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Elevating Psychiatric care What We Treat

Depression Treatment Options

Because of the stigma of mental illness and depression in particular, many people with depression try to treat themselves with drugs and alcohol to get relief. However, this can lead to addiction, exacerbate symptoms, affect relationships at home, school and work and create new health problems. Delaying professional treatment for depression can lead to risky behavior and suicide. Most suicides are caused by depression.

The best way to address your symptoms is to get a professional diagnosis and follow the treatments prescribed for you. It is important to understand that there is no quick fix but over time treatments will help better manage and improve your symptoms.

There are a number of different types of depression treatments available to people who suffer from this condition. Some of the most common treatments include medication, therapy, and self-help.

Prescription antidepressants are often the first line treatment along with psychotherapy. Studies show that this combination of drugs and therapy are the most successful approach to treating depression. These medications can help to balance the chemicals in the brain that are thought to be responsible for depression. Antidepressants can ease symptoms. They can take several weeks to begin working and some will cause side effects that may resolve with time. Children, teens, and young adults may experience suicidal thoughts in the first few weeks taking an antidepressant and will need to be closely watched.

When side effects do not resolve or your symptoms are not eased, you may need a trial of another type of antidepressant, or a combination of medications to find the ones that work best for you. Depression and anxiety often come together so Dr. Poulakos may recommend an antidepressant and an antianxiety drug. He will work with you to find the most effective medication or combinations for you.

Common types of antidepressants include:

  • Selective serotonin reuptake inhibitors (SSRIs) include Lexaproâ, Prozacâ, Paxilâ, and Zoloftâ regulate the brain chemical serotonin. SSRIs are a common first treatment option. However, children and young adults might develop more negative thoughts including suicidal thoughts with SSRIs so they will be closely monitored when Dr. Poulakos prescribes these drugs.
  • Selective norepinephrine reuptake inhibitors (SNRIs) include Cymbaltaâ, Effexorâ, and others.
  • Atypical antidepressants are drugs that affect dopamine including Wellbutrin and Remeron.
  • Tricyclic antidepressants such as Elavilâ are effective but can cause more severe side effects than SSRIs they are not the first drug to be recommended.
  • MAO inhibitors are only offered when other antidepressants fail to manage symptoms.
  • Antipsychotics may be useful for a type of depression called manic depression.
  • L- methylfolate is a prescription strength B vitamin called Deplinâ. It that has shown good success in treating depression.
  • Ketamine is drug that has been used to treat pain. Spravatoâ is FDA approved nasal spray to treat treatment – resistant depression. Treatment-resistant depression is when you have major depression and have tried and failed to find relief from your symptoms with other antidepressants. It requires medical supervision.  Studies are show it can help people who have major depression or are suicidal.

Therapy is another common treatment for depression. This type of treatment can help people to learn how to better deal with their condition. It can also help them to understand why they may be feeling depressed and how to change their thinking patterns. People with mild to moderate depression may find that talk therapy alone relieves their symptoms. Types of therapy include:

  • Cognitive behavior therapy (CBT). CBT can help change negative thought patterns and teach positive thinking techniques.
  • Acceptance and commitment therapy. This is a form of CBT that designed to help you develop positive behaviors even when you have negative thoughts using strategies like mindfulness and goal setting.
  • Interpersonal therapy can help you resolve relationship issues.
  • Dialectical behavior therapy (DBT) is helpful to problem solve.

Self-care is important. Getting healthy sleep, eating a healthy diet, stress management and activities like exercise, mediation and yoga can help.

Group therapy is another option for those who suffer from depression. These groups can provide support and information to people who are dealing with this condition. They can also help to provide a sense of community for those who may feel isolated.

Brain stimulation therapy can help people with severe depression. ECT, TMS an VNS

  • Electroconvulsive Therapy (ECT) is performed under anesthesia and is safe and effective to treat people with severe depression.
  • Transcranial magnetic stimulation (TMS) is an office procedure that offers the potential for long term symptom remission in people with major depression with no side effects.
  • Vagus nerve stimulation (VNS) is only used when other brain stimulation therapies have not helped to improve symptoms.

There are many treatments that can help you live a better life and manage your depression. With the right treatment(s) your symptoms can be managed, but there is the risk you will experience another episode of depression. If you have been previously treated successfully you will have developed the skills to recognize that you are suffering again and can prevent it or seek treatment early.

There is no cure for depression. Finding the treatments that work for you takes time. Often the best option is a combination of treatments. Dr. Poulakos will guide you in discovering the best combination of treatments to help manage your depression.

Dr. Poulakos offers evidence-based, individualized treatment using medication and psychotherapy, and state-of-the-art treatments. He is a caring and compassionate doctor who will work with you to find solutions that meet your unique needs. Contact him at his New York, New York office to schedule an appointment to receive the correct diagnosis and all your treatment options.

At a Glance

Dr. Paul Poulakos

  • Attending Psychiatrist at Mount Sinai Beth Israel Medical Center
  • Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai
  • Past Clinical Assistant Professor of NYU Langone Medical Center
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