For some, depression symptoms don't ever completely disappear; no matter how many depression treatments they try. What then?

Gold Standard for Treating Depression (part 32)

First of all, responders (those who find some relief through medications, but not remission) are very common in depression treatment. This is a reality of the illness. The goal is to lessen depression symptoms as much as possible.

It helps if you can remember that depression is an illness that often requires daily management. A good analogy is the care needed to manage diabetes on a daily basis. People with diabetes can live full and healthy lives, but they must be vigilant in how they manage the illness.

If you respond to the antidepressant medications, but still must deal with depression symptoms, you will have to do the same. The good news is that you can continually search for the combination of treatments that will work for you so that you can move past the daily maintenance and have more time to enjoy your life.

video: Depression Treatment Interviews w/Julie Fast

For many, depression seems like it will last forever. But will it really?

Gold Standard for Treating Depression (part 31)

When you're depressed, it certainly feels like the depression will never end and that you will have to live with the depression symptoms for the rest of your life. Fortunately, this is rarely the case; people with depression can and do get better. The more you explore and utilize your depression medication(s) and other treatment options, the more chance you have of ending the power depression has over your life.

How Often Does Depression Go Into Remission?

As seen by the Star*D research results, it's very possible that over 50% of people with depression can go into remission when a person finds the right combination of treatments for depression. People who reach remission (virtual absence of symptoms) generally function better socially and at work and have a better chance of staying well than do people who only achieve a partial positive response but not a remission. Even if you have partially responded to depression treatment in the past but have not experienced a remission in your initial treatments, there is still a good chance you can experience a remission in the future.

video: Depression Treatment Interviews w/Julie Fast

Information and insight into the two kinds of suicidal thoughts and how to handle thoughts of wanting to kill yourself.

Gold Standard for Treating Depression (part 30)

There are two kinds of suicidal thoughts you may experience when you're depressed. The first are passive thoughts. These include thoughts such as, I wish I were dead. Things would be better if I were dead. What is the point to my life? I wish I could just walk in front of that bus and die. These thoughts are scary, but there are a normal part of depression. They often worsen when your depression is triggered by an outside event.

Though passive suicidal thoughts must be addressed and talked about with a healthcare professional, they are not as severe as the active suicidal thoughts that come with specific plan for suicide. Active suicidal thoughts are dangerous and need immediate attention. They include thoughts such as, I'm going to kill myself tomorrow. I'm going to buy a gun. There is no point to life. I'm going to end it now.

It cannot be said enough that active suicidal thoughts must be taken very, very seriously and treated immediately. It helps to somehow remind yourself, even when the thoughts are at their most desperate and you really do feel it would be much better if you were dead, that it is depression talking. Suicide is about ending pain and does not mean you want to end your life.

Talk to someone and treat it as an illness. If you had serious pneumonia and were scared you were going to die, you would get help. You need to do the same for suicidal thoughts caused by depression.

video: Depression Treatment Interviews w/Julie Fast

When depression becomes so severe, a person may require psychiatric hospitalization for depression.

Gold Standard for Treating Depression (part 29)

Though psychiatric hospitalization is not an alternative therapy to medications, it's often a last resort choice for those who do not respond well to traditional depression treatment or for those who have not received treatment at all.

The most important thing for people with depression to remember regarding hospitals is that there is nothing wrong or weak about being treated in a psychiatric hospital for depression. If a person had life-threatening pneumonia, a hospital would be the first treatment choice. And people would certainly never think the ill person should just stick it out at home and 'take care of their problems!'

It's very sad and dangerous that depression is not seen in the same way as other physiological illnesses. If someone is severely depressed -- they are in a life-threatening situation that often requires hospitalization. Hospitals can be a safe place for people who are depressed. They provide the attention and medical help needed to get someone out of a severe and usually life-threatening depression. If you experience suicidal thoughts with a plan of how to kill yourself, then hospitalization is a safe and effective way to help you get out of the depression so that more traditional treatments can be used.

video: Depression Treatment Interviews w/Julie Fast

Learn about Vagus Nerve Stimulation, a medical treatment for severe and treatment-resistant depression.

Gold Standard for Treating Depression ( part 27)

Vagus nerve stimulation (VNS) was originally used for hard to treat epilepsy. In 2005, the FDA approved a VNS device to treat adult patients with long-term or recurrent major depression that has not had an adequate response to four or more adequate antidepressant treatments.

How is it Performed?

A pacemaker like device is planted under the collar bone that periodically releases a charge of electricity through a wire that goes into the neck to wrap around the vagus verve. It periodically stimulates the brain and affects the hypothalamus. It's important to remember that this technique is used in extremely severe treatment resistant depression.

About 50% of people notice symptom improvement but it may take up to a year. 25% experience full remission. One of the problems is that the treatment can cost $20,000 if not covered by insurance.

Suggested Reading: Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression by Charles E., III Donovan, John M. Zajecka, and Nancy Williger

video: Depression Treatment Interviews w/Julie Fast

ECT, electroconvulsive therapy or shock therapy, may help severe depression if antidepressants or other depression treatments aren't effective.

Gold Standard for Treating Depression (part 26)

For some people, taking antidepressants, working with a therapist and making personal changes is not enough to find significant relief from depression. The following alternative depression treatments are sometimes used for severe depression that does not respond to more conventional treatments and may be an option for you if your depression is persistent and does not improve with more traditional treatments.

ECT (Electroconvulsive Therapy)

Before you read the following section, you may need to let go of the often negative portrayal of ECT seen in movies or sensationalized in books. ECT is a proven and often used treatment for serious depression as well as for depression that has not responded to the more traditional depression treatments.

ECT is a procedure where a short application of electric current to the brain induces a seizure. Prior to ECT treatment, a patient is put to sleep using general anesthesia and a muscle relaxant is given. Electrodes are placed on the patient's scalp and a finely controlled electric current is applied which causes a brief seizure in the brain. Because the muscles are relaxed, the seizure will usually be limited to slight movement of the hands and feet.

Patients are carefully monitored during the treatment. The patient awakens minutes later, does not remember the treatment or events surrounding the treatment, and is often confused. Some statistics state that this confusion typically lasts for only a short period of time while others show that some people given ECT have persistent short term memory loss.

When is ECT Used?

ECT is used as a last resort and is often a very effective and much-needed therapy. Patients who receive ECT are often severely psychotic as well as depressed and pose a threat to themselves either from suicide or life-threatening anorexia. ECT is one of the fastest and most effective ways to relieve symptoms in severely depressed or suicidal patients so that more traditional therapy can then be used.

How Does ECT Work and What are the Concerns?

What is known is that there are changes in all three neurotransmitters- serotonin, norepinephron and dopamine when ECT is used. ECT and antidepressants work in the same way. Antidepressants normalize neurotransmitters and ECT does the same, but much quicker. In terms of safety, ECT is considered very safe by many in the medical community. Some statistics report that there can be short term memory loss for about six weeks. Other statistics that do not support the above finding strongly suggest that the memory loss can be severe and persistent. This does not mean that ECT is necessarily dangerous or should not be used. It means that a person receiving ECT should know the risks.

ECT is usually followed by psychotherapy and medication under a psychiatrist's care. Unfortunately, ECT is not a permanent treatment and may have to be repeated to maintain stability. After a person recovers, there is a very high relapse rate unless they continue to take antidepressants. Another alternative is maintenance ECT on an outpatient basis.

Am I a Candidate for ECT?

Dr. John Preston, author of The Complete Idiot's Guide to Managing Your Moods notes, "ECT is indicated for people who are hospitalized with very severe depression as well as for those who have experienced long term, severe and persistent depression that has not responded to more traditional treatments. It is not to be taken lightly and is not usually given for milder depression.

Another problem is that ECT is very expensive. The person receiving treatment usually stays in the hospital for three weeks. If someone is depressed and severely psychotic, they need to be in the hospital anyway so this is often a good time for treatment. Before ECT is considered, you should discuss all available treatment options for your condition with your doctor."

ECT may be an option for you if you have spent years trying to successfully treat depression with only partial relief.

Suggested Reading: Shock: The Healing Power of Electroconvulsive Therapy by Kitty Dukakis, Larry Tye

video: Depression Treatment Interviews w/Julie Fast

Can you use alternative depression treatments or lifestyle changes without antidepressant medications to treat depression? That depends...

Gold Standard for Treating Depression (part 25)

Non-medication treatment of depression, especially when combined with therapy, can definitely have positive results. Whether it will work for you depends on the severity of the depression.

How many depression symptoms you can tolerate is up to you, but it's very important to remember that depression is a sign of a chemical imbalance in the brain and as with any imbalance, medications are often needed along with personal changes.

For some people, a combination of the above ideas and psychotherapy can produce positive results, for others, these therapies are not enough and they will need to add medications to their plan. The more awareness you have of how your lifestyle, thoughts, and behaviors affect depression, as well as finding a way to stop walking into situations or continuing behavior that causes or worsens your depression, the better chance you have of ending your depression.

video: Depression Treatment Interviews w/Julie Fast

Medications aren't the only way to treat depression. There are many alternative depression treatments that work for some people.

Gold Standard for Treating Depression (part 24)

For many people, augmenting lifestyle changes with less traditional choices can help reduce depression symptoms as well. Yoga, meditation, herbal and homeopathic supplements from naturopaths, acupuncture, biofeedback, bodywork, chiropractic treatment and energy healing are just some of the choices you have. Using these techniques alone to treat depression once again depends on the severity of your symptoms. It may be that you want to treat depression naturally and feel that this is the path you want to take, while others may use these therapies along with antidepressant medications and other lifestyle changes.

No matter what you decide, it's important to be realistic and try additional depression treatments if the above are not enough to manage depression successfully. It's also important that you discuss any herbal treatments with a healthcare professional to make sure the herbs do not lead to more depression symptoms or adversely interact with a drug you're currently taking.

video: Depression Treatment Interviews w/Julie Fast

Many people have no idea how to help a person deal with depression. You have to teach them. Here's how.

Gold Standard for Treating Depression (part 23)

The people around you may love you, but this does not mean they know how to help you. Seeing you cry or talk about how your life is worthless can be very confusing to others if you normally do not talk this way.

The best means to help the people you care about help you is to explain that depression is an illness that causes you to think and act in a certain way. Teach them what you sound like and what you do when you're depressed so that you can notice the symptoms together and do something about them before they go so far. You can then tell them how they can help.

For some people, asking for help through taking a walk together works, while for others, quiet physical contact makes a difference. What is important is that the people in your life don't only help you the way they want to help you. All people with depression have different needs. You need to clearly and rationally tell them what you need.

video: Depression Treatment Interviews w/Julie Fast

There are many triggers for depression. It's important to know your depression triggers to manage your depression successfully.

Gold Standard for Treating Depression (part 22)

Triggers are the number one environmental cause of depression. They can send you into a deep depression overnight or cause you to stay depressed for years. There are many triggers you can avoid in order to manage the illness and though you may think you have no control over many of the depression triggers in your life, you will probably have to make at least some changes in order to find relief from depression symptoms.

Common Depression Triggers

• Argumentative, negative and aggressive people (if this describes you, reducing your depression symptoms can help with the problem)
• Stressful work- especially work with constantly changing hours
• Travel - especially travel with time changes.
• Relationship problems
• Non-supportive family members and friends
• Drug and alcohol use
• World events
• Isolation
• Medication side-effects

You probably have your own list. If you continually walk into the triggers you know affect your depression, success in managing and hopefully ending depression is less likely than if you avoid the triggers, no matter how difficult this may be. Think of one thing from the above list that you can change today. Or maybe you have one of your own that you have wanted to avoid.

You do have choices when it comes to ending depression. Looking for and managing the triggers that cause stress and unhappiness can significantly reduce your depression symptoms. This an especially powerful tool if you currently get less than optimal relief from medications or can't take them at all due to side effects.

video: Depression Treatment Interviews w/Julie Fast