Part 4: Finding the Right Depression Treatment
In this Q&A series, three people with depression and two experts who treat mental health conditions shed light on the daily challenges of managing depression and offer their tips on how to live better with the condition—or to support a loved one. This is the fourth part of the series.
Panel at a Glance:
- Mani Garcia-Lesy, 42. Doctoral student at the City University of New York’s Health Psychology and Clinical Science program. Diagnosed with depression at 29.
- Bianca Thompson, 30. Certified nursing assistant in Oklahoma City. Diagnosed with depression at 19.
- Sara (not her real name), 30. Content strategist for a book publisher in New York City. Diagnosed with depression at 14.
- Jacob Appel, MD. Psychiatrist and assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City.
- Becky Whetstone, PhD. Licensed psychotherapist in private practice in Little Rock, Arkansas.
PART 4: Depression Treatment
Q: What does your treatment plan currently consist of? What led to finding the right treatment for you?
Sara:I went through a lot of treatment plans. I had a number of therapists — so many I’ve lost count of them all. Most of them did cognitive-behavioral therapy. I was in an outpatient program at one point. I did group therapy. My favorite was dialectical behavior therapy, which I think was the most helpful for teaching me how to manage negative emotions. I actually never found the perfect therapist for me, so I eventually gave up on that once I felt stable with medication. It took close to six years of trying different medications, doctors, and treatment plans before I found something that worked. It can take a long time — long enough that I think many people give up hope.
Bianca:My treatment plan is composed of medication, therapy, support groups, symptom monitoring, and several healthy lifestyle changes I’ve made. Medication helps with some of my symptoms, but it’s talk therapy that has helped me change my mind-set. Attending support groups helps by allowing me to share day-to-day struggles with other people living with a similar illness.
When it comes to lifestyle changes, I maintain a good balance between the hours I spend working, the hours I spend with others, and the hours I spend doing things I enjoy. Going to a movie or dinner with a friend helps keep me from isolating myself and allows me to feel “normal,” and painting is relaxing and gives me a way to express emotions that I struggle to talk about. Finally, journaling helps me monitor my symptoms and spot subtle changes in my thoughts. I practice letting my feelings come without judging them or trying in any way to control them.
Mani: For several years, my treatment consisted of medications combined with psychotherapy. Eventually, I was able to manage depression without medication, and I continued with psychotherapy only. I currently see a therapist as needed, and I have found the principles of mindfulness, emotion regulation, and compassion-based therapies to be very effective. I have also found the practice of parkour — a discipline that grew out of military obstacle training — to be a living metaphor of many of the core principles of talk therapy (mindfulness, facing and overcoming fears, connecting with a community), so I am really enjoying how it helps me. For me, it seems that the “right treatment” changes as I do, so I have had to learn to embrace the challenge of figuring out what works for me as time goes by.
Dr. Whetstone:It is vitally important that you bond with your therapist. If you don’t feel chemistry with them or don’t like their style, find someone else. We are all trained differently and have different personalities and interests. You can find your match if you just look around. It’s also important to look at lifestyle, nutrition, physical activity, and what you do to nourish yourself spiritually. (For me, it’s being out in nature regularly.) We have to have plenty of nourishing time. In addition, I’m trained to do hypnosis and find that it’s a huge benefit to my clients, and I highly recommend meditation. Interventions such as neurofeedback and biofeedback can also be really helpful because they train your brain to function in a healthier way. Finally, many think taking antidepressant medications is a cop-out, but this is a misguided view. I share my own experiences with depression and taking medications because I want to help remove any shame associated with the illness.
Dr. Appel:Although no one treatment is effective for every patient’s illness, current data suggests that a combination of talk therapy and medication produces the most successful outcome for mild to moderate depression. The types of talk therapy include cognitive-behavioral therapy (CBT), supportive therapy, and a therapy known as interpersonal therapy (IPT), which works well for depression that’s related to specific life experiences. Finally, electroshock therapy (ECT) is by far the most efficacious treatment for depression, and it should certainly be considered for severe or treatment-resistant depression. Although it does come with side effects, major advances have been made in the field of ECT over the past decade, and these side effects have been minimized significantly.
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