Treatment Of Depression

Treatment Of Depression

Most people suffering from depression do not seek any treatment or support. Although there is no specific proven cure for the condition, treatment involving psychotherapies, medications and other approaches can significantly help in the recovery process.


Depression Treatment

Depression, also known as major depressive disorder (MDD) and clinical depression, is a severe mood disorder where depressive episodes can last over two weeks. It is a devastating condition that impacts millions of individuals globally. MDD is characterized by chronic sadness, low mood, insomnia, loss of interest in activities, irritability, feelings of worthlessness, psychotic symptoms or psychomotor retardation 1 , and suicidal ideation, in some cases. However, the disorder can be different for everyone. When left untreated, the condition can become debilitating and can affect the patient’s ability to function in daily life. “Untreated depression is associated with increased deaths, adverse outcomes, deficits in function, increased use of health services, poor on-the-job performance, and increased absenteeism,” adds a 2008 study 2.

However, with proper diagnosis and effective treatment, teamed with healthy lifestyle choices, one can recover fully from the disorder. Primary care physicians commonly recommend a combination of medications and psychotherapy under the guidance of a trained & certified psychiatrist, psychologist or therapist. According to recent research 3 , the type of treatment, the duration and the setting of treatment can depend on a number of different factors which can influence the effectiveness of the treatment process. These factors typically include:

  • Severity of the disorder
  • Development of the symptoms overtime
  • History of depression
  • Existing medical or mental health conditions
  • Dual diagnosis or co-occurring disorders
  • Family history
  • Personal circumstances
  • Use and abuse of substances, like drugs and alcohol

This is why it is best to consult a mental health professional and talk about the symptoms to understand which treatment approach may be most appropriate for the individual.

Treatment Approaches For Depression

Even though major depressive disorder (MDD) is a serious and life-threatening mental disorder, it typically responds positively to treatment. A mental health professional can help a patient devise an appropriate treatment plan 4 that can be safe and effective for them. It can also help to address other comorbid conditions as well. However, it is crucial that a proper evaluation is conducted to rule out any underlying causes for the depressive symptoms. Treatment plans for depression generally involve a combination of psychotherapy and medications 5 . However, if the symptoms are severe, a doctor may recommend hospitalization or an outpatient treatment program to relieve the symptoms.

Here is a closer look at the different treatment options available for major depressive disorder:

1. Psychotherapy

Psychological therapy or talk therapy under the guidance of a psychologist, psychiatrist or therapist can help to identify thought and behavior patterns of the patient that are unhelpful and empower them to change such patterns. It can also enable them to learn essential coping skills to deal with the symptoms. Several studies 6 have shown that psychological treatment can be highly effective in treating this condition. Different types of psychological treatments are available for the treatment of depression, such as:

  • Cognitive behavioral therapy (CBT)
  • Interpersonal therapy (IPT)
  • Mindfulness-based cognitive therapy (MBCT)
  • Group therapy

Apart from these, a doctor may also recommend other types of therapies based on the severity of symptoms and the individual. Research 7 shows that psychotherapies tend to be highly effective in treating major depressive disorder and can even help “highly comorbid MDD patients.” According to a 2017 study 8 , psychotherapy treatment involving cognitive behavioral therapy (CBT), interpersonal therapy (IPT) or supportive therapy can substantially decrease symptoms after treatment. “Depression can be efficaciously treated with six to eight sessions of psychotherapy, particularly cognitive behavioral therapy and problem-solving therapy,” adds another 2012 study 9 .

Psychotherapy aims to help the sufferer to:

  • Learn better coping and problem-solving skills
  • Deal with daily life stressors and other crisis
  • Recognize & replace negative thoughts and behaviors with positive alternatives
  • Strengthen and develop positive relationships
  • Explore & embrace different opportunities and experiences
  • Identify triggers that can worsen depressive symptoms
  • Set realistic goals in life
  • Regain control in life and experience content & satisfaction

Here are some of the most highly recommended psychotherapy approaches for depression:

A. Cognitive behavioral therapy (CBT)

CBT is perhaps one of the most helpful and beneficial psychological treatment options for major depressive disorder. It is a structured approach that enables the sufferer to identify distorted thoughts and behavior and understand how they affect our mental and emotional health. Cognitive behavioral therapy 10 is one of the most studied and effective treatment approaches for this disorder and can be recommended for patients of all ages. Studies have found that CBT can be recommended as the “first choice of treatment for depressive symptoms and disorders” in children and adolescents. The patient needs to cooperate with their therapist to recognize unhelpful thoughts and behaviors that make the symptoms worse. CBT also enables us to learn how we can develop rational thinking and approach daily challenges in a more optimistic, realistic way that enables us to solve problems.

CBT is primarily based on the following principles:

  • Psychological issues are partly caused by disordered thinking
  • Psychological issues are partially caused by unhelpful, learned behavior patterns
  • A person can always learn coping strategies to better deal with psychological issues

This treatment is primarily developed as a short-term treatment approach and can prove to be helpful over 10-20 sessions. However, the number of sessions may vary for each individual depending on the severity of the disorder. CBT also encourages the patient to develop a cooperative & collaborative relationship with their therapist to set treatment goals, agendas and transfer feedback. According to a 2018 study 11 , CBT can be confidently used to alleviate and prevent symptoms of anxiety and depression in patients. “Cognitive behavior therapy (CBT) is efficacious in the acute treatment of depression and may provide a viable alternative to antidepressant medications (ADM) for even more severely depressed unipolar patients when implemented in a competent fashion,” explains a 2010 study 12 .

Other studies 13 have found that online, hybrid and multimedia-based CBT can also be as effective as face-to-face sessions. One 2019 study 14 explains “For acute symptoms of depression, group, telephone, and guided self-help treatment formats appeared to be effective interventions, which may be considered as alternatives to individual CBT.” Further research 15 shows that CBT can also help to reduce risk of relapse in MDD patients in remission.

B. Interpersonal therapy (IPT)

IPT is a structured, yet short-term therapy that helps in treating depressive disorders by focusing on issues related to personal relationships. It is “a time-limited, empirically validated treatment for mood disorders,” explains a 2004 study 16 . IPT also enables the sufferer to develop crucial skills that can help them to cope with such relationship problems. It has been found that IPT can be as effective as antidepressants. This therapy can not only help adults to overcome the condition, it can also help adolescents and children deal with depressive symptoms as well. According to a 2020 study 17 , interpersonal psychotherapy is “a time-limited and diagnosis-targeted intervention,” which can be effectively applied to various age groups, such as adolescents and elderly. Interpersonal therapy enables us to identify unhelpful patterns in relationships that can make us susceptible to depression. By recognizing such negative relationship patterns we can learn how to better manage our relationships and our emotions.

As our social relationships have a substantial impact on our emotional and mental health, addressing relationship issues can help to relieve depression symptoms. IPT teaches the patient how to express and communicate their emotions, needs and expectations in a better and healthier way, use problem-solving to cope with conflicts and recognize negative relationship patterns that can impact their mood. The therapy process may involve an interview conducted by the therapist based on which personal relationship issues will be identified. This will also enable the therapist and the patient to set treatment goals and structure the therapy sessions. Based on the identified problems and set goals, an IPT program may involve around 20 therapy sessions that can be upto an hour long with 1 or 2 sessions per week spanning over 12-16 weeks. One 2013 study 18 has found that interpersonal therapy is a “manualized treatment that addresses symptoms associated with interpersonal aspects of depression.” It has been found to be efficacious in significantly reducing symptoms in MDD & other depressive disorders and preventing relapse, especially in “low-income non-treatment-seeking pregnant women.” Another 2011 study 19 adds “There is no doubt that IPT efficaciously treats depression, both as an independent treatment and in combination with pharmacotherapy.”

C. Dialectical behavior therapy (DBT)

DBT 20 , a form of cognitive behavioral therapy, can also be helpful in treating depression. This form of therapy has been developed for individuals who are unable to regulate difficult emotions and are prone to engaging in self-injurious behaviors and suicidal thoughts. “DBT is a comprehensive, cognitive-behavioral treatment originally designed to help suicidal women,” explains a 2006 study 21, 3(9), 62–68. )) . Patients undergoing dialectical behavior therapy are encouraged to practice mindfulness and be fully aware of the present moment as it unfolds without judgment. This enables them to focus their thoughts and better manage their emotions. DBT can also be helpful in gaining better problem-solving skills and social interaction skills that allow them to handle difficult situations and relationships in a healthier manner. A 2019 study 22 revealed that Dialectical Behavior Therapy Skills Training Group (DBTSTG) is “effective in decreasing depression and suicide reattempt.”

Research 23 shows that skills training based on dialectical behavior therapy can help sufferers with treatment-resistant major depressive disorder to gain skills that promote healthier emotional processing which can reduce their depressive symptoms. According to a 2014 study 24 , DBT has been found to be helpful in significantly improving self-injurious behavior in patients. One 2009 study 25 has found that dialectical behavior therapy can significantly improve depressed mood in patients. “Dialectical behavioral therapy (DBT), along with the CBT approach, is another of the methods which can be an effective treatment for depression in patients with substance abuse. DBT includes skills of distress tolerance, emotional regulation skills, and interpersonal relations skills as well as the skills of mindfulness,” adds a 2018 study 26 .

D. Behavior therapy (BT)

This therapy 27 is a crucial aspect of CBT. However, behavior therapy does not focus on changing the patient’s attitudes and beliefs, unlike cognitive behavior therapy. This form of therapy helps to reduce symptoms of depression by promoting satisfying, pleasing and rewarding behavior and actions that can help to counter negative patterns of behavior, such as lethargy, inactivity, withdrawal, isolation and avoidance. Hence, BT helps to relieve depressive symptoms by altering the behaviors of an individual. According to a 2018 study 28 , “Behavior therapy involves primarily the application of principles derived from research in experimental and social psychology for the alleviation of human suffering and the enhancement of human functioning.” Research 29 shows that BT can be effective in improving depressive symptoms as this therapy focuses on how environmental cues affect our behavior.

E. Mindfulness-based cognitive therapy (MBCT)

Mindfulness-based cognitive therapy was originally developed to “prevent relapse in individuals with depressive disorders,” explains a 2018 study 30 . MBCT is a form of psychotherapy that incorporates elements of cognitive therapy (CT) and mindfulness meditation. CT emphasizes on present communication, thought and behavior patterns and is focused on solving problems, instead of analyzing the past to identify the cause of the problems. Cognitive therapy has been found to be highly effective 31 for treating depression and other mental health issues. Mindfulness meditation 32 refers to the meditative practice to bring your attention and awareness to the present moment, without judgment. It can enable a person to calm their mind, detach from their thoughts, reduce stress and anxiety and release negativity. Mindfulness is your ability to be fully aware of the present moment as it unfolds without allowing your thoughts or emotions to dominate you or reacting to them unnecessarily. Experts 33 state that MBCT combines cognitive therapy interventions with mindfulness meditation training and is delivered in a group setting to help people cope with acute depression.

Mindfulness-based cognitive therapy is used to help patients focus on their thoughts, feelings and physical sensations, such as breathing, without trying to change them. It can enable the patients to prevent their minds from being overwhelmed by unpleasant thoughts & feelings about the past of the future. This can not only alleviate stress and anxiety but can also help in relieving depressive symptoms. As the sufferer learns to identify negative thought and behavior patterns, they can prevent them from adversely influencing their mental and emotional well-being. Several studies 34 have found that this therapy can be beneficial and efficacious when “delivered effectively and safely in routine clinical settings.” According to a 2015 study 35 , “MBCT encourages individuals with MDD to become more aware of their internal events (ie, thoughts, feelings, and bodily sensations) and to change the ways in which they relate to these thoughts.” The study adds that mindfulness-based cognitive therapy has been found to be an effective therapy option for depression in empirical trials, systematic reviews and meta-analyses.

It also helps to reduce the risk of relapse. It has been observed that MBCT is also effective for adolescents and young adults with MDD. “MBCT leads to a decrease in depressive symptoms, reduction in depression relapse rate and improvement in terms of mindfulness,” states another recent 2020 research paper.

F. Psychodynamic psychotherapy (PDT)

Also known as psychoanalytic psychotherapy, it is a type of depth psychology that focuses on revealing the sufferer’s unconscious and subconscious thoughts in order to relieve psychic stress and tension. During the therapy session, the patient is encouraged by the psychoanalytic therapist to openly speak their mind without worrying about any criticism or judgment. This allows the patient to become more aware of their inner hidden thought & behavior patterns or content which may influence their mental disorder. It is a form of talk therapy that has been devised to enable the sufferer to explore, understand and become aware of their full range of thoughts & feelings that may be hidden from them. It allows them to understand how unconscious emotions, repressed memories and unresolved conflicts from the past can affect our current experience. The therapist will help the patient learn coping skills by encouraging self-examination and self-reflection. Research has found that psychodynamic psychotherapy 36 is effective in treating depression in patients.

According to a 2015 study 37 , studies support the use of psychodynamic therapy (PDT) in MDD treatment as it can have both significant short 38 and long term positive effects.”PDT may be a preferred alternative to pharmacotherapy and certainly adds to the effectiveness of medication,” adds the study. One 2018 study 39 has found that short-term psychodynamic psychotherapy (STPP 40 ) is empirically supported as an effective treatment of depression. Another 2019 study 41 revealed that this therapy can also be helpful for adolescents with MDD as it encourages them to explore themselves and involves insight, openness, acknowledgment, autonomy and acceptance of the self.

G. Light therapy

This form of therapy is specifically recommended and can prove beneficial for seasonal affective disorder, currently known as major depressive disorder with seasonal pattern. Light therapy exposes the patient to bright, artificial full spectrum light using a light box. This helps to improve depressive symptoms, regulate emotions, mood and levels of melatonin, a hormone associated with the sleep-wake cycle. Also known as bright light therapy (BLT 42 ), it is “an increasingly promising treatment option, particularly for those disorders that show seasonal variation in symptoms, delayed circadian phase, and depressive symptoms.” explains a 2017 study 43 .

However, light therapy can also be used in the treatment of non-seasonal depression as well. According to a 2016 study 44 , “light therapy may be effective for patients with non-seasonal depression and can be a helpful additional therapeutic intervention for depression.” Additional research 45 shows that light therapy can also be significantly effective in the treatment of nonseasonal depression among elderly adults, also known as geriatric depression.

2. Medications

Antidepressants 46 are the primary and the most commonly prescribed medications for depression. “Antidepressants offer substantial benefits in the short and long term to millions of people suffering from depression,” states a 2012 study 47 . However, a mental health professional may also prescribe mood stabilizers, stimulant medications, antipsychotic drugs and anti-anxiety medications for short-term use. Depending on the severity of the condition, a doctor may recommend psychotherapies along with medications for faster recovery. Antidepressants may also be prescribed when other treatment approaches have not garnered desirable outcomes. It can help to relieve symptoms by balancing brain chemicals or neurotransmitters. Most commonly prescribed medications for major depressive disorder may include:

A. Selective serotonin reuptake inhibitors (SSRIs)

SSRIs 48 are perhaps the most widely prescribed medications for this condition as these have fewer adverse effects and are regarded as safer and more tolerable 49 for most patients. Common selective serotonin reuptake inhibitors may include sertraline (Zoloft), escitalopram, paroxetine (Paxil), citalopram (Celexa), vilazodone and fluoxetine (Prozac).

B. Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Studies 50 show that SNRIs can prove to be beneficial in treating a broader range of depressive symptoms and can be considered as standard initial treatment for major depressive disorder. Serotonin norepinephrine reuptake inhibitors “have probable superior antidepressant activity to most selective serotonin reuptake inhibitors (SSRIs), especially in more severe depression,” explains a 2008 study 51 . Commonly recommended SNRIs include desvenlafaxine (Pristiq), venlafaxine, levomilnacipran (Fetzima), milnacipran and duloxetine (Cymbalta)

C. Tricyclic antidepressants

Although these medications can be effective 52 in treating depression, these can have some serious side effects due to their anticholinergic activity 53 . Hence, tricyclic antidepressants are not generally prescribed and are only recommended when SSRIs and SNRIs do not prove successful. Although effective in managing severe depressive symptoms, TCAs, such as nortriptyline, imipramine (Tofranil), protriptyline (Vivactil), doxepin, desipramine (Norpramin), amitriptyline and trimipramine, “are potentially lethal in overdose, so their use in the suicidal patient must be accompanied by comprehensive clinical care, taking precautions to minimise risk of suicide,” suggests one study 54 .

D. Monoamine oxidase inhibitors (MAOIs)

MAOIs are a different class 55 of drugs from other antidepressants and are usually prescribed when other medications are ineffective and unsuccessful in alleviating the symptoms. However, as these drugs have safety & tolerability issues and can have adverse interactions 56 with food, doctors recommend a strict diet for patients. A 2012 study 57 states that MAOIs “have proven efficacy for treating depression and for decades have been a preferred treatment for patients with atypical depression, high levels of anxiety, anergic bipolar depression, and treatment-resistant depression.” Common types of monoamine oxidase inhibitors (MAOIs 58 ) include isocarboxazid, phenelzine (Nardil) and tranylcypromine.

E. Atypical antidepressants

Apart from the drugs mentioned above, atypical antidepressants 59 may also be recommended for the treatment of depression. Common types of this medication 60 include mirtazapine (Remeron), vortioxetine (Trintellix), venlafaxine, trazodone, bupropion and nefazodone. Studies have found that atypical antidepressants may be toxic during overdose 61 .

Side Effects Of Medications

Medications must be taken only after consulting a doctor and conducting a proper diagnosis as certain drugs can have severe side-effects. Some of the most common side-effects 62 of medications for depression may include the following:

  • Anxiety
  • Blurry vision
  • Constipation
  • Drowsiness & dizziness
  • Dry mouth
  • Fatigue
  • Headaches
  • Irregular heart rate
  • Low blood pressure
  • Nausea
  • Weight gain
  • Agitation
  • Sweating
  • Seizures
  • Sexual problems
  • Trouble sleeping

If an individual is experiencing any of these or other side-effects, they need to talk to their doctor and find ways to relieve these adverse symptoms immediately. According to recent research 63, “Over half of all people who take antidepressants have side effects. They usually occur during the first few weeks of treatment and are less common later on.” The researchers also found that antidepressants, such as SSRIs and SNRIs, were highly effective for treating chronic, moderate & severe depression.

Efficacy Of Medications In Depression Treatment

Regardless of the adverse effects, antidepressants are typically effective and safe. According to a 2017 study 64 , selective serotonin reuptake inhibitors (SSRIs) are considered to be “the first line antidepressants” for MDD due to its side effect & safety profile. As antidepressants take around two weeks to show any effect, the sufferer needs to be patient in order to see results. Moreover, they may also need to alter their medication and dosage under the guidance of their doctor as each person may experience the mood disorder differently. Moreover, such medications are generally not addictive. “The patient should be advised that antidepressants are not addictive and that the dose which gets you well, keeps you well,” suggests another 2017 study 65 . Research 66 also suggests that antidepressants tend to be effective in about 60% of patients and can take around 6-8 weeks to show its full therapeutic effect. It also found that tricyclic antidepressants can prove to be “toxic” when overdosed, however, other SSRIs tend to be “less dangerous” and can be prescribed to patients prone to self-injury or suicidal behavior.

One should not stop taking medications once they start seeing the effects. Medications must be stopped gradually under the supervision and guidance of their doctor. One 2020 study 67 suggests that maintenance therapy and dedicated attention is necessary for a period of at least 6 months after remission to avoid treatment failure and prevent relapse. It also found that SSRIs with flexible dose adjustments can be highly effective for preventing relapse.

Medications & Suicidality

Although antidepressants are typically safe, these may increase the risk of suicide 68 in certain inidviduals, especially in children, adolescents and adults under the age of 25. This is why it is required by the United States Food and Drug Administration (FDA) that all antidepressant medications include a black box warning 69 . This was decided in 2004 when the FDA found out that children and adolescents taking antidepressants showed signs of suicidal thoughts and behaviors in controlled trials, according to a 2020 study 70 . Another 2012 study 71 revealed that “Clinicians should be aware of the fact that both TCAs and SSRIs may induce or cause worsening of suicidal ideations; hence, there is a need for early follow-up and encouraging support and supervision of patients, especially in the early phase of treatment.” The researchers also suggest that this severe side effect can be successfully clinically identified and anticipated and the healthcare professional can appropriately change the treatment plan in time. This may include changing dosage of medications, removing antidepressant drugs from the prescription, providing stronger psychological support, and prescribing mood-stabilizing agents, antipsychotics or anxiolytic medications, if needed.

This is why, if a patient is taking antidepressants then they should be closely observed by family members for signs of abnormal behavior or worsening depression. Moreover, a doctor should be consulted immediately in case of an emergency. However, it should be noted that many researchers believe antidepressants can reduce suicidal behavior 72 by improving mood in the long run. Many of the early reports of suicide risk with SSRIs came from randomized clinical trials, which were underpowered to detect a relationship between SSRI use and suicidal ideation or behavior. A 2010 study 73 explains that most early reports on suicide risk with SSRIs were underpowered to detect the association. Moreover, both current & future studies may not be able to conclusively disprove or prove the relationship between SSRIs and suicidal behavior in adults. “Nevertheless, it appears that the SSRIs are quite safe in this regard and the benefits outweigh any risks by a large extent. Any increase in the risk of non-fatal self harm appears to be very small,” adds the study.

3. Brain Stimulation Therapies

Apart from therapy and medications, there are certain other treatment options that can be recommended by a doctor, particularly in cases where antidepressants and psychotherapies are not that beneficial. These approaches may involve brain stimulation therapies which can be an effective alternative treatment for treatment-resistant depression (TRD). “Brain stimulation treatments are an important clinical consideration,” explains a 2015 study 74 . Another 2013 research 75 found that brain stimulation therapies are efficacious in treating major depressive disorder and TRD.

Here are some of the most helpful brain stimulation therapies recommended by doctors for this condition:

A. Electroconvulsive therapy (ECT)

ECT is a generally safe procedure for treating psychiatric disorders. During this therapy, the patient is put under anesthesia and a brief cerebral seizure is deliberately triggered by passing small electric currents through the individual’s brain. This process can rapidly alter the brain chemistry, impact neurotransmitters and reverse the symptoms of MDD. Electroconvulsive therapy is primarily recommended for patients who had no success with medications, unable to take antidepressants for various reasons or have high suicide risk. It is considered to be relatively safe and beneficial, states recent research 76 . “Despite lots of criticisms encountered, ECT has still been used commonly in clinical practice due to its safety and efficacy,” explains another 2017 study 77 . In fact, researchers have found that the effectiveness rate for electroconvulsive therapy for MDD is around 80-90% 78 .

B. Transcranial magnetic stimulation (TMS)

TMS is a non-invasive brain stimulation procedure where magnetic fields are utilized to send electric currents to particular brain regions for triggering nerve cells within the brain. This can help to regulate moods and relieve MDD symptoms 79 . As repetitive electromagnetic pulses may be required for the treatment of depression, it is identified as repetitive transcranial magnetic stimulation (rTMS 80 ). It is primarily suggested for patients who do not positively respond to antidepressants and therapies. According to a 2019 study 81 , “Prefrontal TMS therapy repeated daily for four to six weeks is a neuromodulation technique approved by the US Food and Drug Administration for the treatment of major depressive disorder (MDD) in patients resistant to medications.”

C. Deep brain stimulation (DBS)

DBS refers to a neurosurgical procedure involving the placement of a brain pacemaker or a neurostimulator. The process includes implanting electrodes in the patient’s brain for sending electrical impulses to certain parts of the brain. This can help to treat symptoms of depression. However, the process is generally considered safe and is reversible. “Although DBS is still an emerging treatment, promising efficacy and safety have been demonstrated in preliminary trials in patients with treatment-resistant depression (TRD),” states a 2014 study 82 . However, it should be noted that deep brain stimulation has been approved by the FDA 74 for the treatment of obsessive compulsive disorder (OCD) and Parkinson’s disease, but not for treatment-resistant depression. Regardless, research 83 shows that DBS is effective in improving depressive symptoms in patients with refractory depression, resistant major depression, recurrent unipolar depression & borderline personality disorders.

Apart from these, some other brain stimulation therapies for this mood disorder may include the following approaches:

  • Transcranial direct current stimulation (tDCS 84 )
  • Magnetic seizure therapy (MST 85 )
  • Vagus nerve stimulation (VNS 86 )
  • Cranial electrotherapy stimulation (CES 87 )
  • Theta-burst stimulation (TBS 88 )

4. Hospitalization

In extreme cases or when the patient is at a high risk for suicide, a doctor may reccommend immediate hospitalization 89 . Moreover, when the sufferer is incapable of taking care of themselves or highly prone to self-harm and harm to others. Proper psychiatric treatment provided by healthcare professionals at a hospital, such as a psychiatrist, clinical psychologist, nurses, social workers and rehabilitation therapists, can help the patient to recover better and stay safe until the condition stabilizes. A doctor may also recommend day treatment programs or partial hospitalization 90 depending on the severity of the symptoms and the individual. These can offer outpatient treatment, counseling and support necessary for managing the symptoms.

Prognosis

Although major depressive disorder may have substantial possible morbidity & mortality, and often leads to substance abuse and suicidality, most of the patients can effectively alleviate the symptoms with appropriate treatment. Research shows that according to various recent randomized trials intensive treatment in primary care for depression has clinical benefits. According to a 2019 study 91 , early recognition and treatment are extremely important for proper recovery as longer duration of untreated depression can lead to worse symptoms and outcomes. Response and remission is related to early improvement of the disorder. However, comorbidities can make the recovery process longer. “Well-established treatments such as electroconvulsive therapy (ECT) are clinically relevant for treatment-resistant populations, and novel transcranial stimulation methods such as theta-burst stimulation (TBS) and magnetic seizure therapy (MST) have shown promising results,” adds the study. Moreover, antidepressants like ketamine can also help in the treatment of MDD.

Recovery Is Possible With Treatment

Depression is a devastating condition that can affect a person’s ability to function, their relationships, their career and their ability to care for themselves. It may also lead to suicidal ideation and behaviors, if left untreated. However, with early identification and appropriate treatment one can fully recover from the condition. As depressive disorders can affect each person differently, it is crucial that the doctor devises the right treatment plan suited to the patient’s unique symptoms. Moreover, the recovery time may also vary for each individual depending on the symptoms severity, comorbid conditions, treatment compliance and lifestyle. Regardless, they need to be determined and have patience as treatment can lead to improved symptoms and full recovery.

If you or someone you know is experiencing depressive symptoms, then consult a mental health professional immediately.

References:
  1. Paykel E. S. (2008). Basic concepts of depression. Dialogues in clinical neuroscience, 10(3), 279–289. https://doi.org/10.31887/DCNS.2008.10.3/espaykel []
  2. McCarter T. (2008). Depression overview. American health & drug benefits, 1(3), 44–51. []
  3. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: Overview. [Updated 2020 Jun 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279285/ []
  4. Duval, F., Lebowitz, B. D., & Macher, J. P. (2006). Treatments in depression. Dialogues in clinical neuroscience, 8(2), 191–206. https://doi.org/10.31887/DCNS.2006.8.2/fduval []
  5. Cuijpers, P., Stringaris, A., & Wolpert, M. (2020). Treatment outcomes for depression: Challenges and opportunities. The Lancet Psychiatry, 7(11), 925-927. https://doi.org/10.1016/s2215-0366(20)30036-5 []
  6. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: How effective is psychological treatment? [Updated 2020 Jun 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430661/ []
  7. Saloheimo, H. P., Markowitz, J., Saloheimo, T. H., Laitinen, J. J., Sundell, J., Huttunen, M. O., A Aro, T., Mikkonen, T. N., & O Katila, H. (2016). Psychotherapy effectiveness for major depression: a randomized trial in a Finnish community. BMC psychiatry, 16, 131. https://doi.org/10.1186/s12888-016-0838-1 []
  8. Health Quality Ontario (2017). Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment. Ontario health technology assessment series, 17(15), 1–167. []
  9. Nieuwsma, J. A., Trivedi, R. B., McDuffie, J., Kronish, I., Benjamin, D., & Williams, J. W. (2012). Brief psychotherapy for depression: a systematic review and meta-analysis. International journal of psychiatry in medicine, 43(2), 129–151. https://doi.org/10.2190/PM.43.2.c []
  10. Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. (2016). How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry, 15(3), 245-258. https://doi.org/10.1002/wps.20346 []
  11. Mohamadian, F., Bagheri, M., Hashemi, M. S., & Komeili Sani, H. (2018). The Effects of Cognitive Behavioral Therapy on Depression and Anxiety among Patients with Thalassemia: a Randomized Controlled Trial. Journal of caring sciences, 7(4), 219–224. https://doi.org/10.15171/jcs.2018.033 []
  12. Driessen, E., & Hollon, S. D. (2010). Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators. The Psychiatric clinics of North America, 33(3), 537–555. https://doi.org/10.1016/j.psc.2010.04.005 []
  13. López-López, J. A., Davies, S. R., Caldwell, D. M., Churchill, R., Peters, T. J., Tallon, D., Dawson, S., Wu, Q., Li, J., Taylor, A., Lewis, G., Kessler, D. S., Wiles, N., & Welton, N. J. (2019). The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis. Psychological medicine, 49(12), 1937–1947. https://doi.org/10.1017/S003329171900120X []
  14. Cuijpers, P., Noma, H., Karyotaki, E., Cipriani, A., & Furukawa, T. A. (2019). Effectiveness and acceptability of cognitive behavior therapy delivery formats in adults with depression. JAMA Psychiatry, 76(7), 700. https://doi.org/10.1001/jamapsychiatry.2019.0268 []
  15. Zhang, Z., Zhang, L., Zhang, G., Jin, J., & Zheng, Z. (2018). The effect of CBT and its modifications for relapse prevention in major depressive disorder: A systematic review and meta-analysis. BMC Psychiatry, 18(1). https://doi.org/10.1186/s12888-018-1610-5 []
  16. Markowitz, J. C., & Weissman, M. M. (2004). Interpersonal psychotherapy: principles and applications. World psychiatry : official journal of the World Psychiatric Association (WPA), 3(3), 136–139. []
  17. Rajhans, P., Hans, G., Kumar, V., & Chadda, R. K. (2020). Interpersonal Psychotherapy for Patients with Mental Disorders. Indian journal of psychiatry, 62(Suppl 2), S201–S212. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_771_19 []
  18. Toth, S. L., Rogosch, F. A., Oshri, A., Gravener-Davis, J., Sturm, R., & Morgan-López, A. A. (2013). The efficacy of interpersonal psychotherapy for depression among economically disadvantaged mothers. Development and psychopathology, 25(4 Pt 1), 1065–1078. https://doi.org/10.1017/S0954579413000370 []
  19. Cuijpers, P., Geraedts, A. S., van Oppen, P., Andersson, G., Markowitz, J. C., & van Straten, A. (2011). Interpersonal psychotherapy for depression: a meta-analysis. The American journal of psychiatry, 168(6), 581–592. https://doi.org/10.1176/appi.ajp.2010.10101411 []
  20. Peprah K, Argáez C. Dialectical Behavioral Therapy for Adults with Mental Illness: A Review of Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 Oct 20. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525629/ []
  21. Chapman A. L. (2006). Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont (Pa. : Township[]
  22. Lin, T. J., Ko, H. C., Wu, J. Y., Oei, T. P., Lane, H. Y., & Chen, C. H. (2019). The Effectiveness of Dialectical Behavior Therapy Skills Training Group vs. Cognitive Therapy Group on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan. Archives of suicide research : official journal of the International Academy for Suicide Research, 23(1), 82–99. https://doi.org/10.1080/13811118.2018.1436104 []
  23. Feldman G, Harley R, Kerrigan M, Jacobo M, Fava M. Change in emotional processing during a dialectical behavior therapy-based skills group for major depressive disorder. Behav Res Ther. 2009 Apr;47(4):316-21. doi: 10.1016/j.brat.2009.01.005. Epub 2009 Jan 17. PMID: 19232571. []
  24. Stiglmayr, C., Stecher-Mohr, J., Wagner, T., Meiβner, J., Spretz, D., Steffens, C., Roepke, S., Fydrich, T., Salbach-Andrae, H., Schulze, J., & Renneberg, B. (2014). Effectiveness of dialectic behavioral therapy in routine outpatient care: the Berlin Borderline Study. Borderline personality disorder and emotion dysregulation, 1, 20. https://doi.org/10.1186/2051-6673-1-20 []
  25. Zargar, F., Haghshenas, N., Rajabi, F., & Tarrahi, M. J. (2019). Effectiveness of Dialectical Behavioral Therapy on Executive Function, Emotional Control and Severity of Symptoms in Patients with Bipolar I Disorder. Advanced biomedical research, 8, 59. https://doi.org/10.4103/abr.abr_42_19 []
  26. Sahranavard, S., & Miri, M. R. (2018). A comparative study of the effectiveness of group-based cognitive behavioral therapy and dialectical behavioral therapy in reducing depressive symptoms in Iranian women substance abusers. Psicologia, reflexao e critica : revista semestral do Departamento de Psicologia da UFRGS, 31(1), 15. https://doi.org/10.1186/s41155-018-0094-z []
  27. Gelder M. (1997). The future of behavior therapy. The Journal of psychotherapy practice and research, 6(4), 285–293. []
  28. Eelen P. (2018). Behaviour Therapy and Behaviour Modification Background and Development. Psychologica Belgica, 58(1), 184–195. https://doi.org/10.5334/pb.450 []
  29. Churchill, R., Caldwell, D., Moore, T. H., Davies, P., Jones, H., Lewis, G., & Hunot, V. (2010). Behavioural therapies versus other psychological therapies for depression. The Cochrane database of systematic reviews, (9), CD008696. https://doi.org/10.1002/14651858.CD008696 []
  30. MacKenzie, M. B., Abbott, K. A., & Kocovski, N. L. (2018). Mindfulness-based cognitive therapy in patients with depression: current perspectives. Neuropsychiatric disease and treatment, 14, 1599–1605. https://doi.org/10.2147/NDT.S160761 []
  31. Scott J. (2001). Cognitive therapy for depression. British medical bulletin, 57, 101–113. https://doi.org/10.1093/bmb/57.1.101 []
  32. Wielgosz, J., Goldberg, S. B., Kral, T., Dunne, J. D., & Davidson, R. J. (2019). Mindfulness Meditation and Psychopathology. Annual review of clinical psychology, 15, 285–316. https://doi.org/10.1146/annurev-clinpsy-021815-093423 []
  33. Barnhofer, T., Crane, C., Hargus, E., Amarasinghe, M., Winder, R., & Williams, J. M. (2009). Mindfulness-based cognitive therapy as a treatment for chronic depression: A preliminary study. Behaviour research and therapy, 47(5), 366–373. https://doi.org/10.1016/j.brat.2009.01.019 []
  34. Tickell, A., Ball, S., Bernard, P., Kuyken, W., Marx, R., Pack, S., Strauss, C., Sweeney, T., & Crane, C. (2020). The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services. Mindfulness, 11(2), 279–290. https://doi.org/10.1007/s12671-018-1087-9 []
  35. Deen, S., Sipe, W., & Eisendrath, S. J. (2016). Mindfulness-based cognitive therapy for treatment-resistant depression. Mindfulness-Based Cognitive Therapy, 133-144. https://doi.org/10.1007/978-3-319-29866-5_12 []
  36. Ribeiro, Â., Ribeiro, J. P., & von Doellinger, O. (2018). Depression and psychodynamic psychotherapy. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 40(1), 105–109. https://doi.org/10.1590/1516-4446-2016-2107 []
  37. Fonagy P. (2015). The effectiveness of psychodynamic psychotherapies: An update. World psychiatry : official journal of the World Psychiatric Association (WPA), 14(2), 137–150. https://doi.org/10.1002/wps.20235 []
  38. Hilsenroth, M. J., Ackerman, S. J., Blagys, M. D., Baity, M. R., & Mooney, M. A. (2003). Short-term psychodynamic psychotherapy for depression: an examination of statistical, clinically significant, and technique-specific change. The Journal of nervous and mental disease, 191(6), 349–357. https://doi.org/10.1097/01.NMD.0000071582.11781.67 []
  39. Driessen, E., Abbass, A. A., Barber, J. P., Connolly Gibbons, M. B., Dekker, J., Fokkema, M., Fonagy, P., Hollon, S. D., Jansma, E. P., de Maat, S., Town, J. M., Twisk, J., Van, H. L., Weitz, E., & Cuijpers, P. (2018). Which patients benefit specifically from short-term psychodynamic psychotherapy (STPP) for depression? Study protocol of a systematic review and meta-analysis of individual participant data. BMJ open, 8(2), e018900. https://doi.org/10.1136/bmjopen-2017-018900 []
  40. Ho C, Adcock L. Short-Term Psychodynamic Psychotherapy for the Treatment of Mental Illness: A Review of Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 Oct 12. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525874/ []
  41. Løvgren, A., Røssberg, J. I., Nilsen, L., Engebretsen, E., & Ulberg, R. (2019). How do adolescents with depression experience improvement in psychodynamic psychotherapy? A qualitative study. BMC psychiatry, 19(1), 95. https://doi.org/10.1186/s12888-019-2080-0 []
  42. Terman, M., Terman, J. S., Quitkin, F. M., McGrath, P. J., Stewart, J. W., & Rafferty, B. (1989). Light therapy for seasonal affective disorder. A review of efficacy. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2(1), 1–22. https://doi.org/10.1016/0893-133x(89)90002-x []
  43. Campbell, P. D., Miller, A. M., & Woesner, M. E. (2017). Bright Light Therapy: Seasonal Affective Disorder and Beyond. The Einstein journal of biology and medicine : EJBM, 32, E13–E25. []
  44. Perera, S., Eisen, R., Bhatt, M., Bhatnagar, N., de Souza, R., Thabane, L., & Samaan, Z. (2016). Light therapy for non-seasonal depression: systematic review and meta-analysis. BJPsych open, 2(2), 116–126. https://doi.org/10.1192/bjpo.bp.115.001610 []
  45. Chang, C. H., Liu, C. Y., Chen, S. J., & Tsai, H. C. (2018). Efficacy of light therapy on nonseasonal depression among elderly adults: a systematic review and meta-analysis. Neuropsychiatric disease and treatment, 14, 3091–3102. https://doi.org/10.2147/NDT.S180321 []
  46. Harmer, C. J., Duman, R. S., & Cowen, P. J. (2017). How do antidepressants work? New perspectives for refining future treatment approaches. The lancet. Psychiatry, 4(5), 409–418. https://doi.org/10.1016/S2215-0366(17)30015-9 []
  47. Penn, E., & Tracy, D. K. (2012). The drugs don’t work? antidepressants and the current and future pharmacological management of depression. Therapeutic advances in psychopharmacology, 2(5), 179–188. https://doi.org/10.1177/2045125312445469 []
  48. Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. [Updated 2021 May 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554406/ []
  49. Ferguson J. M. (2001). SSRI Antidepressant Medications: Adverse Effects and Tolerability. Primary care companion to the Journal of clinical psychiatry, 3(1), 22–27. https://doi.org/10.4088/pcc.v03n0105 []
  50. Zajecka, J. M., & Albano, D. (2004). SNRIs in the management of acute major depressive disorder. The Journal of clinical psychiatry, 65 Suppl 17, 11–18. []
  51. Isaac M. T. (2008). Treating depression with SNRIs: who will benefit most?. CNS spectrums, 13(7 Suppl 11), 15–21. https://doi.org/10.1017/s1092852900028273 []
  52. Arroll, B., Macgillivray, S., Ogston, S., Reid, I., Sullivan, F., Williams, B., & Crombie, I. (2005). Efficacy and tolerability of tricyclic antidepressants and SSRIs compared with placebo for treatment of depression in primary care: a meta-analysis. Annals of family medicine, 3(5), 449–456. https://doi.org/10.1370/afm.349 []
  53. Moraczewski J, Aedma KK. Tricyclic Antidepressants. [Updated 2020 Dec 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557791/ []
  54. Judd, F., & Boyce, P. (1999). Tricyclic antidepressants in the treatment of depression. Do they still have a place?. Australian family physician, 28(8), 809–813. []
  55. Sub Laban T, Saadabadi A. Monoamine Oxidase Inhibitors (MAOI) [Updated 2021 Apr 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539848/ []
  56. Sabri MA, Saber-Ayad MM. MAO Inhibitors. [Updated 2020 Jun 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557395/ []
  57. Thase M. E. (2012). The role of monoamine oxidase inhibitors in depression treatment guidelines. The Journal of clinical psychiatry, 73 Suppl 1, 10–16. https://doi.org/10.4088/JCP.11096su1c.02 []
  58. Fiedorowicz, J. G., & Swartz, K. L. (2004). The role of monoamine oxidase inhibitors in current psychiatric practice. Journal of psychiatric practice, 10(4), 239–248. https://doi.org/10.1097/00131746-200407000-00005 []
  59. Whittington, C. J., Kendall, T., & Pilling, S. (2005). Are the SSRIs and atypical antidepressants safe and effective for children and adolescents?. Current opinion in psychiatry, 18(1), 21–25. []
  60. Horst, W. D., & Preskorn, S. H. (1998). Mechanisms of action and clinical characteristics of three atypical antidepressants: venlafaxine, nefazodone, bupropion. Journal of affective disorders, 51(3), 237–254. https://doi.org/10.1016/s0165-0327(98)00222-5 []
  61. Buckley, N. A., & Faunce, T. A. (2003). ‘Atypical’ antidepressants in overdose: clinical considerations with respect to safety. Drug safety, 26(8), 539–551. https://doi.org/10.2165/00002018-200326080-00002 []
  62. Qato, D. M., Ozenberger, K., & Olfson, M. (2018). Prevalence of prescription medications with depression as a potential adverse effect among adults in the United States. JAMA, 319(22), 2289. https://doi.org/10.1001/jama.2018.6741 []
  63. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: How effective are antidepressants? [Updated 2020 Jun 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK361016/ []
  64. Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical Practice Guidelines for the management of Depression. Indian journal of psychiatry, 59(Suppl 1), S34–S50. https://doi.org/10.4103/0019-5545.196973 []
  65. Ng, C. W., How, C. H., & Ng, Y. P. (2017). Managing depression in primary care. Singapore medical journal, 58(8), 459–466. https://doi.org/10.11622/smedj.2017080 []
  66. Pharmacological Treatment of Mental Disorders in Primary Health Care. Geneva: World Health Organization; 2009. Chapter 4, Medicines used in depressive disorders. Available from: https://www.ncbi.nlm.nih.gov/books/NBK143201/ []
  67. Kato, M., Hori, H., Inoue, T., Iga, J., Iwata, M., Inagaki, T., Shinohara, K., Imai, H., Murata, A., Mishima, K., & Tajika, A. (2020). Discontinuation of antidepressants after remission with antidepressant medication in major depressive disorder: A systematic review and meta-analysis. Molecular Psychiatry, 26(1), 118-133. https://doi.org/10.1038/s41380-020-0843-0 []
  68. Courtet, P., & Lopez-Castroman, J. (2017). Antidepressants and suicide risk in depression. World psychiatry : official journal of the World Psychiatric Association (WPA), 16(3), 317–318. https://doi.org/10.1002/wps.20460 []
  69. Fornaro, M., Anastasia, A., Valchera, A., Carano, A., Orsolini, L., Vellante, F., Rapini, G., Olivieri, L., Di Natale, S., Perna, G., Martinotti, G., Di Giannantonio, M., & De Berardis, D. (2019). The FDA “Black Box” Warning on Antidepressant Suicide Risk in Young Adults: More Harm Than Benefits?. Frontiers in psychiatry, 10, 294. https://doi.org/10.3389/fpsyt.2019.00294 []
  70. Spielmans, G. I., Spence-Sing, T., & Parry, P. (2020). Duty to Warn: Antidepressant Black Box Suicidality Warning Is Empirically Justified. Frontiers in psychiatry, 11, 18. https://doi.org/10.3389/fpsyt.2020.00018 []
  71. Nischal, A., Tripathi, A., Nischal, A., & Trivedi, J. K. (2012). Suicide and antidepressants: what current evidence indicates. Mens sana monographs, 10(1), 33–44. https://doi.org/10.4103/0973-1229.87287 []
  72. Pompili, M., Serafini, G., Innamorati, M., Ambrosi, E., Giordano, G., Girardi, P., Tatarelli, R., & Lester, D. (2010). Antidepressants and Suicide Risk: A Comprehensive Overview. Pharmaceuticals (Basel, Switzerland), 3(9), 2861–2883. https://doi.org/10.3390/ph3092861 []
  73. Selvaraj, V., Veeravalli, S., Ramaswamy, S., Balon, R., & Yeragani, V. K. (2010). Depression, suicidality and antidepressants: A coincidence?. Indian journal of psychiatry, 52(1), 17–20. https://doi.org/10.4103/0019-5545.58890 []
  74. Blumberger, D. M., Hsu, J. H., & Daskalakis, Z. J. (2015). A Review of Brain Stimulation Treatments for Late-Life Depression. Current treatment options in psychiatry, 2(4), 413–421. https://doi.org/10.1007/s40501-015-0059-0 [][]
  75. Blumberger, D. M., Mulsant, B. H., & Daskalakis, Z. J. (2013). What is the role of brain stimulation therapies in the treatment of depression?. Current psychiatry reports, 15(7), 368. https://doi.org/10.1007/s11920-013-0368-1 []
  76. Salik I, Marwaha R. Electroconvulsive Therapy. [Updated 2020 Nov 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538266/ []
  77. Singh, A., & Kar, S. K. (2017). How Electroconvulsive Therapy Works?: Understanding the Neurobiological Mechanisms. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, 15(3), 210–221. https://doi.org/10.9758/cpn.2017.15.3.210 []
  78. Persad E. (1990). Electroconvulsive therapy in depression. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 35(2), 175–182. https://doi.org/10.1177/070674379003500214 []
  79. Janicak, P. G., & Dokucu, M. E. (2015). Transcranial magnetic stimulation for the treatment of major depression. Neuropsychiatric disease and treatment, 11, 1549–1560. https://doi.org/10.2147/NDT.S67477 []
  80. Chail, A., Saini, R. K., Bhat, P. S., Srivastava, K., & Chauhan, V. (2018). Transcranial magnetic stimulation: A review of its evolution and current applications. Industrial psychiatry journal, 27(2), 172–180. https://doi.org/10.4103/ipj.ipj_88_18 []
  81. Rizvi, S., & Khan, A. M. (2019). Use of Transcranial Magnetic Stimulation for Depression. Cureus, 11(5), e4736. https://doi.org/10.7759/cureus.4736 []
  82. Delaloye, S., & Holtzheimer, P. E. (2014). Deep brain stimulation in the treatment of depression. Dialogues in clinical neuroscience, 16(1), 83–91. https://doi.org/10.31887/DCNS.2014.16.1/sdelaloye []
  83. Eitan, R., & Lerer, B. (2006). Nonpharmacological, somatic treatments of depression: electroconvulsive therapy and novel brain stimulation modalities. Dialogues in clinical neuroscience, 8(2), 241–258. https://doi.org/10.31887/DCNS.2006.8.2/reitan []
  84. Brunoni, A. R., Moffa, A. H., Fregni, F., Palm, U., Padberg, F., Blumberger, D. M., Daskalakis, Z. J., Bennabi, D., Haffen, E., Alonzo, A., & Loo, C. K. (2016). Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data. The British journal of psychiatry : the journal of mental science, 208(6), 522–531. https://doi.org/10.1192/bjp.bp.115.164715 []
  85. Daskalakis, Z. J., Dimitrova, J., McClintock, S. M., Sun, Y., Voineskos, D., Rajji, T. K., Goldbloom, D. S., Wong, A., Knyahnytska, Y., Mulsant, B. H., Downar, J., Fitzgerald, P. B., & Blumberger, D. M. (2020). Magnetic seizure therapy (MST) for major depressive disorder. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 45(2), 276–282. https://doi.org/10.1038/s41386-019-0515-4 []
  86. Lv, H., Zhao, Y. H., Chen, J. G., Wang, D. Y., & Chen, H. (2019). Vagus Nerve Stimulation for Depression: A Systematic Review. Frontiers in psychology, 10, 64. https://doi.org/10.3389/fpsyg.2019.00064 []
  87. Huang, Y. J., Lane, H. Y., & Lin, C. H. (2017). New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity. Neural plasticity, 2017, 4605971. https://doi.org/10.1155/2017/4605971 []
  88. Oberman, L., Edwards, D., Eldaief, M., & Pascual-Leone, A. (2011). Safety of theta burst transcranial magnetic stimulation: a systematic review of the literature. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society, 28(1), 67–74. https://doi.org/10.1097/WNP.0b013e318205135f []
  89. Prina, A. M., Cosco, T. D., Dening, T., Beekman, A., Brayne, C., & Huisman, M. (2015). The association between depressive symptoms in the community, non-psychiatric hospital admission and hospital outcomes: a systematic review. Journal of psychosomatic research, 78(1), 25–33. https://doi.org/10.1016/j.jpsychores.2014.11.002 []
  90. Goldman, L. S., Nielsen, N. H., & Champion, H. C. (1999). Awareness, diagnosis, and treatment of depression. Journal of general internal medicine, 14(9), 569–580. https://doi.org/10.1046/j.1525-1497.1999.03478.x []
  91. Kraus, C., Kadriu, B., Lanzenberger, R., Zarate, C. A., Jr, & Kasper, S. (2019). Prognosis and improved outcomes in major depression: a review. Translational psychiatry, 9(1), 127. https://doi.org/10.1038/s41398-019-0460-3 []
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