WHAT ARE THE TREATMENTS FOR ADULT DEPRESSION?
Treatments for adult depression include psychotherapy and the prescription of antidepressant medications. Treatment varies depending on the severity of the symptoms and the origins of the depressive symptoms. It takes into account the preferences of the patient. Antidepressants are necessary in the treatment of characterized depressions, of moderate or severe intensity. They are less so in the minor forms, which are more a matter of psychotherapy.
TREATMENT FOR EVERY TYPE OF DEPRESSION
We can treat depression by playing on two complementary registers: antidepressant drugs and psychotherapy.
Faced with a mild depression with little impact on daily life, a general practitioner instead recommends psychotherapeutic support. If the depressive episode is more troublesome (characterized but moderate), he prescribes an antidepressant and possibly psychotherapy.
If the episode is more characterized (numerous symptoms, intense and lasting), he prescribes an antidepressant treatment, exercises psychotherapeutic support and sometimes advises psychotherapy.
If the context is complex, if the depression seems to resist treatment, if the sick person so desires or if they have already experienced psychiatric disorders, the general practitioner can refer their patient to a psychiatrist.
If hallucinations or delusions are associated with depression, neuroleptic drugs may be prescribed.
Hospitalization is reserved for cases where the risk of suicide is real, in very severe forms with significant physical symptoms, or when the patient is very isolated.
ARE THE DRUGS EFFECTIVE?
The effectiveness of antidepressants is scientifically and clinically proven for certain categories of depression. It should be emphasized that these drugs are really necessary in the treatment of characterized depressions, of moderate or severe intensity, but not in the minor forms.
Some patients still refuse this treatment because they think that their will power may be enough to get better, or because they are afraid of becoming dependent on the drug. Both of these ideas are wrong. Depression is an illness and in the majority of cases it is very difficult to cope with it on your own. When we have any other disease, we do not hesitate to seek treatment.
Unlike anxiety medications, antidepressants carry no risk of true addiction. It is simply necessary to respect the doctor’s prescription and not to stop the treatment too soon or suddenly, to avoid relapses and symptoms related to the discontinuation of the treatment.
Sometimes the prescribed treatment has no effect. The doctor can then try a new substance, more suitable for the patient. However, there are so-called “resistant” depressions, against which drug treatments are little or not effective. Seismotherapy sessions (electroshock) are sometimes necessary.
SHOULD WE COMBINE AN ANXIOLYTIC WITH AN ANTIDEPRESSANT?
Due to the mechanisms of action of antidepressants in the brain, it often takes a few weeks for the beneficial effects to be felt. It is quite common for the doctor to prescribe, at the start of treatment with an antidepressant, an anxiolytic of the benzodiazepine family .
Two main reasons can justify it. If the patient’s suffering is very great, the anxiolytic can act in a few hours on certain symptoms, such as anxiety and insomnia , and thus quickly relieve the patient. On the other hand, if the depressed person has a strong suicidal tendency, taking an anxiolytic helps minimize the risk of acting out while waiting for the antidepressants to take effect. But this prescription must be temporary. Anxiolytics do not cure depression and should not be taken for more than a few weeks. Beyond that, their action is reduced and the risk of dependence is real.
In cases where the depression is complicated by persistent anxiety disorders, the doctor may choose to prescribe an antidepressant active also against the anxiety disorders