Beyond Blue

I just shared my belief that depression is conquerable. But how? Here are some treatment facts, according to “The Johns Hopkins White Papers 2007: Depression and Anxiety” by Karen L. Swartz, one of the physicians who evaluated me in Spring 2006. (I must assign a lot of power to her because I dreamed last night she was Vice President of the United States. I assisted with her campaign.):

“These days, medications are the most common form of therapy for depression. Any given antidepressant has up to a 70 percent chance of working in a particular person. Psychotherapy alone can work as well as antidepressant medications with fewer side effects but requires more time.

“Severe cases are depression are best treated with medication. (That statement is important. Those contemplating suicide are suffering from severe depression.) In the most extreme cases, electroconvulsive therapy may be recommended. Up to 90 percent of extremely depressed people improve with electroconvulsive therapy when it is used as a first-line treatment. However, the therapy is usually used only after other therapies have failed. When used as a last resort, the response rate drops to 50-60 percent.

“Combination therapy (medication plus psychotherapy) has been shown in some research studies to be more effective than either therapy alone for mild to moderate depression. Recent research suggests that combination therapy may prevent or delay relapses and recurrences of depression.

“By themselves antidepressant drugs usually produce a significant improvement by four to six weeks, although it may take up to 12 weeks on a therapeutic dose to see the full benefit. If a person’s depression responds fully to medication after this period, treatment moves on to the continuation phase, which lasts for six months to one year at the same dosage level. Those who have improved somewhat but still have a few symptoms after six weeks should be reassessed six weeks later. At the reassessment, the physician may adjust the dosage to improve response.

“When a drug does not work, a doctor may prescribe an antidepressant from a different class of medications, because drugs in the same class tend to work similarly. When a drug from one class is producing good results but causes unacceptable side effects, switching to a different medication within the same class can often help. In 20-50 percent of patients, adding the drug lithium can help boost the action of an antidepressant.”

Read on for new studies into treatment-resistant depression.

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