Treatments for Depression

The good news about depression is that you have a number of excellent treatments to choose from. More than 80% of people who get treatment for depression say that it helps them feel better.

Here’s a rundown of some of the most common approaches. Many people use a mix. For instance, you might try medicine and therapy at the same time. Some studies show that using both together is better than using either one alone.

Talk Therapy for Depression

Talking with a trained therapist is one of the best treatments for depression. Many studies show that it helps. Some people choose to be in therapy for several months to work on a few key issues. Other people prefer to stay in therapy for years, gradually working through larger problems. The choice is up to you. Here are some common types of therapy.

• Cognitive behavioral therapy helps you see how behaviors — and the way you think about things — play a role in your depression. Your therapist will help you change some of these unhealthy patterns.
• Interpersonal therapy focuses on your relationships with other people and how they affect you. Your therapist will also help you identify and change unhealthy behaviors.
• Problem solving therapy focuses on the specific problems you currently face, and on helping you find solutions to those problems.

Antidepressant Medicines

Medicines are the other key treatment for depression. There are now dozens of antidepressants that your health care provider can choose from. They include:

• SSRIs (selective serotonin reuptake inhibitors.) These common medicines include some well-known names, like Lexapro, Paxil, Prozac, and Zoloft. Side effects are generally mild. They include stomach upset, sexual problems, insomnia, dizziness, weight change, and headaches.
• Researchers have developed many types of antidepressants in recent years. These include drugs like Remeron, Wellbutrin, Cymbalta, and Effexor. Cymbalta and Effexor may also ease chronic pain in people with depression. Side effects are usually mild. They include stomach upset, sleep problems, sexual problems, dizziness, and weakness.
• Tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) were some of the first medicines used to treat depression. While they work well, they can cause serious side effects and interact with some drugs and foods. Because newer medicines work just as well, these drugs aren’t used as often anymore. But if you can’t take newer medicines for some reason, your health care provider may suggest these.

ECT (Electroconvulsive Therapy) for Depression

This is a safe and effective treatment for people with depression that is resistant to medication. It’s typically used on people who haven’t been helped by medicines or therapy.

In ECT, your doctor will use electric charges to create a controlled seizure. These seizures seem to change the chemical balance of the brain. It may sound scary. But during the procedure, you’ll be unconscious, so you won’t feel anything.

ECT tends to work very quickly. It also works well — about 80%-90% of people who receive it show improvement. The most common side effect is temporary memory loss.

You might have up to 12 sessions over a few weeks. Some people get “maintenance” therapy with ECT to prevent depression from returning.

Vagus Nerve Stimulation (VNS) for Depression

Vagus Nerve Stimulation (VNS) is a new option for people with severe, treatment-resistant depression. Approved by the FDA in 2005, it’s used only on people who haven’t been helped by at least four antidepressants.

VNS involves implanting a small electrical generator in your chest, like a pacemaker. The device is attached with wires to the vagus nerve, which runs from the neck into the brain. Once implanted, the device sends electrical pulses to the vagus nerve every few seconds. The pulses are then delivered via the vagus nerve to the area of the brain thought to regulate mood. The electrical charges may change the balance of chemicals in your brain and relieve depression.

The device must be implanted by a surgeon, but patients can usually go home the same day.

Alternative Treatments for Depression

Some people use herbs, supplements, and other alternative therapies for depression. However, none of these approaches has been proven to work. Herbs and supplements — like St. John’s wort — can have side effects and cause interactions with other medicines. Never start taking an herb or supplement without talking to your doctor first.

Other alternative treatments — like acupuncture, hypnosis, and meditation — may help some people with their symptoms. Since they have few risks, you might want to try them, provided that your health care provider says it’s OK.

Tips for Summer Depression – School’s out. It’s hot. And you’re not having any fun.

Ah, the joys of summer. The withering heat. School vacations, when your kids give you minute-to-minute updates on their boredom levels. Isn’t summer supposed to be fun and relaxing? If you’ve got summer depression, it isn’t.

For some people, summer depression has a biological cause, says Ian A. Cook, MD, the director of the Depression Research Program at UCLA. For others, the particular stresses of summer can pile up and make them feel miserable.

What makes depression in summer especially hard is that you feel like you’re supposed to be having a great time. Everyone else seems so happy splashing in the water and sweating in their lawn chairs. So why can’t you? And more importantly, what can you do to make this summer easier? Here’s what you need to know about summer depression.

Understanding Summer Depression

Why do some people feel more depressed in summer? Here’s a rundown of reasons.

• Summertime SAD. You’ve probably heard about seasonal affective disorder, or SAD, which affects about 4% to 6% of the U.S. population. SAD typically causes depression as the days get shorter and colder. But about 10% of people with SAD get it in the reverse — the onset of summer triggers their depression symptoms. Cook notes that some studies have found that in countries near the equator – like India – summer SAD is more common than winter SAD. Why do seasonal changes cause depression? Experts aren’t sure, but the longer days, and increasing heat and humidity may play a role. Specific symptoms of summer depression often include loss of appetite, trouble sleeping, weight loss, and anxiety.
• Disrupted schedules in summer. If you’ve had depression before, you probably know that having a reliable routine is often key to staving off symptoms. But during the summer, routine goes out the window – and that disruption can be stressful, Cook says. If you have children in grade school, you’re suddenly faced with the prospect of keeping them occupied all day, every day. If your kids are in college, you may suddenly find them – and all their boxes of stuff – back in the house after a nine-month absence. Vacations can disrupt your work, sleep, and eating habits – all of which can all contribute to summer depression.
• Body image issues. As the temperature climbs and the layers of clothing fall away, a lot of people feel terribly self-conscious about their bodies, says Cook. Feeling embarrassed in shorts or a bathing suit can make life awkward, not to mention hot. Since so many summertime gatherings revolve around beaches and pools, some people start avoiding social situations out of embarrassment.
• Financial worries. Summers can be expensive. There’s the vacation, of course. And if you’re a working parent, you may have to fork over a lot of money to summer camps or babysitters to keep your kids occupied while you’re on the job. The expenses can add to a feeling of summer depression.“This summer, we have worries about the economic crisis layered on top of everything else,” says Cook.  “People are feeling more financially strapped. They’re wondering, ‘If I go on vacation, will be job still be there when I get back?’”

• The heat. Lots of people relish the sweltering heat. They love baking on a beach all day. But for the people who don’t, summer heat can become truly oppressive. You may start spending every weekend hiding out in your air-conditioned bedroom, watching pay-per-view until your eyes ache. You may begin to skip your usual before-dinner walks because of the humidity. You may rely on unhealthy takeout because it’s just too stifling to cook. Any of these things can contribute to summer depression.

Tips for Coping With Summer Depression

What can help you feel better? What can you do to make this summer different? Here are some tips on taking control of summer depression.

• Get help. It’s simple. If you think you’re getting depressed, no matter what time of year, get help. Talk to a therapist, like a psychologist or social worker. Or see your doctor or a psychiatrist who can prescribe medicines. Never take the signs of depression lightly. Don’t wait them out, assuming they’ll resolve. Sometimes, what started as summer depression can turn into a longer-lasting bout of major depression, Cook tells WebMD.

  And even if your depression will resolve in September, that’s no reason to ignore it in June. We’re talking about three months of potentially avoidable misery. “A temporary depression can still be pretty awful,” says Cook. While the symptoms lift in a few months, the impact on your family and job can be permanent.

• Plan ahead. Cook says there’s one advantage to a summer depression: you know when it’s coming. June is right there on the calendar. So if you’re feeling OK in the spring, think about the specific aspects of your life that become difficult during the summer. What will help prevent summer depression? What’s the best way to take time off from work? Would signing up the kids for summer programs or camp help relieve your stress? You’ll feel a lot more in control heading into the summer if you have plans in place.
• Sleep. Vacations, summer barbecues, the short nights – they can all encourage you to stay up later than usual. But not getting enough sleep is a common trigger for depression. So make a concerted effort to get to bed on time.
• Keep up with your exercise. Many studies have found that regular physical activity can help keep depression at bay. So even if it’s getting too hot for your normal activities, find other ways to stay active and head off summer depression. Start earlier in the morning or later in the evening, when it’s not so hot. Consider fitness equipment for the cool basement. If an annual membership to a gym is too expensive, consider joining one for a couple of months just to get you through the summer.
• Don’t overdo dieting and fitness. Don’t kick off the summer with a frenzy of dieting and exercise in order to fit into last year’s bathing suit. It’s bound to make you unhappy and anxious. Instead, exercise sensibly and eat moderately. If you try an insanely restrictive diet, you probably won’t be able to keep it up. And that “failure” will just leave you more demoralized and worsen your summer depression.
• Protect yourself. Don’t let obligations drag you down. Maybe you always host the enormous family barbecue on Memorial Day or the July 4 picnic. But if you’re feeling overwhelmed, give it a pass this year. Ask another relative to host. Don’t risk pushing yourself into a summer depression just to live up to tradition.
• Think about why. If you struggle with summer depression year after year, ask yourself if there’s a reason. Do you associate summer with a difficult time in the past – the death of a loved one or the break-up of a relationship? Have you had previous bouts of depression during the summer? Without even realizing it, you may have started to associate the summer with sadness – an association that gets stronger every summer that you spend depressed. If you do have some unhappy connection with the summer, sorting it out could help you break the cycle.
• Talk to your doctor about adjusting your medication. If you’re on medicine for depression, and you find that summer – year after year – makes your depression worse, talk to your doctor about changing your dosage. Maybe he or she could up your dose in the late spring and taper it back down in the fall. It could really help head off summer depression problems, Cook says.
• Plan your vacation carefully. Before you book your plane tickets or load up your car’s roof rack for your annual summer vacation, ask yourself this: Is this what you really want? Or is it an obligation you’re fulfilling to a relative? Will it make you happy? Or will it stretch your finances, stress you out, and make you fall behind at work? Consider alternatives. Instead of taking a whole week off at once, might it be better to take off several long weekends spread out through the summer? Would taking time off but staying at home – a “staycation” – be more relaxing? Don’t get locked into a vacation that won’t feel like a vacation.

• Don’t beat yourself up. One thing that’s hard about summer depression is that you feel so out of step. Everyone else seems to be having such a swell time. You aren’t. You keep asking yourself, “What’s wrong with me?”

  Try not to think that way. “So much of our misery grows out of the gap between where we are and where we think we ought to be,” says Cook. So stop worrying about how you feel relative to other people. Stop assuming that you’re supposed to be happy just because the calendar says it’s June. Instead, concentrate on what’s triggering your summer depression and how you can overcome it.

  “Treatments do work,” says Cook. “Psychotherapy or medication can blunt the effects of a seasonal depression. Summers really don’t have to be so bad.”