Depression
Treatment of Chronic Depression
(Dysthymia)
There are several treatment options available for
people that suffer from dysthymia.
I.
Pharmacotherapy
The number of studies that focused on the
efficiency of antidepressants on people that
suffer from dysthymia is quite limited, but it is
widely accepted that a significant portion of the
dysthymic population benefits from antidepressant
medication. Antidepressant medications have
proven to reduce most of the symptoms, but
residual symptoms and behavioral patterns
associated with relapse (such as social
withdrawal, low self-esteem, poor
communication skills, hopelessness, negative
cognitive style, lack of motivation)
often persist during or after treatment. Some
of the antidepressants used to treat dysthymia
include: tricyclic antidepressants, monoamine
oxidase inhibitors (MAOIs), specific
serotonin reuptake inhibitors (SSRIs) (which have
shown to be as effective as tricyclics and better
tolerated), and more recently, newer serotonergic
agents.
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II. Psychotherapy
Psychotherapy is another treatment option that is proven
to be effective in treating dysthymia. Psychotherapy
focuses on the psychological impairment associated with
chronic depression. During therapy, the therapist
reassures the client of a depth understanding on the
issues and difficulties caused by depression, assess the
clients needs, self-destructive potential, and suicide
ideation, and guides the patient to adopt functional
cognitive, emotional and behavioral patterns. There are
several types of therapy used with people that suffer
from dysthymia:
A. Individual psychotherapy: Experience and new
research have showed that short-term focused
psychotherapies, that target a specific problem, work
better with depressed people than long-term analytic
approaches that target personality changes. Some of the
individual psychotherapies effective in treating chronic
depression are:
Cognitive Behavioral Therapy
(CT): This is a form of therapy based on the
idea that the thoughts, and not the external
events or people, trigger the feelings and
behaviors. It is considered one of the most rapid
forms of therapy in terms of its results, and is
one of the most studied forms of therapy for
chronically depressed people. Research shows that
those suffering from chronic depression respond
very well to cognitive behavioral therapy, and
the depressed symptoms register a significant
reduction similar with those achieved in
controlled antidepressant trials.
Cognitive behavioral therapy focuses on several
key topics such as: (1) the relationship
established between thinking and mood, (2)
identifying dysfunctional thoughts, automatic
thoughts and rational responses, and core
beliefs, (3) identifying and understanding the
cognitive distortions, and the level of
assertiveness displayed by the person.
Interpersonal Psychotherapy
(IPT): This is a short-term,
contractual, "here and now" focused
psychotherapy that has proven to be effective in
treating depressed people. Recent studies have
showed that individual interpersonal
psychotherapy may be effective in treating
dysthymic patients that did not respond to
antidepressants.
Interpersonal psychotherapy focuses on three main
goals: (1) symptom relief, (2) the person’s
level of adaptation to the social and
interpersonal circumstances associated with the
depression onset and evolution, and (3) restoring
the person’s level of functioning.
Cognitive-Behavioral Analysis
System of Psychotherapy: This is new
form of therapy elaborated to treat chronic
depression. It combines the cognitive-behavioral
and interpersonal interventions. Its main
goal is to teach the person to take
responsibility for their depression and regain
control over their moods using adaptive
strategies.
The therapy sessions are planned around several
key topics such as: (1) challenging the depressed
person to identify pessimistic assumptions, (2)
establishing causal connections between a mature
thinking and better outcomes, and (3) changing
the patient’s negative patterns of
interaction with family, friends and other
members of the society.
B. Group Therapy: Group therapy offers the
comfort of shared experiences among people with the same
affliction while reducing a person's sense of isolation.
Each group is lead by one or two therapists. This form of
therapy encourages feedback among its participants by
expressing the feelings triggered by the
discussion’s subject or situation, or becoming aware
of the way each person interacts with others. It also
offers the possibility to interact with others that share
same problem and provides the opportunity to safely
exhibit new behaviors. Group therapy offers a save
environment which helps participants build a comfortable
level of trust in each other that allows them to talk
honestly about personal and intimate issues.
C. Family Therapy: Family therapy is
another form of psychotherapy that can be effective in
treating chronic depression. Depression affects not only
one person, but the entire family by intefering with its
normal functioning. This form of therapy is focusing on
the problem as a system of interaction between family
members by identifying the role of a sick person in the
family structure and level of functioning. Family therapy
emphasizes family relationships as an important factor in
its members psychological health. The therapy sessions
centers around several key topics such as: (1) a
comprehensive family assessment, (2) a systematic
progression following defined treatment stages, (3)
establishing the family’s responsibility toward
changes, and (4) improving the family ability to cope
better with depression.
Article by Alina Morrow,
MS Psychology
OmniMedicalSearch.com
Depression
Bibliography
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