Depression, PND, & Anxiety Information

Psychotherapy

In psychotherapy, or counseling, one receives assistance in understanding and resolving problems that may be contributing to depression. This may be done individually or with a group and is conducted by health professionals such as psychiatrists, psychologists, social workers, or psychiatric nurses. It is important to ask about the therapist's training and approach; a very close bond often forms between practitioner and client, and it is important that the client feel understood by the clinician.


Counselors can help a person make changes in thinking patterns, deal with relationship problems, detect and deal with relapses, and understand the factors that contribute to depression.


There are many therapeutic approaches, but are aimed at improving one's personal and interpersonal functioning. Cognitive therapy, also known as Cognitive Behavior Therapy, focuses on how people about themselves and their relationships. It helps depressed people learn to replace negative depressive thoughts with positive ones, as well as develop more effective coping behaviors and skills. Therapy can be used to help a person develop or improve interpersonal skills in order to allow him or her to communicate more effectively and reduce stress. Interpersonal psychotherapy focuses on the social and interpersonal triggers that cause their depression. Narrative therapy gives attention to each person's "dominant story" by means of therapeutic conversations, which also may involve exploring unhelpful s and how they came to prominence. Possible social and cultural influences may be explored if the client deems it helpful. Behavioral therapy is based on the assumption that behaviors are learned. This type of therapy attempts to teach people more healthful types of behaviors. Supportive therapy encourages people to discuss their problems and provides them with emotional support. The focus is on sharing information, s, and strategies for coping with daily life. Family therapy helps people live together more harmoniously and undo patterns of destructive behavior.


Transcranial magnetic stimulation

Repetitive transcranial magnetic stimulation (rTMS) is under study as a possible treatment for depression. Initially designed as a tool for physiological studies of the brain, this technique shows promise as a means of alleviating depression. In this therapy, a powerful magnetic field is used to stimulate the left prefrontal cortex, an area of the brain that typically shows abnormal activity in depressed people.


rTMS has been proposed as an alternative to ECT that would have fewer side effects. No sedation is needed, and the only reported side effects are a slight headache in some patients and facial muscle contraction during treatment. However, clear evidence that it is effective is still awaited.


Recent work in Poland suggested that weak, variable magnetic fields may offer relief from depression in those who have t responded to medication. However, some of the existing work has been questioned, with claims that the effect is t as significant once environmental conditions are controlled for.


Vagus nerve stimulation

Vagus nerve stimulation therapy is a treatment used since 1997 to control seizures in epileptic patients and has recently been approved for treating resistant cases of clinical depression. The VNS device is implanted in a patient's chest with wires that connect it to the vagus nerve, which it stimulates to reach a region of the brain associated with moods. The device delivers controlled electrical currents to the vagus nerve at regular intervals

Electroconvulsive therapy

Electroconvulsive therapy (ECT), also known as electroshock or electroshock therapy, uses short bursts of a controlled current of electricity (typically fixed at 0.9 ampere) into the brain to induce a brief, artificial seizure while the patient is under general anesthesia.


ECT has acquired a fearsome reputation, in part from its use as a tool of repression in the former USSR and its fictional depiction in films such as One Flew Over the Cuckoo's Nest, but remains a common treatment where other means of treatment have failed or where the use of drugs is unacceptable (as in pregnancy). Also, in contrast to direct electroshock of years ago, most countries w allow ECT to be administered only under anaesthesia. In a typical regimen of treatment, a patient receives three treatments per week over three or four weeks. Repeat sessions may be needed. Short-term memory loss, disorientation, and headache are very common side effects. In some cases, permanent memory loss has occurred, but detailed neuropsychological testing in clinical studies has t been able to prove permanent effects on memory. ECT offers the benefit of a very fast response; however, this response has been shown t to last unless maintenance electroshock or maintenance medication is used. Whereas antidepressants usually take around a month to take effect, the results of ECT have been shown to be much faster. For this reason, it is the treatment of choice in emergencies (e.g., in catatonic depression in which the patient has ceased oral intake of fluid or nutrients).


There remains much controversy over electroshock. Advocacy groups and scientific critics, such as Dr Peter Breggin, c for restrictions on its use or complete abolishment. Like forms of psychiatric treatment, electroshock can be given without a patient's consent, but this is subject to legal conditions dependent on the jurisdiction.