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Description: OK quick, off the top of your head answer these questions. What is the standard form of treatment for clinical depression and what percentage of people with depression treated that way experience substantial relief of their symptoms? If you said anti-depressant medication  as you answer to the first question you are correct but would it surprise you to learn that only 50 to 60 percent of those treated with anti-depressants experience a reduction in the depressive symptoms over their first 2 months on the medication AND that nearly 80% of those who are prescribed anti-depressants stop taking them within a month of starting them? Think about what these (lots of research supported) numbers suggest about the treatment of depression and then about what else we do or should consider when trying to figure out what treatment approach should be taken on a person-by-person basis. Once you have your thoughts/proposals in order have a read through the article linked below to see what researchers in treatment of depression have to say on this.

Source: Depression too often gets deemed ‘hard to treat’ when medication falls short Elissa H. Paterson and Jay Kayser, The Conversation.

Date: March 15, 2023

Image by Holger Langmaier from Pixabay

Article Link:

So, is depression a social problem or a disease? Whichever direction you lean in with your answer to that question you have to see that we need to think about and to work harder the challenge of how to most effectively treat depression. The ‘medicate and move on’ (depression as a chemical imbalance in the brain) approach to treating depression does not seem to be very effective and rather than holding out hope for more effective medication it may be time to consider a broader approach to dealing with depression. Psychotherapy (cognitive behavior therapy) helps but also walking in nature, exercising, working on getting better sleep, and all sorts of other things also seems to help. So maybe we need to broaden our treatment options list a bit AND do the research needed to help us figure out how to optimize treatment options for depression on a person by person basis.

Questions for Discussion:

  1. What does the debate about the effectiveness of antidepressant medications involved?
  2. What are some of the ‘other than medication’ approaches to treating depression?
  3. What would research designed to work out optimal depression treatment approaches on a person by person basis look like?

References (Read Further):

Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., … & Geddes, J. R. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Focus, 16(4), 420-429. Link

Schroder, H. S., Patterson, E. H., & Hirshbein, L. (2022). Treatment-resistant depression reconsidered. SSM-Mental Health, 2, 100081. Link

Cuijpers, P., Stringaris, A., & Wolpert, M. (2020). Treatment outcomes for depression: challenges and opportunities. The Lancet Psychiatry, 7(11), 925-927. Link

Burns, R. A., Windsor, T., Butterworth, P., & Anstey, K. J. (2022). The protective effects of wellbeing and flourishing on long-term mental health risk. SSM-Mental Health, 2, 100052. Link

Brown, D. J., Arnold, R., Fletcher, D., & Standage, M. (2017). Human thriving. European Psychologist, 22(3). Link

Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2022). The serotonin theory of depression: a systematic umbrella review of the evidence. Molecular psychiatry, 1-14. Link

Remes, O., Mendes, J. F., & Templeton, P. (2021). Biological, psychological, and social determinants of depression: a review of recent literature. Brain sciences, 11(12), 1633. Link

Sarris, J., O’Neil, A., Coulson, C. E., Schweitzer, I., & Berk, M. (2014). Lifestyle medicine for depression. BMC psychiatry, 14(1), 1-13. Link

Posternak, M. A., Solomon, D. A., Leon, A. C., Mueller, T. I., Shea, M. T., Endicott, J., & Keller, M. B. (2006). The naturalistic course of unipolar major depression in the absence of somatic therapy. The Journal of nervous and mental disease, 194(5), 324-329. Link

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