Biology 103
2003 Second Paper
On Serendip

Clinical depression is a disease that involves feelings of sadness lasting for longer than two weeks and is often accompanied by a loss of interest in life, hopelessness, and decreased energy. (3) Depression affects 340 million people in the world today. One in every 4 women and one in every 10 men develop depression during their lifetime. About half the cases of depression are untreated and about 10 to 15 percent of all depressed people commit suicide. (4) There are many different types of depression including major depression, Bipolar Disorder, Dysthymia, and Seasonal Affective Disorder (SAD), and there are different degrees of depression ranging from less severe to major severe. (3) There are various ways to treat depression, but what most people do not know is that depression is one of the most treatable mental illnesses.

There are a variety of drugs called antidepressants which help to increase certain neurotransmitters in your brain. There are also various types of counseling, psychotherapy, self-help techniques, and alternative therapies to help a person overcome
depression. In many cases, doctors combine different forms of therapies and treatments to produce the best result in depression cases. (1) The most widely used therapy today is antidepressants. Antidepressants are usually divided into three categories: Selective Serotonin Reuptake Inhibitors (SSRI), Tricyclic Antidepressants (TCA), and Monoamine Oxidase Inhibitors (MOAI). (1) SSRIs raise the level of serotonin in the brain because low levels of this neurotransmitter have been connected to depression. TCAs increase the level of norepinephrine in the brain. MOAIs increase the levels of epinephrine, norepinephrine, and serotonin in the brain.(1)

Another form of treatment for depression is psychotherapy. In some cases, psychotherapy can be just as effective as medication and antidepressants. There are many types of psychotherapy such as psychiatry, counseling, or cognitive behavior therapy. (2) Counseling is used to help a person understand his or her feelings and to help them deal with these feelings. Counseling can be different depending on each person's needs. There is individual counseling, group therapy, or therapy with a partner or relation. Counselors ask patients where these feelings came from, what brought them on, and together they explore options on how to overcome the feelings of sadness. Ultimately, counseling is a way for people to take a more positive, satisfying view on their own lives.(2)

There is also cognitive behavior therapy, which recognizes that a patient's self-criticism and self-disparaging thoughts are what lead them to depression. Cognitive therapy seeks to correct these negative thoughts and replace them with positive ones in order to overcome feelings of hopelessness and dejection.(5) Scientific studies show that cognitive behavior therapy is hopeful in its results. However, recent research shows that pharmacotherapy works better than cognitive behavior therapy in moderately to severely depressed patients.(5) Critics of pharmacotherapy claim that antidepressants remove the feelings of depression in a person but fail to get rid of the underlying problems behind those feelings. However,supporters of pharmacotherapy claim that the negative thoughts of a depressed person are the result of major depression and not the cause.(5)

There are other over the counter medications that are available to depressed people, such as St. John's Wort and S-adenosylmethionine (SAM-e). St. John's Wort is an herbal remedy which has reported to be effective in many depression cases in Europe. It is only used to treat mild to moderate cases of depression and can not be used to treat any form of major depression.(1) It has a few side effects so it can not be taken with other forms of prescription antidepressants. SAM-e is a natural component of living cells whose formula is derived from yeast. It is said to have very few side effects, but its effectiveness is controversial.(3)

Electroconvulsive therapy is an older form of therapy developed in the 1930s to treat a large variety of mental disorders. It sends tiny electric charges into the brain to stimulate the neurotransmitters in the brain. It is less frequently used now because of the permanent side effects which include sleep problems, memory loss, confusion, and sometimes brain damage.(1) However, for patients with sever depression or who do not respond to other forms of medication, electroconvulsive therapy is still an option. Phototherapy is another alternative for patients with Seasonal Affective Disorder (SAD). It is the exposure to natural sunlight that the patient lacks, therefore phototherapy creates a way for artificial light to enter the patient's eyes. A light box is set up with full spectrum bulbs that create between 2000 and 1000 lux, and the patient sits within 3 feet of the box for 30 to 60 minutes every morning. (3)

Another les intense treatment for depression is activity and exercise. Doctors believe that regular aerobic exercise stimulates the body's natural release of endorphins, chemicals that make you feel happy and self-satisfied. Walking, running, bicycling, swimming, or any other activity done for 20 minutes at least 3 times a week is shown to improve a person's confidence. Sometimes, becoming physically fit can have beneficial effects on a person's emotional well-being. (3)

While each therapy works differently person, most doctors suggest the combination of therapies to overcome depression. Most patients take a combination of antidepressant medication and psychotherapy. There was a research study done by doctors from the University of Nevada School of Medicine and Reno Veterans and a psychologist from the Clevland Clinic Foundation. (6) They studied the effects of different treatments on depression and came up with this conclusion: "Psychotherapy, notably cognitive–behavioral intervention or interpersonal psychotherapy, should be considered the treatment of first choice for depression primarily because of superior long-term outcome and fewer medical risks than drugs or combined treatment..."(6) The authors also said, "If antidepressants are used, psychotherapy should be included because of the higher risk for relapse with medication alone."(6)

In conclusion, there are many ways to treat depression depending on the form or severity of the disease. However, it seems that the combination of medication and psychotherapies is the most widely recommended treatment when trying to overcome depression. Other alternatives such as St. John's Wort and phototherapy work for mild cases of depression, while electroconvulsive therapy can be effective in cases of major or severe depression. However, doctors must be careful in prescribing the correct medication for the patient because of the many dangerous side affects associated with them. Maybe one day there will be a cure for depression just as we are searching for a cure for cancer or AIDS, and then people will not have to deal with this disease that causes them to lose 10 percent of the productive years during their lives.(4)

References

1)Depression Treatment and Help

2)50+Health-Home/Treatments for Depression

3)Other Treatments for Depression

4)Depression- Net, Info on Depression

5)Major Depressive Disorder: Treatment

6)Depression Treatment


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