Over the past decade, we’ve experienced something of a revelation in terms of both how we treat and talk about mental illness. Not only have new medications and interventions come to market, but public officials talk about the issue, and celebrities are increasingly open about their own struggles with mental health issues.
One facet that still isn’t discussed very much, however, is perhaps the most pressing issue: the effectiveness – or relative lack of it – of popular medications.
Despite the fact that SSRIs are generally the first line of treatment for depression, research has shown that these medications, the mechanisms of which are honestly understood but poorly, are about as effective as a placebo. Though they benefit some patients and can be necessary, especially for those with more severe depression, the best ways to treat depression for many other individuals aren’t any medication at all, or at least not the most widely used varieties.
Doctors need to weigh the possible benefits of medication against the risks, which can even include suicidal ideation, before making any recommendations.
Among the many ways that patients may manage their depression, perhaps the simplest and most effective involves behavioral change. Lifestyle changes such as engaging in more exercise, sleeping more, spending further time outdoors, and even adopting a spiritual practice can all improve one’s mood.
In some countries, there’s even been a shift toward “prescribing” art – activities like reading poetry or visiting museums – as a protocol for mood disorders.
In addition to behavioral changes, another effective way you can manage your depression is by participating in talk therapy or other popular forms of therapeutic intervention, such as cognitive behavioral therapy (CBT). These therapeutic approaches can help people alter their thought patterns, understand their circumstances, and re-contextualize their situation so they can cope more effectively. Sometimes, this kind of mixed regimen may eliminate the need for medication.
New Pharmaceutical Frontiers
Not only do we not really understand why SSRIs work when they do, for many people they don’t work at all … and those are often the same people who need medication desperately to manage their otherwise debilitating depression. Today, these patients are often treated via polypharmacy, which poses serious risks.
The medication may have to be switched frequently. Researchers are hard at work on alternative interventions.
Among the treatments which have shown potential are HCN channel blockers, research into which has benefited from support by the Brain Research Foundation. These studies remain in the preliminary phases, but mouse models indicate that such drugs could modulate vital pathways and relieve symptoms of depression.
Of all the simple changes you can make to your day-to-day life to manage your depression, one basic practice that has shown transformative effects is practicing gratitude. Identify even a few small items in your daily life – a pet, a friend, a delicious meal – or write notes of gratitude to others, and this can improve your outlook and mood and help you find deeper meaning in your life, with no medication required.
Some people take the suggestion that depression might be treated without medication as a way of denial that their condition is serious or as a suggestion that it isn’t real. But talk to anyone who has been treated for highly severe depression and you’ll see they’ve been taught a variety of ways to manage their situation.
Medication and invasive treatments such as ECT may help, but they’re typically only part of the solution. Solid and lasting management of your depression requires living more deeply into your life … and medication can’t do that for you.