Treatments for Depression

Treatments for Depression

1. Electroconvulsive Therapy

   • How does ECT work?
     • increase the rates of serotonin
     • stimulates / generates improvements in depressive symptoms
     • improves blood flow in the brain
     • restores the brain's ability to regulate mood by enhancing the transmission of neurotransmitters
   • Side effects
     • memory loss
     • cardiovascular changes
     • headaches
   • Effectiveness of ECT for depression
     • Sackheim (1989) - real ECT is significantly more effective than placebo ECT
       • however bilateral was more effective than unilateral
     • Sackheim - ECT is more effective than anti-depressant drugs
       • however, the use of medication following ECT can prevent relapse
     • ECT is more effective in the short term treatment of depression
       • however, lacks reliability as the trials haven't been compared with newer anti-depressants
   • doesn't cure the potential cause, only the symptoms

2. Cognitive Behavioural Therapy

   • aim - train clients to distance themselves from things; distinguish fact from fiction; see things in proportion; not to see things in such extreme terms
   • Thought catching
     • individuals are taught how to see the link between their thoughts and the way they feel
     • they might be asked to record any emotion-arousing events, the automatic 'negative' thoughts associated with these events and then their 'realistic' thoughts that might challenge these negative thoughts
     • by challenging the dysfunctional thoughts and replacing them with more constructive ones, clients are encouraged to try out new ways of thinking, and in turn, behaving
   • Behavioural activation
     • based on the common-sense idea that being active leads to rewards that act as an antidote to depression
     • the characteristic of many depressed people is that they no longer participate in activities that they previously enjoyed
     • in CBT, therapist and client identify potentially pleasurable activities and anticipate then deal with any cognitive obstacles ( "I won't be able to do that" )
   • Butler (2006) - CBT was highly effective for treating depression
     • however, Holmes (2002) - the single greatest study into effective treatment for depression showed that CBT was less effective that medication
   • CBT takes full account of the patient's thoughts, attitudes and feelings
     • however, it focuses more of treating symptoms rather than getting to the cause of problems