We present the third and final part of the extensive article on depression by ISEP alumna Ana María Ospina. The alumna’s Master’s Final Project on this topic can be consulted and downloaded for free here: MFP – Understanding depression: a review of the most important aspects. In this conclusion, the author discusses treatments for depression. You can consult the first two parts here: Part 1 and Part 2.
The Treatment of Depression
Regarding the treatment of depression, there is psychological treatment, pharmacological treatment, and alternative treatment (ECT, light therapy, and herbal medicine). No single clinical or therapeutic approach can effectively address depression.
Beck’s Cognitive Therapy
Among psychological therapies is Beck’s cognitive therapy, which is related to cognitive psychology, concerned with the study of mental processes and structures. This model is based on the idea of a close relationship between environment, cognition, affect, behavior, and biology. Thought processes are highlighted as the factors that mostly trigger psychological disorders. Cognitive therapy dedicates most of its time to producing changes at this level.
Ellis’s Rational Emotive Behavior Therapy
There is also Ellis’s rational emotive behavior therapy (REBT), which is based on the principle that people are not disturbed by events, but by what they think about those events, i.e., their interpretation. Ellis believed that behavioral and emotional problems could originate from thought, emotion, and behavior. REBT’s treatment aims to question fundamental beliefs, to replace them with more constructive or rational ones.
Behavioral Activation Therapy
We also find behavioral activation therapy, whose objective is to counteract depressive symptoms and, as a consequence, help patients regain a productive and emotionally satisfying life. Its methodology is based on “activating” individuals with depression by scheduling and performing behaviors that increase the likelihood of positive reinforcement from the environment.
Acceptance and Commitment Therapy
This is Acceptance and Commitment Therapy (ACT), a third-generation therapy whose objective is not to reduce symptoms, but to educate the patient and reorient their life in a more holistic way. It is based on the idea that what causes discomfort is not the events themselves, but how we relate emotions to them and how we interpret them. It does not seek to avoid suffering, but rather to accept our own mental and psychological experience to reduce the intensity of symptoms. It aims to show that control over events is inherently problematic and is what causes the problem. With ACT, the goal is for the patient to accept pain, based on a series of paradoxes, experiential exercises, metaphors, among others.
Cognitive Behavioral Therapy
Cognitive-behavioral therapy (CBT) works by teaching patients to recognize thought styles that predispose them to unhelpful conclusions or dysfunctional thoughts. For this, it is necessary to train the person to be able to reflect on their own way of thinking and to consider which points are conflictive and which are not. In this way, the aim is to develop the ability to question the categories they work with and detect typical thought patterns that cause them problems. The process by which cognitive aspects that cause discomfort are recognized and acted upon is based on Socratic dialogue (cognitive restructuring). This implies that during part of the CBT sessions, the therapist will provide the necessary feedback for the patient to detect, by their own means, the contradictions or undesirable conclusions that their thought styles and cognitive schemas lead them to. In this process, the therapist asks questions and highlights statements that the patient themselves has made, so that the latter can delve deeper into the study of their own thinking.
Other Techniques for Depression
There are other techniques for treating depression, but the most important and recognized ones are those just mentioned.
In many cases, psychological treatment is not enough, and it is necessary to resort to pharmacological treatment to be used jointly to stabilize the patient. Medications regulate the functioning of serotonin, norepinephrine, and dopamine. There are different types of antidepressants, some with fewer and others with more side effects. The antidepressants recommended first are SSRIs, which are the most effective and have fewer side effects, followed by dual-action antidepressants, then tricyclics which have many side effects, and the least recommended due to their danger are MAOIs.
Electroconvulsive Therapy
When psychotherapy and pharmacology do not work, ECT or electroconvulsive therapy, which uses electricity, is recommended. It is used in cases of severe depression and psychotic depression, when there is a risk of suicide or intense inhibition or agitation. Its use is especially recommended for pregnant women with severe depressive, manic, or schizophrenic episodes, as they cannot take pharmacological treatment.
Light Therapy
There is also light therapy, which holds that exposure to sunlight has beneficial or harmful effects on the human body, depending on the duration and frequency of exposure, the intensity of sunlight, and the individual’s sensitivity. Moderate exposure of the human body to the sun produces a feeling of health, natural calm, and general well-being, in addition to a stimulating action (psychologically and physiologically). It is a treatment in which people are exposed to the light of a lamp that emits luminosity similar to sunlight but filters ultraviolet light. These must be special lamps, because since light enters through the eyes, not the skin, the luminosity they emit must not damage the cornea or retina of the eye. This technique has been developed based on the fact that melatonin has a depressive effect. It is based on the principle that by lengthening the photoperiod (increasing exposure), the production of melatonin and its undesirable manifestations can be reduced. Melatonin production increases in darkness and decreases with light. The effectiveness of light therapy has been demonstrated in all forms of depression.
It is the method used to treat seasonal affective disorder, which occurs due to the decrease in sunlight in certain areas of the planet during specific seasons (autumn, winter).
Herbal Medicine
Finally, herbal medicine consists of natural remedies to alleviate depression, based on a series of medicinal plants, home remedies, and even foods that can help overcome the disorder in a healthy and natural way.
Depression is extensively covered in various ISEP Master’s programs, especially highlighting the Master in Clinical and Health Psychology. If you are interested in the topic, do not hesitate to ask for more information!