Three Therapies for Depression
The earlier you begin treatment for depression, the more effective your outcome will be. Even in the most severe cases, there are treatments that can alleviate your symptoms. Depression is typically treated with psychotherapy, medications, or a combination of the two. Today, in addition to the typical psychotherapy-medication path, more emphasis is on behavioral therapies in conjunction with alternative medicine treatments and environmental therapy. The following are just a few of the treatments in use to alleviate symptoms associated with major depression.
1. Psychological Treatment
Psychological treatments, also known as talk therapy, are a critical factor in successfully treating major depressive disorder. Psychological therapy focuses on teaching you strategies to better deal with negative thinking patterns, establish better coping skills, and relieve unresolved trauma. Various types of therapy fall under the umbrella of psychological treatment, and psychotherapy can be experienced in different formats. Depending on your needs, treatment may involve more than one format. Standard psychotherapy formats include individual therapy, group therapy, couples therapy, and family therapy.
There are several types of psychological treatments available.
The ones that have shown the most success in treating depression are:
- Cognitive therapy. This short-term goal-focused therapy concentrates on the ways our thought patterns impact our emotional states. Cognitive therapy helps you identify and change negative thinking patterns or cognitive distortions. Mindfulness-based cognitive group therapy uses mindfulness meditation practices to make you more aware of your thought patterns and help you focus on the present moment.
- Cognitive-behavioral therapy (CBT). This short-term therapy is one of the most effective psychological therapy options for treating depression. CBT effectiveness is based on the understanding that the way we think and act affects the way we feel. CBT focuses on identifying distorted thoughts or beliefs that cause negative feelings or actions. It does not consider unconscious issues from your past. Therapists work with you to identify the thought patterns and behaviors contributing to your depression, change negative or irrational thought patterns, and modify behaviors.
- Interpersonal therapy (IPT). This is also a more limited therapy addressing past and present interpersonal interactions to determine how interpersonal conflict and lack of social support impact depression. Therapy may look at conflict resolution techniques in relationships with family, partners, or coworkers.
- Psychoanalytic therapy. This type of psychological treatment is an internally focused treatment that works on the assumption that your current depressive disorder is connected to unconscious unresolved childhood issues. This long-term therapy can build self-awareness by helping you understand how feelings and emotions from the past contribute to your present-day situation.
2. Behavioral Treatment for Depression
Behavioral therapy differs from cognitive therapy in that it focuses on changing behaviors rather than thought patterns. This type of therapy helps you identify and participate in activities that will enhance your positive feelings and overall well-being. Behavioral therapy enables you to identify unhealthy or self-destructive behaviors that may contribute to your depression and replace them with more positive ones.
A central component in behavior therapy is behavioral activation. When you are suffering from depression, you are more likely to avoid participating in activities you enjoy. This results in increasing isolation, higher anxiety levels, and a worsening of your mood, compounding your depression. Behavioral activation helps you identify specific pleasurable activities and set goals to incorporate them into your daily life. Learning this coping strategy can increase your chances of successfully reducing your depression symptoms.
The different types of behavior therapy include behavioral and cognitive play therapy, system desensitization, and aversion therapy, among others.
3. Environmental Treatment
Environmental therapy treatment focuses on the impact that a patient’s physical environment has on their physical and mental health. Environmental factors can be your workplace environment, your home, food, air, or water. Bijlsma & Cohen are two of many clinical experts who have researched the association between toxic exposure and deteriorating health conditions.25 Environmental medicine is based on the belief that allergic and toxic substances produce subtle reactions in the body that accumulate over time, causing illness or disease and behavioral and mental disturbances. Practitioners focus on identifying and removing environmental issues that may cause illness and reducing exposure to toxins. The next step is detoxifying and cleansing the body of all toxic substances and integrating practices that support holistic recovery and healing.
Another form of environmental therapy, or eco-therapy, involves getting back to nature. Eco-therapy practitioners believe that modern society’s focus on technology and its alienation from nature cause much of our depression and anxiety. Since the Industrial Revolution began, our focus has become increasingly removed from the outdoors. There are proven psychological benefits from just getting outside and enjoying nature. Researchers such as Ulrich, Summers, and Vivian among others have found that walking outside in nature every day can be as effective as antidepressant medication for mild-to-moderate depression, and effective as a recovery tool applicable to times of stress, social upheaval, and even during or after a pandemic has ravaged through an entire population.22,23,24
Medications
Antidepressant medications are often the first-line treatment 11 given after a diagnosis of MDD despite the commonly overlooked criteria “C” in the DSM V that requires establishing that the depressive state is not attributable to physiological effects of some substance or medical condition. Nonetheless, antidepressants are the most common treatment for depression. There has been debate about efficacy in general with antidepressants. In published clinical trials out of Germany10 approximately 20-40% of people taking a placebo reported feeling better. An additional 20% of those participating in the trials reported improvements with actual antidepressant medication. It is not uncommon to have to try several antidepressants to find one that has manageable side effects and helps with your symptoms. Because of the risk of withdrawals, never abruptly stop taking your medication. A doctor will need to help you safely decrease your dosage, which may mean gradually titrating down to well below the minimum prescribed doses, i.e., well below 5 mg.7
How Trintellix (Vortioxetine) Works to Treat Depression
The FDA, drug researchers, and drugmakers all admit the precise action of how antidepressants work is unknown.4,12 There has been much research done to clarify the mechanisms of action and how these relate to mental illness, but so far nothing definitive has been established beyond some quite detailed theories and hypotheses, all as yet unproven according to published research in The Lancet.11
1. What Is Trintellix (Vortioxetine)?
Trintellix is a doctor-prescribed SSRI-type antidepressant medication used in treating major depressive disorder in adults as young as age 18 and up.4,26,27 Trintellix was designed to influence the serotonin neurotransmitter, and possibly other areas of neurochemistry. Decades of research as reported by Sangkuhl et al in The Journal of Pharmacogenetics and Genomics have not discovered any definitive explanation of how SSRI medications work.12
2. What Type of Antidepressant Is Trintellix?
Trintellix is classed as an SSRI antidepressant, which means selective serotonin reuptake inhibitor.
3. Does Trintellix Help With Major Depressive Order?
Kirsch et al did a massive review of all the clinical trials researching SSRI efficacy for the treatment of MDD that had been submitted to the FDA prior to drug approval. The evidence of the efficacy of antidepressants compared to placebo was poor, meaning the results resulted in less than what could be considered clinically significant.14
4. Is Trintellix a Mood Stabilizer?
A mood stabilizer is a drug used to treat bipolar disorders. Trintellix is not a mood stabilizer, is not approved to treat bipolar, and is not in the same category as drugs such as lithium.15
Side Effects of Using Trintellix to Treat Depression
The FDA has reported and stated on the package insert that Trintellix is associated with a number of adverse side effects, some of which require cessation of the drug or reducing the dosage by half for patient safety.4 As stated above, these are not dissimilar to the adverse effects of other antidepressants.
The most common are:
- Decreased sex drive
- Heartburn
- Gas and constipation
- Dry mouth
- Blurred vision
- Spinning sensation
- Change in taste sensations
- Nausea and vomiting
More severe side effects that require a call to your doctor are:
- Coordination issues
- Agitation
- Muscle twitching
- Increased thirst
- Breathing issues
- Vomiting blood
- Seizures
- Black stools
Trintellix can cause many serious side effects, including suicidal thoughts, serotonin syndrome, mania, hypomania, increased bleeding, vision problems, discontinuation syndrome, and low salt levels. Be sure to keep up with your regular health care appointments.
What to Do If Your Antidepressant Stops Working
According to the Journal of Advances in Psychopharmacology, author Penn advises that since there is little to no evidence available to assess the efficacy of SSRIs, they are generally considered “working” if a person can tolerate the side effects.15
If you feel your antidepressant medication is no longer working, or you are dissatisfied with the side effects of your current medicines, talk to your doctor. It may be helpful to contact a nutritional psychiatrist20 or other holistic practitioners familiar with alternative treatments for depression. It is of extra importance for your safety to have the proper support when changing medications or adjusting dosages.21 If your medication no longer works, there may be better alternatives. Contact Alternative to Meds for more information on treatments that can help with your depression besides Trintellix.
