Depression - Part III
In the first two segments of this discussion on the illness of Depression, issues of causes, symptoms, and effects of depression have been examined. In this segment, the different types of treatment will be covered. Since to some extent the type of treatment is determined by the cause, the reader is referred to the initial segment (March 1999) to review the different causes.
Obviously, if there is a primary medical
illness which is causing or aggravating the depression, then the
most important treatment should be directed toward that condition.
For this reason, anyone who has symptoms of depression is encouraged
to consult a physician to determine the presence or absence of
those medical problems (thyroid disorder, for instance) which might
affect the choice of treatment for depression.
There is no easily available laboratory or
X-ray test which can determine the presence of a biochemical imbalance
which might be causing or accompanying
depression. Yet, there are many research studies which
indicate that many if not all severe depressive episodes have some
of biochemical imbalance, and treatment with medication designed
to correct such imbalance is often part of a treatment program.
Such medications belong to a class called
Antidepressants; in the United States, there are currently 24 such
and other countries have more. Antidepressant medications are
not tranquilizers, which are designed primarily to relieve anxiety
(which may be a symptom of depression); tranquilizers (such
as Valium, Xanax, Librium, and others) do not have the ability
alter the biochemical imbalance.
Antidepressant medication does not cover
up symptoms, but rather is designed to restore a normal chemical
balance to the system. When antidepressants
are properly prescribed, 2/3 of patients will improve
within 8 weeks, with at least a 50% reduction in symptoms. These are
not addictive medications, but may have discomforting side effects,
and may take several weeks to begin to have beneficial effect.
Some of the newer antidepressants (Prozac, Zoloft, Paxil, Celexa, Wellbutrin, Effexor, Remeron, others) have better side effect profiles.
In view of the high incidence of recurrence
in depression, it is very important to continue medication
for an adequate period of time. Treatment with antidepressant medication
should continue for at least six months for first episodes, and
for several years or indefinitely for recurrent episodes.
Non-medical treatments such as psychotherapy
or counseling should be used in the treatment of depression. There
are different styles or theories
of counseling; the more traditional analytically based treatments
will focus on an examination of recurrent emotional reactions
which may have roots in childhood, cognitive therapy will focus
tendency to develop erroneous patterns of thinking and behavior
which can cause conflict.
A problem for Christians undergoing counseling
treatment may be that many of the traditional types of counseling
focus on understanding and
improving the self, while Christ calls us to deny
based counseling seeks to find unconfessed sinful patterns
and roots which may interfere with a believer's experiencing the
joy of the abundant life Christ promises His servants.
Research studies have consistently shown
that the best treatment results are
seen with a combination of antidepressants and counseling.
Other treatment approaches may be recommended, either alone or
bright light therapy may be recommended if there is a significant
seasonal component, and herbal remedies (St. John's Wort,
for example) have shown some promise.
Depression is a treatable, recoverable disorder.
The person suffering from depression must be persistent, and must
hold on to faith, even
might suggest otherwise. A frequent symptom of depression
may be hopelessness, but we have reason for hope.
Thousands of years ago, the prophet Jeremiah
described his own feelings of hopelessness: "I am the man who
seen affliction ... He has driven me and made me walk in darkness
and not in light ... And my soul has been rejected from peace;
I have forgotten happiness. So I say, 'My strength has perished,
and so has my hope from the Lord'". (Lam 3:1ff).
Yet, less than three verses after his lament,
Jeremiah proclaims the truth of what we know makes dealing with
depression, as well as other worldly stresses and problems, have
a hopeful outcome: "This I recall to my mind, therefore I have
hope. The Lord's lovingkindnesses indeed never cease. For His compassions
never fail. They are new every morning; great is Thy faithfulness.
'The Lord is my portion', says my soul, therefore I have hope in
Him." (Lam 3:19, 22-24).
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