cluster of mood disorders, called "depressive disorders,"
is characterized by features such as sadness, feelings of
hopelessness and helplessness, low motivation and energy,
and diminished interest in life. The depressive disorders
include major depressive disorder (or "major depression"),
dysthymia, and depressive disorder NOS. (
depressive disorders should not be confused with another
category of mood disorders, called "bipolar disorders").
cause of depressive disorders has long been debated, but
thus far we know that there are multiple causes of depression
and no one factor is solely responsible. Although there
is recognition of a certain predisposition toward depression,
the evidence for a significant genetic contribution is weak.
A predisposition can be thought of as a kind of physical
threshold to develop a particular disorder that is set a
little lower for some individuals.
The potential for developing depression is greatly influenced
by developmental history, life events, and coping skills.
These and multiple other personal/social/environmental factors
determine whether depression breaks into the forefront,
and whether it does so strongly enough to merit a diagnosis
of a depressive disorder.
for people with depression very often involves addressing
more than one problem, as many people with depression present
with a variety of other diagnoses and conditions. Therefore,
individual treatment often encompasses a number of techniques
and treatment packages in addition to the ones described
in this section.
of Medication for Treating Depression
are several different types of medications used for depression,
including the SSRIs, TCAs, and MAOIs as well as other, newer
medications that affect the brain "chemicals"
dopamine and norepinephrine. The value of medication is
that it can help reduce a person's depressive symptoms;
thus, it can make it easier to implement various psychotherapy
principles and approaches. Some drawbacks to a medication-only
approach to treatment are that a person's problems,
their thoughts about their problems and the ways that they
commonly use to deal with these problems, still exist. Consequently,
when the medication is stopped, depressive symptoms most
often return. For these reasons, it is best that if you
do take medication for depression, you also get therapy.
of Psychotherapy for Treating Depression
as with medications, there is not one single type of therapy--there
are numerous different types. Psychotherapy treatment interventions,
just as medical interventions, must have scientific evidence
of effectiveness in reducing symptoms. Researchers develop
treatment techniques based on their theoretical understanding
of the disorder being addressed, but they do not consider
the techniques as valid until they have been shown in clinical
studies to effectively reduce symptoms. Often researchers
will compare the effectiveness of different therapy models
and techniques to determine which technique or combination
of techniques is most effective.
studies conducted at major universities and medical schools
throughout the world consistently demonstrate that cognitive-behavioral
therapy (CBT) is effective for the treatment of major depression.
Furthermore, most people who have CBT maintain their improved
mood when tested a year or more after ending therapy. In
cognitive-behavioral therapy, the goals are not only to
reduce your depressive symptoms but to keep those symptoms
from returning. Among the variations of cognitive-behavioral
therapy are models that heavily emphasize behavioral interventions,
others cognitive, while yet others combine both types of
therapies used in the treatment of depression, often in
conjunction with CBT, may include interpersonal and psychodynamic.
Interpersonal therapies focus on the client's disturbed
personal relationships that both cause and exacerbate depression.
Psychodynamic therapies focus on the client's internal conflicts
resulting from family-of-origin and/or other past experiences.