Treatment of depressive disorder

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Treatment must be in a totally individualised form, as there are different types of disorder and symptoms that may present differently from one person to another.

The main therapeutic alternatives available are psychological and pharmacological treatment. Both are not mutually exclusive, totally the opposite, since a very large percentage of individuals affected by a depressive disorder benefit from combined psychological and pharmacological treatment.

Psychological treatment

Cognitive-behavioural psychotherapy and, to a lesser extent, interpersonal psychotherapy, have scientifically demonstrated their efficacy in the short and long-term treatment of the majority of depressive disorders.

The main objectives of psychological treatment:

Psychological treatment of the depressive symptoms

Treatment of the depressive symptoms.

Smiling person with episodes of hyperactivity or mania due to bipolar disorder

Modification of personality traits that can lead to the appearance of depressive disorders.

Person who came up with an idea

The learning of strategies for the early identification of the symptoms and prevention of relapses.

When the word “treatment” is used, it refers to an intervention process (in this case with psychological techniques) aimed at modifying a pathological condition or dysfunction, and thus managing to improve the state of the person that has it. Based on this definition, the support, the advice, the accompaniment, or talking, are alternatives that, by themselves, although they can be useful for the individual (for example, on their mood), are not psychological treatments.

Pharmacological treatment

Among the different drug groups that can be prescribed for a depressive disorder, the drugs called antidepressants form the main basis of pharmacological treatment.

The efficacy of this treatment is very well-demonstrated for moderate or severe cases of major depression. On the other hand, there is still not an adequate scientific basis to suggest an elevated efficacy in individuals that have a mild episode of a major depression, a dysthymia, or an adjustment disorder. Despite this, clinical experience suggests that, in determined situations, the prescribing of an antidepressant drug can be recommended in this wide sub-group of patients, in combination with psychological treatment.

As regards antidepressant drugs, a key aspect is to be aware that the antidepressant effect usually starts to be observed from the 3rd or 4th week of treatment. Likewise, it is important to mention that many antidepressant drugs are available, each one them with particular characteristics as regards effectiveness and, especially, as regards the side-effects profile.

Treatment complications

The type and intensity of the side effects will appear in one form or another depending on the person and the antidepressant drug.

Decreased sexual appetite

Reduction in sexual desire and/or difficulty in achieving an orgasm. In males, it can occasionally cause difficulty in obtaining a full erection.

Person putting a hand to the head, with a symbol indicating dizziness and malaise

Gastrointestinal problems, in particular a feeling of nausea or mild oppression in the pit of the stomach.

Scale with an arrow pointing upwards indicating a weight increase

Slight weight increase.

Dryness of mouth

Dryness of mouth.

Recurring dreams

Greater tendency to dream, with sensation that the dreams are more vivid or real and remembered more.

Reduced self-esteem

Affective “anaesthesia”. The person explains that in situations with a marked emotional component they have a lower emotional response, with a greater capacity than usual to confront these types of situations in a more relaxed way.

All these side-effects usually appear while taking the antidepressant drug. The only exceptions are the nausea-type gastrointestinal discomforts, which usually subside within a maximum period of one week.

Contrary to the general belief, the majority of antidepressant drugs do not cause drowsiness.

Substantiated information by:

Joana Guarch Domenech
Victor Navarro Odriozola

Published: 3 April 2018
Updated: 3 April 2018

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