Treatment of Depression


By Harold L. Burke, Ph.D.

 

Depression information, treatments, current research, resources, and helpful hints

All of us may feel depressed at times; this is a normal part of living. However, an individual may be suffering from Major Depression if the depression is sufficiently severe as to cause significant distress or to interfere with occupational, social, or other functioning. Fortunately, on the Web and in libraries, there is much depression information as well as information on mood disorders and mental disorders and the treatment of depression and similar disorders. There are numerous treatments for depression including several alternative, holistic treatments. The Brain Therapy Center provides free information, psychological/neuropsychological assessment, treatment, current research information, resouces, and helpful tips.

Typical symptoms of depression include:

• Feeling sad (dysphoria) or empty
• Diminished interest or pleasure in almost all activities (anhedonia)
• Significant change in weight or appetite (not related to diet)
• Insomnia or hypersomnia
• Mental or motor agitation or slowing
• Fatigue
• Feelings of worthlessness or inappropriate guilt
• Diminished ability to think, concentrate, or make decisions
• Recurrent thoughts of death

Associated symptoms may include irritability, pervasive negativity and pessimism, hopelessness, and decreased libido.

The prevalence of Major Depression is 15% of the general population. It is the #2 cause of overall disability, the #1 cause of disability among women, and the 7th leading cause of death by suicide.

The causes of depression are multiple and not definitively known. However, much is being discovered about the relationships among neurobiological factors (e.g., genes, neurochemicals, firing patterns among neurons) and “psychological” factors (e.g., the way in which one thinks about oneself, the world, and the future).

Such discoveries offer much hope for individuals suffering from depression, and there are several well-documented and clinically-proven methods for treating this disorder. Such methods include psychotherapy (particularly cognitive-behavioral therapy), antidepressant medications, and exercise. In addition, there are several alternative therapies with less efficacy research that have been used by many clinicians with reported success. EEG biofeedback (neurofeedback) is one such method that appears to be more holistic and not reliant on medications. (Please see special page on EEG Biofeedback on this website for an explanation of this exciting methodology.)       

Several Treatment Modalities for Depression

At the Brain Therapy Center, our staff specializes in several treatment modalities including individual psychotherapy and neurofeedback We use primarily five types of psychotherapy, depending upon the needs of each client and combined synergistically to optimize effect:

• Cognitive therapy helps individuals replace dysfunctional, inaccurate thoughts and images (causing depression) with thoughts and images that are more accurate and decrease depression.
• Behavioral therapy is the systematic application of scientific principles of learning theory to change behavior. By changing certain maladaptive behavioral patterns, depression can be decreased.
• Logotherapy assists the client in achieving more meaning in life. This is primarily utilized after the major depression has decreased significantly so that the client has a reason to get up in the morning and can look forward to a more fulfilling life, thus decreasing the probability of a relapse.
• Existential therapy assists the client in examining the relationship between depression and very basic life choices.
• Medical hypnosis assists the client in entering an extremely relaxed but focused state so that subconscious processes of healing can occur.

EEG biofeedback (neurofeedback) uses operant conditioning to alter brain waves so that a client’s brain can achieve more flexibility and stability.

We at the Brain Therapy Center also have the requisite knowledge to allow us to have a close working relationship with physicians who may be prescribing antidepressant medications. (Dr. Harold Burke, Director of the Brain Therapy Center, has earned an M.S. and a Ph.D., has completed two years of basic medical sciences, and is currently enrolled in a post-doctoral Master of Science program in Clinical Psychopharmacology.)

Some Helpful Hints

• Seek help from a mental health professional. For example, a licensed clinical psychologist has had extensive education and training in treating mood disorders such as depression. A psychiatrist should be considered if you are primarily interested in psychotropic medications. Your primary care physician is certainly licensed to prescribe antidepressants, but psychiatrists have had much more training and experience in treating depression with antidepressant medications. In any case, do not procrastinate in seeking help especially if you have had previous episodes of depression. There is mounting evidence that repeated episodes get worse, increase the probability of future episodes, and actually cause brain damage.

 

• Exercise, particularly with aerobic exercise, can be very beneficial. This exercise does not have to be intense to benefit the patient. Even 10 minutes of walking will increase your energy for 60-120 minutes and improve your mood. If possible, do 10 minutes of gentle stretching, 20 minutes of aerobic exercise, and 5-10 minutes of stretching as a cool down. Do this at least three times per week, but remember that the level of intensity does not make that much difference. Research has found that such exercise increases deep sleep, decreases stress reactivity, increases self-esteem, and increases such chemicals as BDNF (brain-derived neurotropic factor) that actually “heals” the brain. All of these effects, in turn, decrease depression. Be active. Do not just lie in bed or sit on the couch even though the depression may make you want to do just that. If possible, try to get outside for your exercise because the sunlight may help decrease your depression. Of course, consult with your physician if you have any questions or doubts whatsoever about the wisdom of your doing exercise.

 

• Decrease your stress levels as much as possible. Recent evidence has revealed how stress and its biological consequences cause depression to get worse. Psychotherapy, biofeedback, exercise (e.g., aerobic, yoga, Tai Chi) and meditation/prayer have been shown to be effective in decreasing stress.

 

• Try to improve your sleep. Insomnia may be one of your symptoms, and you need to get adequate amounts of sleep. In addition, inadequate sleep makes depression worse by further interfering with correct levels of neurotransmitters in the brain. Taking excessive over-the-counter sleep aids is not a good answer; they can make things worse. Taking benzodiazepines (such as Xanax^®) on a chronic basis is also not the answer; they too can make the depression worse. Seeking advice from a physician, improving sleep habits, and exercising regularly can improve your sleep and decrease your depression.

 

• Self-help books, such as Feeling Good: The New Mood Therapy by Dr. David Burns, may be helpful. However, please realize that there is no substitute for a mental health professional especially if your depression is severe and if you have any thoughts of suicide or frequent thoughts of death.

 

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