an unfortunate stigma. Although successful as a depression treatment, many seek alternative therapies prior to resorting to medication or intense therapy. Per physician approval, lifestyle adjustments enhance other treatment with the potential to boost your depressed mood.

Depression Treatment: Diet

Chemical-laden processed foods are not healthy for the human body. A fast food drive-thru might fill a void for a moment, but a soda and fries hardly constitutes as brain food. The average diet consists of a plethora of foods that promote depression including but not limited to artificial sweeteners, soda, caffeinated coffee, energy drinks, alcohol, high-fat dairy products, refined cereals and pastries, candy, processed meat, and cake, donuts, and cookies made from white flour.

Never underestimate the power of a diet rich in vitamins and minerals for depression treatment. Popularity aside, there is a great deal of rationale behind the latest dietary trends like kale chips and superfood smoothies. Replacing the dietary offenders in your diet with healthier options is an asset to depression treatment. Learn more about food for depression.

Foods That Treat Depression

Complex Carbohydrates

The average clean eater frequently omits carbs from their dietary allowance. However, carbohydrates are the body’s main source of energy. Neglecting a proper intake of carbohydrates deprives the brain of the nutrients it desperately calls for during depression treatment.

The type of carbs consumed does matter. You have probably noticed dense carbohydrates like white rice and white flour make you feel sluggish, foggy and with less concentration. Contrarily, complex carbs are part of a well-balanced diet that regulate mood.

Examples of Depression Fighting Grains:

• Brown rice
• Whole wheat bread
• Buckwheat (Pseudo-grain)
• Millet
• Barely
• Oatmeal
• Quinoa

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Fruit and Vegetables (Vitamins, Minerals, and Complex Carbohydrates)

To treat depression through diet, fruits and vegetables should make up at least 50% of your plate. And no, the tomato sauce on a supreme pizza does not count. Fruits and vegetables provide vitamins and minerals, like folate, vitamin E, and B vitamins, with antidepressant effects. Fruits and vegetables are also complex carbs. Depression fighting root vegetables such as sweet potato, beetroot, and parsnips are prime examples of the latter.

Antioxidants

Cells in the human body are continuously dying off and regenerating after exposure to daily stressors. Brain cells are particularly susceptible to die off from oxidative stress. Depression complicates this regularly occurring process. To counteract cell death caused by depression, a diet rich in antioxidants is restorative. Antioxidants are a defender against cell destruction and cell aging and they encourage healthy regeneration.

Examples of Antioxidants:

• Dark chocolate
• Walnuts
• Pecans
• Carrots
• Apricots
• Broccoli
• Cantaloupe
• Collard greens
• Pumpkin
• Spinach
• Berries: Blueberries, strawberries, cranberries, raspberries, blackberries

Lean Protein

Protein is essential for the dietary treatment of depression. Various protein sources contain a chemical called tryptophan, which increases serotonin. Blood sugar levels remain consistent when receiving adequate amounts of protein—keeping the brain alert and functioning is conducive to treating mental disorders.

Examples of Lean Protein:

• Beans
• Soy products
• Peas
• Greens
• Almonds
• Turkey
• Chicken

Omega-3 Fatty Acids

Studies consistently show that healthy sources of omega-3 fatty acids improve depression symptoms. Omega-3 fatty acids have an impact on neurotransmitters pathways. They influence the central nervous system through cytokine modulation, which entails inhibiting the inflammatory mediators called cytokines.

Examples of Omega-3 Fats:

• Flax seeds
• Chia seeds
• Hemp seeds
• Brussel sprouts
• Walnuts
• Fish

Depression Treatment: Meditation

Legs crossed, arms lifted, an index finger and thumb meeting in perfect circular symmetry—meditation is generally depicted as an overdramatized ordeal filled with lots of “um’s” and strange postures. However, five to ten minutes of lying in bed or sitting in a chair are sufficient to practice meditation for depression treatment.

Meditation is a group of practices to train the mind. It involves concentrating on the awareness of breathing, a thought, mantra, or even a prayer in the present moment. As the mind wanders, the goal of meditation is to steer the mind back by abandoning the thought. The relaxing effect of meditation is revolutionary for treating depression.

Dopamine, serotonin, and norepinephrine are the basis of using meditation to treat depression. Electrophysiology revealed alterations in brain function in a study of 16 participants meditating for thirty minutes a day. The nervous system undergoes biologic changes that maintain optimal circulation to the brain and increases neurotransmitters. Meditation strengthens the functioning of telomerase, an enzyme necessary for healthy brain cells. Reconnecting with the self you thought you lost is a treasured solace in finding a depression treatment that works.

References

González-de-Olano D, Matito A, Orfao A and Escribano L. Advances in the understanding and clinical management of mastocytosis and clonal mast cell activation syndromes. F1000Research 2016, 5(F1000 Faculty Rev):2666

Hall-Flavin, D. (2016). MAOIs and diet: Is it necessary to restrict tyramine? Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/maois/faq-20058035 

Logan AC. Omega-3 fatty acids and major depression: A primer for the mental health professional. Lipids in Health and Disease. 2004;3:25.doi:10.1186/1476-511X-3-25.

Osher Y, Belmaker R. Omega-3 fatty acids in depression: a review of three studies. CNS Neurosci Ther. 2009;15:128–133. doi:10.1111/j.1755-5949.2008.00061.x.

Cheyanne Perry

Cheyanne is currently studying psychology at North Greenville University. As an avid patient advocate living with Ehlers Danlos Syndrome, she is interested in the biological processes that connect physical illness and mental health. In her spare time, she enjoys immersing herself in a good book, creating for her Etsy shop, or writing for her own blog.