Midwife Matters

For many people, depression cannot always be controlled for any length of time simply by exercise, changing diet, or taking a vacation. It is, however, among the most treatable of mental disorders: between 80% and 90% of people with depression eventually respond well to treatment, and almost all patients gain some relief from their symptoms.

Before a specific treatment is recommended, a psychiatrist should conduct a thorough diagnostic evaluation, consisting of an interview and possibly a physical examination. The purpose of the evaluation is to reveal specific symptoms, medical and family history, cultural settings and environmental factors to arrive at a proper diagnosis and to determine the best treatment.

Medication: Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain. These medications are not sedatives, “uppers” or tranquilizers. Neither are they habit-forming. Generally antidepressant medications have no stimulating effect on those not experiencing depression.

Antidepressants may produce some improvement within the first week or two of treatment. Full benefits may not be realized for two to three months. If you’re taking antidepressants and feel little or no improvement after several weeks, consult with your health care provider to adjust the dose of the medication or try another antidepressant.

Psychiatrists usually recommend that patients continue to take medication for six or more months after symptoms have improved. After two or three episodes of major depression, long-term maintenance treatment may be suggested to decrease the risk of future episodes.

Psychotherapy: Psychotherapy, or “talk therapy,” is sometimes used alone for treatment of mild depression; for moderate to severe depression, it is often used in combination with antidepressant medications. Psychotherapy may involve only the individual patient, but it can include others. For example, family or couples therapy can help address specific issues arising within these close relationships. Group therapy involves people with similar illnesses.

Depending on the severity of the depression, treatment can take a few weeks or substantially longer. However, in many cases, significant improvement can be made in 10 to 15 sessions.