Depression Treatment Options

However the client should be aware of the treatment options so that he /she can discuss with the consultant. Broadly speaking, the treatment of depression rests on two factors Medication, and Psychotherapy or Counselling.

  • Medication is required for moderate and severe depressive disorder cases.
  • Counseling and psychotherapy serves as an edge in treating depression and need to be started simultaneously along with medicines.
  • You should continue the full course of psychotherapy even if you are feeling better to prevent a relapse.
  • Suddenly stopping antidepressants can precipitate a relapse. Medication needs be tapered gradually under your doctor’s supervision.



Pune ST bus driver runs amok killing 8 people, injuring over 30 people and smashing 37 vehicles before he was forcibly brought to a halt by two youths. The man appeared dazed and glassy eyed and was later discovered that he was suffering from schizophrenia, a mental illness. 25 million people suffer from schizophrenia in our country and an attempt is made to rehabilitate them and make them economically…Edit

Pune ST bus driver runs amok killing 8 people, injuring over 30 people and smashing 37 vehicles before he was forcibly brought to a halt by two youths. The man appeared dazed and glassy eyed and was later discovered that he was suffering from schizophrenia, a mental illness. 25 million people suffer from schizophrenia in our country and an attempt is made to rehabilitate them and make them economically…Edit


Ramesh (37 years old) had been coming for therapy for depression for a week now. One evening he came for the session really frustrated. He asked tentatively whether loss of memory could be due to his depression or the related antidepressants that he was given by his psychiatrist. He then went on to explain that he had excellent memory as far as numbers were concerned, so much so that as a child he could remember almost all 49 children’s marks in the class as the teacher called them out aloud before handing over the papers. Yet the previous evening when he had to give his new office number to his very important client he could not just get it right. It almost cost him his contract as the client got offended.

When I asked him when he started noticing this forgetfulness in him, he mentioned that a little before his divorce 3 years ago he had been noticing his forgetfulness but had been too emotionally wrapped up to pay further attention to it. He now realizes that the forgetfulness has been increasing over the years. Initially he thought that he was preoccupied and later brushed it off as a sign of early ageing and even hereditary. But yesterday’s incident was disturbing him.

First and foremost any physical disorder needs to be eradicated. Secondly causal factors as well as the mechanism of forgetting need to be understood. Usually mental decline begins by the age of 40 or 50. However people who are undergoing high emotional stress for an extended period of time also experience these symptoms as early as in their 30’s. Some of the stressors one cannot do away with given the stressful and competitive environment we live in, however we can counter them with certain changes in lifestyle. Health conscious people interested in living quality life introduce yoga/ physical exercises to their routine along with dietary changes. Similarly for mental health one needs to introduce what is called Neurobics in their life, a mental gym. Also contrary to popular belief, the mental decline most people experience is not due to the steady death of nerve cells. Instead, it usually results from the thinning out of the number and complexity of dendrites, the branches on nerve cells that directly receive and process information from other nerve cells that forms the basis of memory. Dendrites receive information across connections called synapses. If connections aren’t regularly switched on, the dendrites can atrophy.

The function of memory is primarily carried out by the cortex and the hypothalamus in the brain. Hypothalamus is the emotional seat of the brain. Anything which is emotionally laden is usually easier to recall, however if there is a flood of emotions it leads to confusion however if this flood continues for extended period of time, it can even cause atrophy in dendrites. This reduces the brains ability to put new information into memory as well as to retrieve old information. The good news is that aging brain, however, continues to have a remarkable ability to grow, adapt, and change patterns of connections. Therefore establishing associations and new pathways for connection have a healing effect on the brain.

The exercise program calls for presenting the brain with nonroutine or unexpected experiences using various combinations of your physical senses—vision, smell, touch, taste, and hearing—as well as your emotional “sense.” It stimulates patterns of neural activity that create more connections between different brain areas and causes nerve cells to produce natural brain nutrients, called neurotrophins, that can dramatically increase the size and complexity of nerve cell dendrites. Neurotrophins make surrounding cells stronger and more resistant to the effects of aging. Also, using multisensory approach, retrieving from the memory becomes easier with a web of associations supporting the matter. More often than not, adults don’t exploit the brain’s rich potential for multisensory associations. Think of a baby encountering a rattle. She’ll look at it closely, pick it up, and run her fingers around it, shake it, listen to whether it makes a sound, and then most likely stick it in her mouth to taste and feel it with her tongue and lips. The child’s rapidly growing brain uses all of her senses to develop the network of associations that will become her memory of a rattle. Adults miss out on this multisensory experience of new associations and sensory involvement because we tend to rely heavily on only one or two senses. As we grow older, we find that life is easier and less stressful when it’s predictable. So we tend to avoid new experiences and develop routines around what we already know and feel comfortable with. By doing this, we reduce opportunities for making new associations to a level that is less than idea. Simultaneous sensory input creates a neural “safety net” that traps information for future access.

Social interactions are also non routine and therefore socializing has similar effect. However we find more often than not that people who are undergoing emotional stress / depression want to be left alone and withdraw from social contacts. Is it any wonder why Psychiatrists suggest going for a walk rather that doing a fitness workout alone in your gym? Going for a walk allows one to experience all 5 senses and also provides the brain with social nutrients necessary to heal the brain.

Here are some of the ways in which you can use mental gym to improve on your memory:

1. Involve one or more of your senses in a novel context.
By blunting the sense you normally use, force yourself to rely on other senses to do an ordinary task. For instance: Get dressed for work with your eyes closed. Eat a meal with your family in silence.
Or combine two or more senses in unexpected ways: Listen to a specific piece of music while smelling a particular aroma.

2. Engage your attention. To stand out from the background of everyday events and make your brain go into alert mode, an activity has to be unusual, fun, surprising, engage your emotions, or have meaning for you. Turn the pictures on your desktop upside down. Take your child, spouse, or parent to your office for the day.

3. Break a routine activity in an unexpected, nontrivial way.
(Novelty just for its own sake is not highly Neurobic.)
Take a completely new route to work. Shop at a road side market instead of a supermarket. Normally, placing a key in a lock uses vision and “motor memory”—an unconscious “map” in the parts of our brain that control movement—which provides an ongoing feedback that allows us to sense where parts of our body are in space. (This is called the proprioceptive sense.)

Neurobics is recommended as a lifestyle choice, not a crash course or a quick fix. Simply by making small changes in your daily habits, you can turn everyday routines into “mind-building” exercises. It’s like improving your physical state by using the stairs instead of the elevator or walking to the store instead of driving.

Ramesh worked on these mental gym exercises for about 6 months and started regaining confidence in himself and also noticed his stress reducing, life feeling more meaningful, increase in interest and involvement in routine as well as novel things and social interactions and in general an elevated mood.


When does an everyday anxiety or stress becomes anxiety disorder?
Symptoms of anxiety are more prevalent than the common cold. Every one has experienced a knot in the stomach, heart palpitations, sweaty palms, worrying, irritability, difficulty concentrating, muscle tension, a dry mouth, difficulty sleeping or restlessness at some point in their life. Living in metropolitan city, we live wired in high stress situations and often find ourselves strung up or easily fatigued. How many of us find bodily aches and pains, sleepless nights a common phenomenon and run to the chemist or a spa to distress ourselves? These feelings and symptoms are ubiquitous. But, how does one know when these symptoms are an anticipated, reasonable reaction to endless gridlock, long commutes and the pervasive work holism that is endemic to the greater metropolitan area? Or, how does one know when they are indicative of a more significant problem? Is this temporary patch work kind of a phenomenon enough? One has to determine whether this is temporary or a regular phenomenon and then look into treatment options.
Everyday Anxiety
Everyone experiences anxiety. In small amounts it can be useful. That is, it can serve as a warning signal that something isn’t quite right.
Take a classic example, undoubtedly familiar to anyone who has been a student. You’re in college, the term is nearing its end. Finals are on the horizon. You’re behind in your reading and you’re behind in your studying. Your heart starts to palpitate. You experience feelings of impending doom. You imagine what it would be like to fail your courses. You become worried. And, you are compelled to take action. You hit the books and you study. You pass your finals with flying colors. In this case, your anxiety served a productive, advisory role. In a sense your anxiety was adaptive. It signaled to you that trouble was imminent and it prompted you to take effective action. It helped you to function and to meet the demands of your every day life. A little bit of anxiety can be motivating. It can help us to go to work when we’d rather play, to clean when we’d rather relax and to carry out the responsibilities of our every day lives. But, how do we know when we have crossed the fine line between everyday anxiety and generalized anxiety disorder?
When Everyday Anxiety becomes “Disorder”
This is an important question, many people worry that they may be depressed but anxiety is actually a far more prevalent psychological concern. Anxiety, unchecked, can lead to significant health and mental health difficulties. It is important to know when everyday anxiety crosses the threshold and becomes “anxiety disorder”. The good news: it is also the most treatable. We should become concerned when anxiety begins to persistently interfere with our capacity to function effectively in our everyday lives.
For example, Lets take an example of an executive in a MNC who gets anxious before his presentation. He gets so worried that he has sleepless nights imagining what if he fumbles. Even when he does sleep his sleep isn’t rested and wakes up feeling tired. He doesn’t seem to arrive at any conclusion but keeps replaying the possible scenarios over and over again. His body hurts and he finds himself getting extremely irritated on small issues. There is a general sense that one more thing and that he will snap. This seems to be a recurrent phenomenon, not restricted to performances anymore. He finds himself unable to pay attention at the meetings and seems disoriented, forgetting things generally. While this type of experience is fairly common, if it is recurrent, it is evidence of maladaptive anxiety. That is, the anxiety is getting in the way of the individual’s ability to function effectively in the workplace. Similarly, we should become concerned when anxiety interferes with our establishing and maintaining the kinds of personal relationships that we seek.
For example, let’s take the woman who would like to date and marry but finds rather than enjoying dating — she worries throughout the entire dating experience. Will he call? Won’t he call? What does it mean that he doesn’t call? What does it mean that he asks her out at the “last minute”? Why has he not invited her home? Will it last? Won’t it last? She calls her friends, seeking advice, but doesn’t find it reassuring. If they agree with her, she wants to disconnect. If they recheck on the basis of her worries she gets irritated. Instead of relaxing and having fun, she finds that she can’t enjoy herself. Anxiety that interferes with our ability to have gratifying professional or personal lives warrants evaluation.
Evaluation and Treatment
How does one go about seeking evaluation and treatment and what sorts of treatments are effective? Research has demonstrated that many types of treatment are effective in alleviating anxiety disorders. How one goes about seeking treatment reflects ones personal goals. Some approaches focus primarily on helping the individual to achieve symptom relief. For example, psychiatric medication can be helpful in helping the individual to calm down and not be so reactive to the stressors in her life. Psychodynamic approaches work by helping the individual to deepen their understanding of what is making them so anxious. Individuals are encouraged to talk freely about themselves and their lives with the idea that they may come to understand and overcome their inner conflicts.
For example, the woman who is anxious about dating may be very frightened for many reasons. She could be frightened of intimacy. A psychodynamic psychotherapy will help her to learn more about why she is so frightened of intimacy with the hope that as she deepens her self-understanding, she will become less frightened and more open to entering into a loving relationship. The idea is that if the anxiety can be fully understood and resolved, it is less likely to return.
Research shows that both of these approaches, and combination of them, can be extremely helpful in treating anxiety disorder. One works to give immediate relief and the latter to ensure that the problem or similar such issues are effectively dealt with permanently by the individual. The key is to seek early evaluation with a qualified mental health professional.
Does your anxiety require a professional evaluation?
Answer true or false to the following questions and find out.
For at least the last couple of weeks:
1. I have been excessively worried. I worry excessively about things.
2. I have difficulty settling down and working on a task.
3. I have difficulty concentrating.
4. Most nights, I have difficulty falling asleep or my sleep is fitful and restless. I wake up feeling tired and unrested.
5. My hands are sweaty and damp and often have palpitations.
6. I am irritable, often.
7. I am easily fatigued.
8. My anxiety makes it difficult for me to do my job as well as I should.
9. My anxiety makes it difficult for me to have the kind of relationships that I seek.
10. I experience a lot of muscle tension and body aches and pains.
If you have any of these symptoms persistently, you should seriously consider a psychological help.