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Major Depressive Disorder Treatment
Treatment options depend on the severity and duration of symptoms. Far too often, doctors prescribe medication to people who are suffering from normal sadness to life stresses and loss. Many doctors and psychiatrists blame the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) for this. According to the DSM, major depression is diagnosed after only two weeks of at least five possible symptoms of major depressive disorder.
In reality, most mental health professionals ignore the two-week guideline and don’t diagnose major depressive disorder until the symptoms have been present on most days for two or more months (unless a person is suicidal). Everything from severe stress to a variety of health conditions can mimic several symptoms of MDD.
Mild cases of MDD involve minor chemical imbalances, and can sometimes be treated successfully with a combination of nutritional therapies, aerobic exercise, and counseling or psychotherapy.
Read the Non-clinical Depression section for more information about these strategies
Severe depressive disorder and most cases of moderate depressive disorder require medication to correct the biological imbalances and help repair brain cell damage.
In the same way that insulin is used to treat diabetes, anti-depressants are used to restore chemical balance in the brain. They also help facilitate regeneration of damaged brain cells and broken neural pathways.
When severe damage is present, lifelong medication may be necessary. This can happen when the depression is caused from brain trauma, such as a sports injury, or when depression is not treated early enough. This is especially true for people who have experienced three or more serious depressive episodes.
If other factors have contributed to your depression, such as an unbalanced high-stress lifestyle, poor nutrition or psychological issues, medication will provide the mental clarity necessary for addressing those problems.
How does medication work?
Your brain uses chemicals called neurotransmitters to send messages from one nerve cell to another. The messages pass on information about virtually every function in your body -- from body temperature, appetite and muscle movement to thoughts, memory and emotions. The type of information passed on depends on which neurons are activated and what part of the brain is stimulated.
With depressive illness, one or more of the neurotransmitters serotonin, norepinephrine and dopamine are depleted.
This stops the messages from continuing on their way, disrupting thought, mood, sleep, energy, motivation, memory, cognition, and response to pain.
Anti-depressants are designed to balance the levels and activity of neurotransmitters to restore normal function. Read more about medications for depression
What if medication doesn't work?
Some cases of clinical depression do not respond to any medications available today. New brain stimulation techniques show great potential for treating severe medication-resistant depression. These non-invasive techniques apply brief magnetic pulses tro the brain, essentially “re-wiring” specific neural pathways.
Read more about brain stimulation treatments for depression on the news page of this site.
What about counseling or psychotherapy?
Studies show that many people with mild depressive illness can be effectively treated without medication, through counseling, psychotherapy and lifestyle changes. The two most common approaches are talk therapy and cognitive behavioral therapy.
Even those with severe depressive illness that requires medication can benefit from consulting a mental health professional, along with your medical doctor. The counselor can help you navigate through the treatment process. If non-biological factors have contributed to your depression, a counselor will help you work through them. But keep in mind that clinical depression has psychological symptoms. Focusing on the symptoms without addressing the biological cause will provide little value. Once you are symptom-free from medication (and thinking clearly) a counselor can help you identify and address any non-biological factors that may have contributed to your depression.
Also, you may have damaged some relationships as a result of the irrational perceptions and confused thinking that occurs with clinical depression. A professional counselor can help you restore those damaged relationships.
When seeking a counselor, check their credentials and ask for referrals.
What about divine healing?
I am a Christian who believes in the healing power of God. I prayed for healing from depression, and my miracle came in the form of medication. Sometimes, God heals instantly. I have prayed for healing for other people, some of whom received instant healing. The incident that affected me most was when God healed a little deaf boy. He lived near Chernobyl at the time of the nuclear disaster, which resulted in his hearing loss. I prayed for him, and God instantly restored his hearing. I'll never forget the joy and excitement on his face (and his mother's face) when he realized he could hear.
I believe that all healing comes from God – whether that is experienced as an instant miracle, a process of divine restoration, or a process that includes medication or other forms of medical intervention.
Pray for healing. Pray for wisdom and guidance. And trust God to lead you on the journey of recovery.
Back to major depressive disorder overview
Back to clinical depression introduction
Non-clinical depression
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