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You’ve received a diagnosis of depression — or suspect you might have depression — and you’ve decided to pursue depression counseling. You might have heard of several treatment options. But how can you decide which one is right for you? Here, we’ll break down two of the most common depression counseling strategies. That way, you can make an informed choice with your healthcare provider.

1) Talk therapy

Talk therapy is also called psychotherapy. This form of depression counseling involves discussing your emotions, thought patterns and behaviors with a mental health professional. It can be conducted one-on-one or in a group setting. Here are four common types of talk therapy: 

  • Cognitive behavioral therapy — During cognitive behavioral therapy, your therapist will help you break down your thought and behavior patterns. Then, they’ll help you reprogram the ones that might be contributing to your depression. You won’t focus on your past; instead, you’ll focus on your current patterns and the ways you can move forward with healthier ones. There’s no one-size-fits-all approach. However, your personalized plan could include:

    • Goal-setting.
    • “Homework,” such as journaling.
    • Relaxation techniques.
    • Problem-solving exercises.
  • Dialectical behavior therapy — Dialectical behavior therapy is derived from cognitive behavioral therapy, but it’s adapted for those with very intense emotions. It involves a balance between accepting your situation and behaviors and learning how to change those factors for the better.
  • Interpersonal therapy — This is a short-term form of therapy that usually lasts 12 to 16 weeks. It’s designed to help you improve specific relationships, process grief and work through transitions (like divorce). It typically does not focus on sources of distress that do not have social factors.
  • Psychodynamic therapy — In this type of therapy, you’ll work with your therapist to identify and address childhood experiences and unconscious thoughts or feelings that may be affecting your mood.

You may need talk therapy for only a short period of time, or you may need (or want) to continue therapy long-term to manage your depression. Since there’s no medication involved, there is no risk of physical side effects with talk therapy. However, two considerations are time and cost. Talk therapy sessions generally last around 50 minutes, and weekly sessions are generally recommended, especially at first. 

2) Antidepressant medication

If you choose not to pursue therapy, or if it doesn’t work well enough for you, taking an antidepressant medication is another option for depression treatment. Although the exact mechanisms aren’t clear, depression appears to involve improper signaling in the brain by molecules like serotonin, norepinephrine and dopamine. Antidepressants work by normalizing the interactions of these molecules with their various receptors. There are many different types of antidepressants on the market. Some of the most common are:

  • Selective serotonin reuptake inhibitors (SSRIs) — SSRIs work by blocking the protein that moves serotonin from its place of action back into neurons for recycling. SSRIs are often the first drugs prescribed for depression, as their side effects are typically mild.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) —Like SSRIs, these drugs block the serotonin transporter. However, they also block the norepinephrine transporter.
  • Tricyclic antidepressants — Tricyclic antidepressants are part of an older drug class than SSRIs and SNRIs. They’re typically used only when the newer antidepressants are ineffective, as they tend to have more severe side effects.
  • Monoamine oxidase inhibitors (MAOIs) — MAOIs block the enzyme monoamine oxidase, which normally breaks down serotonin, dopamine and norepinephrine. But MAOIs can have serious side effects. They can also interact with food and other medications. For these reasons, they’re usually prescribed only when other antidepressants fail.
  • Other medication that augments antidepressants — One example is esketamine. Esketamine is an FDA-approved nasal spray for hard-to-treat depression that’s used alongside other antidepressants.

Your mental health provider may also recommend combining antidepressant medications if one type doesn’t relieve your symptoms well enough. 

As with all drugs, side effects are possible with antidepressant medications. It’s up to you and your mental health provider to decide if the benefits outweigh the risks. There is also a very low time commitment for taking antidepressants. However, a recent study found that over five years, talk therapy and medication use are similar in terms of cost-effectiveness. 

Active Path Mental Health offers depression counseling

Active Path Mental Health provides several depression counseling services to help those with hard-to-treat depression, including short-term cognitive behavioral therapy, esketamine treatment and medication management.

Contact our team today for more information or to schedule an initial appointment.

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