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Guidelines For Treating Depression The APA, CANMAT BAP NICE and Texas Medication Algorithm Project have released a number of guidelines for treating depression. They recommend exercise, psychotherapy and antidepressant medication. The guidelines suggest that patients who don't respond to monotherapy, use CBT or SGA prior to beginning medication and increase dosages as necessary. The addition of psychostimulants, lithium, SSRIs or SNRIs or TMAPs could be beneficial for patients who do not respond to monotherapy. 1. Diagnosis A diagnosis is the first step to treating depression. This involves a conversation with an expert in mental health or your doctor, as well as certain forms of therapy. Iampsychiatry will inquire about your symptoms, and how they have affected your life in the last month. They'll also ask whether you've ever had thoughts of self-harm or suicide. Your GP will also examine your general health, family history and life style to determine if you suffer from depression or another mental health condition. You must be honest and open with your doctor, so they can get a true picture of how you are feeling. This will allow them to identify the signs of depression. They can then use these symptoms to rule out other diseases like heart disease or cancer, which may cause similar symptoms. Once your GP has concluded that you may be suffering from depression, they'll rule out the possibility of other ailments through tests. Blood tests, for example, can check thyroid or anemia issues which could be the cause of depression. They can also test your blood for vitamin deficiencies or alcohol and drugs that can mimic depression. If your GP finds that you have depression, they'll tell you the root of the problem and the best approach to manage it. This could include psychotherapy or a combination between therapy and medication. The most effective medications for depression are antidepressants, which alter the balance of chemical substances in the brain. They can be administered by mouth or injections and may take some time before they begin to work. They can also cause side effects such as dry mouth and constipation. 2. Medication Many people can benefit from medication. Your doctor may initially prescribe one or several antidepressants. If your initial treatment isn't producing satisfactory results Your doctor may suggest that you try an alternative medication or alter the dose or time of day you take it. It is crucial to take your medication on a regular basis to getting the most benefit. You should never stop taking your medication unless advised to do so by your physician. Depending on the severity of your symptoms, you may be given a prescription for an antidepressant that is general in nature or an SSRI. An SSRI is an antidepressant which increases the levels of the chemical serotonin in the brain. SSRIs include escitalopram, citalopram, and fluoxetine. Your doctor might also prescribe a serotonin-norepinephrine reuptake inhibitor, or SNRI. Examples of SNRIs include duloxetine (Cymbalta) and Venlafaxine (Effexor XR, Khedezla). If your doctor believes that tetracyclics are more effective than SSRIs and SNRIs, they might prescribe them. SSRIs and SNRIs are usually considered safe for use by adolescents and children. Before you begin any medication, you should inform your doctor if you are any health or allergy issues. Medication can cause side effects like an upset stomach or dry mouth. Most of the time, these side effects are mild and will go away by themselves in a week or two. Do not operate or drive machinery if you are taking medication. Other recreational drugs and alcohol can worsen some depression symptoms, such as insomnia or restlessness. These substances should not be used as they can make depression harder to manage. The use of these substances for a long time, particularly for a long time can result in more serious problems. 3. Psychotherapy Psychotherapy (also known as talk therapy) can assist you in dealing with issues that contribute to depression. This type of treatment is a long-term one, but has been proven to be effective in treating depression. Psychotherapy can be performed in a variety of settings, like private therapists' offices, hospitals, clinics for psychiatry and rehabilitation facilities. It is typically conducted one-on-one but group therapy is also a possibility. Your therapist will inquire about your feelings, behaviors and relationships, and will discuss them with you in a secure and confidential setting. During the initial sessions your therapist will get to get to know you better and suggests a treatment program. This may include psychotherapy, medication, activity and exercise or other treatments like repetitive transcranial magnetic stimulation (rTMS) or electroconvulsive therapy (ECT). Some of them are short-term and focus on specific issues. Interpersonal therapy (IPT) for instance helps people comprehend the root issues like unresolved grievances or conflicts with others. Depression can be caused by a variety of causes, from stress and loss to unresolved traumas or abuse. These may require more intensive therapy and other treatment. Cognitive behavioral therapy (CBT) is also referred to as cognitive restructuring, assists people change their thinking patterns that cause symptoms. It also helps improve coping skills and helps them to manage the stress and tensions of life. Dialectical Behavior Therapy (DBT) blends CBT elements with mindfulness techniques that assist you in recognizing and observing your emotions. Psychotherapy can often help with acute, moderate or severe depression just as antidepressants can. However, it may take longer to work and not everyone responds to it in the same way. It is crucial to attend your therapy sessions and to complete your homework in between sessions (like journaling or meditating). 4. Counseling Whether your depression symptoms are mild or severe it's crucial to find solutions that can help. It is often psychological therapy or counseling. A professional outside can alter your life. You may have to test different therapists before you discover one that clicks with you however, the effort is worth it. There are many types of psychotherapy, but most involve talking about your issues and discovering new ways to cope with the depression. It is also beneficial to discuss your experiences with a group of people who are dealing with similar issues. Group counseling is available in hospitals, medical clinics and therapists' offices. It is also conducted via phone using online telehealth services. Counseling for depression seeks to change negative thoughts and behavior patterns that contribute to the disorder. A therapist could be able to, for instance, guide you on how to manage stress in order to improve your mood. You can be taught to recognize irrational thought patterns and challenge preconceptions which make you feel depressed. You can use EMDR to help release painful or traumatic memories that could contribute to depression. Other therapies such as cognitive behavioral therapy or behavioural activation can be used to help you understand your patterns of behavior and make adjustments. For example, behavioural therapy can be useful if depression causes you to withdraw from social activity. The goal is to promote more social interaction and identify the ways in which your actions impact your mood. These methods are typically used in conjunction with medication. You can find a qualified therapist in your local area by asking your doctor to refer you or calling a mental health center in your community. 5. Exercise The benefits of exercise in preventing and treating depression are well-established. It's not a common treatment. Psychotherapy and medications are more commonly used. An increasing amount of research suggests exercise is as effective as antidepressants and talking therapies for treating depression. In fact, it's more effective than either psychotherapy or drugs alone according to a meta-analysis of more than 150 studies. The research revealed that, on average, those with depression who exercised improved their symptoms by five points using one measure and 6.5 points using another which is clinically significant. The effects were powerful regardless of whether they exercised for just few minutes per day, or for more than an hour a day. Exercise can also be an excellent alternative to medications or psychotherapy, which might not be suitable for everyone. Exercise can help keep our bodies fit and help prevent other mental health issues such as anxiety. Additionally, exercise doesn't have the stigma associated with taking prescription drugs or going to talk therapy. It's open to everyone, comes with no costs attached and can be an extremely empowering method. However, it's still difficult to study exercise as a medicine as it is difficult to determine the impact of factors such as how often people normally exercise and other medications they may be taking. So more research is needed to determine the most effective kind, frequency and duration of exercise for preventing and treating depression. To help patients with depression, GPs are prescribing more exercise as part of their treatment plans. The 'green prescription,' is a program designed to encourage patients to be active by contacting a fitness professional regularly by phone or face-toface.