December 9, 2022

How to fight depression? Experts explain treatments and options

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(CNN Spanish) — Symptoms of depression in young people around the world have doubled during the covid-19 pandemic compared to pre-pandemic levels. One in four adolescents experience clinically elevated symptoms of depression, according to a published analysis in the medical journal JAMA Pediatrics.

In the United States alone, 30% of adults have reported symptoms of anxiety and depressive disorder during the pandemic, compared to 11% reported before its onset, according to the organization Kaiser Family Foundation (KFF). However, despite the fact that 20% of adults reported needing mental health counseling or therapy, they do not receive it.

Depression is a disorder that is due to an alteration in the neurotransmitters that regulate mood and, depending on the American Psychological Association (APA), is a condition that goes beyond sadness.

Dr. Alejandra Solís Flores, a specialist in Psychiatry with a high specialty in sleep disorders, points out that depression not only involves emotional symptoms, but also physical ones, such as variations in appetite or alterations in sleep patterns, and cognitive symptoms, such as impairments in memory, attention, concentration and thinking.

“The thought in a depressed person is a negative thought. All the time he is thinking that he cannot face the situation himself or that the situation is beyond him, “explained Solis Flores to CNN en Español.

For her part, Daniela Chinchilla Ochoa, Ph.D. in Psychology, a specialist in reproductive and women’s mental health, described depression as an inkblot. “Imagine that it starts in one part of your life and begins to spread to different areas. To the extent that these symptoms begin to affect the adaptive capacity of the person, it is how we can classify whether it is a mild, moderate or severe disorder”, he said in an interview with CNN en Español.

“That is why it is important to detect it (a depressive picture) and treat it in time to have a better impact on the person’s quality of life, because it does not disappear,” he added.

However, both mental health specialists say that all types of depression are treatable.

Make the first move

“I believe that [buscar ayuda] It is the first step that patients take a long time to take,” said Solis Flores. “The pandemic has made us give it a lot of importance [a la salud mental]but effectively people ask themselves ‘where or with whom do I have to go?’”, he added.

The psychiatrist indicated that the first step is to go to a doctor and let him know the symptoms, either a general practitioner or a specialist that the patient consults regularly. “They sometimes have training for initial medical management or also to be referred to a mental health specialist,” Solis Flores said.

However, going to a psychologist in the first instance is also an option, since this professional is trained to assess the severity of the symptoms and initiate psychotherapeutic treatment, as necessary.

Solis Flores pointed out that psychiatrists can perform an evaluation. “We are trained to evaluate management in the first instance, whether pharmacological or on many occasions, we evaluate and decide that a psychotherapeutic treatment is more than enough,” she added.

Likewise, Chinchilla Ochoa indicated that when a patient with a picture of moderate and severe depression goes to a psychologist in the first instance, it is most likely that he will refer him to a psychiatrist.

“It is the best dumbbell to have better results,” he added.

The million dollar question: how to treat depression?

Depression affects each person differently, so there is no single treatment that can be applied to all people, which is why the evaluation of each particular case is necessary.

“Many times, when the condition is of multifactorial origin, that is, there is some situation or problem that is generating the symptoms, it would be worthwhile not only to take pharmacological treatment, but also to accompany it with psychotherapeutic treatment,” Solis Flores said.

Psychotherapy, as explained by the specialist, is a series of cognitive-behavioral strategies that, through techniques such as confrontation, reflection and questioning, help manage certain types of behavior.

What is done in psychotherapy is to improve the coping mechanisms that patients often have in the face of certain life circumstances and that are the issues that led us to depression,” explained Solis Flores.

But when is psychotherapy, drug treatment, or both needed? The answer depends on how mild, moderate, or severe the patient’s symptoms are, as well as how long they have been present.

According to Solis Flores “there are cases in which the symptoms are mild, so they could be treated without any drug, but that depends a lot on the severity.”

“MMany times when we tell the patient that pharmacological treatment is required, I understand the resistance or the fear, but the fact of delaying treatment also increases the possibility of complications for patients,” he added.

The specialist explained that as with other diseases, such as diabetes —where glucose levels are regulated through insulin— the brain also works through chemical substances that regulate moods, so, Sometimes, it is necessary to use a pharmacological treatment.

“If you attack that biochemical part of your brain and work on it in parallel with psychotherapy, then you will be able to recover more successfully,” said Chinchilla Ochoa, who said that tricyclic medications are the most effective in the treatment of depression because they do not generate tolerance or dependence. “What does it mean? You don’t need more medication to get the same result and you’re not going to get addicted to it (medication),” she added.

Both specialists highlighted the importance of generating a relationship of trust between the patient and the specialist. When looking for a therapist, the US National Institute of Mental Health (NIHM) offers a tips seriesWhat:

  • Ask about the therapist’s area of ​​expertise.
  • Ask about the types of treatments offered.
  • Find out how long treatment might last and when symptoms and quality of life might improve.
  • Look at different options until you find a therapist with whom you feel comfortable.

What about “mindfulness”?

Full consciousness or “mindfulness” is staying in the present and paying more attention to thoughts, feelings and surroundings without prejudice. But how effective is it in fighting depression?

Solis Flores indicates that, on many occasions, “mindfulness” works as a support method in a psychotherapeutic and pharmacological treatment. “It can be a companion. A lot of times it’s not enough, but it can be a companion and it helps a lot to optimize treatment for depression,” she said.

  • Mindfulness and meditation against autism stress 3:04

“What ‘mindfulness’ asks you is ‘change your focus of attention’, which is what cognitive behavioral therapy does,” says Chinchilla Ochoa. “It is very common that when we are sad, when we are depressed, we focus on a thought that becomes ruminant, that becomes cyclical and is what keeps us constantly sad. What ‘mindfulness’ does is change the focus of attention to something else and normally takes it to the senses, not so much to your thoughts, it takes it to your body,” he added.

However, the Dr. in Psychology indicates that “mindfulness” is one more technique for treatment and not a replacement for psychotherapy and medication.

In the case of mindfulness-based cognitive therapy (MBCT), it seeks to teach people with a history of depression to disconnect from dysfunctional thoughts that are deeply ingrained. There is evidence that MBCT is effective as a treatment to prevent relapse in people with recurrent depression.

“These studies have provided evidence for the efficacy of MBCT on par with maintenance antidepressant pharmacotherapy and lead to a relative risk reduction of the order of 30-40%,” reads in a study.

Mindfulness-based cognitive therapy according to the APAis an eight-week group program that incorporates mindfulness exercises, such as yoga, body awareness, and daily tasks, with complete attention to what one is doing.

Is there a cure for depression?

According to Solis Flores, there is a cure, although it depends on whether the depressive episode is managed and whether the patient complies with the treatment time. “The patient may be without symptoms and may never have a depressive episode again. However, we also know that having had a previous depressive episode is already a risk factor for presenting it in the future,” she explained.

The psychiatry specialist indicated that this does not mean that a person who suffered a depressive episode will always be depressed or that they will not overcome depression.

“We can get ahead, it can be cured, but it has to be vigilant or make the patient aware of the symptoms that they presented in the event of a future episode if it occurs. It is not a law, but it is a risk factor to have a depressive episode again in the future,” he concluded.

How to help or seek help?

According to the APA, social isolation increases the risk of depression, although it adds that prolonged discussion of problems with friends can actually “increase depression as well.”

Therefore, as depression is an illness that “carries high costs in terms of interpersonal relationship problems,” according to the APA, it can also lead to problems for the family and cause the person to lose productivity problems.

Psychologists, behavioral therapy and medications are treatments approved by experts.

What to do in case of having a loved one with depression, according to the American Foundation for Suicide Prevention.

1. Do not leave the person alone.

2. Remove any firearms, alcohol, drugs, or sharp objects that could be used in a suicide attempt.

3. Call the US National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

4. Take the person to an emergency room or seek help from a medical or mental health professional.

For more tips and warning signs, Click here.

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