Psychotherapy

Psychotherapy, also known as "talk therapy", is a core treatment option for those suffering from major depressive disorder. Cognitive behavioral therapy and interpersonal therapy have shown successful outcomes for depressive episodes.

Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, aims to change negative thought and behavior patterns associated with depression. In CBT, patients work with a therapist to identify unrealistic or negative thoughts and replace them with more realistic perspectives. Through behavior modification techniques, patients also learn healthier coping strategies for stressful life events and daily stressors that may trigger Global Major Depressive Disorder (MDD) Treatment

symptoms. Numerous studies have found CBT alone or in combination with antidepressants can significantly reduce symptoms of depression.

Interpersonal Therapy
Interpersonal therapy focuses on improving relationships and social support networks that may impact mood. Therapy involves addressing grief, role disputes, role transitions and interpersonal deficits. By resolving relationship problems and cultivating healthy support systems, patients gain coping strategies that protect against onset of future depressive episodes. Research supports interpersonal therapy as an evidence-based treatment with outcomes comparable to antidepressant medication.

Antidepressant Medication
When depression is moderate to severe, the current clinical guidelines recommend antidepressant medication, either alone or combined with psychotherapy, as the frontline treatment approach. Several classes of antidepressants have demonstrated efficacy in reducing depressive symptoms.

Selective Serotonin Reuptake Inhibitors
Selective serotonin reuptake inhibitors, or SSRIs, are the most commonly prescribed class of antidepressants due to their generally mild side effect profile. SSRIs work by blocking the reabsorption of serotonin, increasing its levels between brain synapses. Common SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro). Multiple large clinical trials have shown SSRIs to be significantly more effective than placebo in treating major depression.

Serotonin-Norepinephrine Reuptake Inhibitors
Serotonin-norepinephrine reuptake inhibitors, or SNRIs, function similarly to SSRIs but also impact norepinephrine. SNRIs approved by the FDA for major depressive disorder include venlafaxine (Effexor) and duloxetine (Cymbalta). These antidepressants are alternatives or augmenting agents when SSRIs alone do not provide full relief of depressive symptoms. Research supports SNRIs as generally well-tolerated and effective treatment options.

Tricyclic Antidepressants and Others
Older tricyclic antidepressants blocking reuptake of serotonin and norepinephrine have demonstrated efficacy similar to newer drugs despite more side effects. Monoamine oxidase inhibitors remain useful for some patients. Novel medications targeting cholinergic and glutamatergic systems are also in clinical trials for treatment-resistant depression. Transcranial magnetic stimulation and deep brain stimulation show promise as alternatives to standard antidepressants.

Overall, major depressive disorder treatment depends on patient factors, symptom severity, risk of side effects, co-occurring psychiatric conditions and patient preference. Careful medication management under a physician's supervision can help maximize benefits while minimizing risks for this complex, but highly-treatable mental illness. With appropriate treatment individualized to the individual, even severe and chronic depression can achieve substantial relief of symptoms.