Tuesday, April 28, 2009

Treating depression...what works and what doesn't

Although major depressive disorder is sometimes seen as a hopeless cause by the afflicted, proper treatment and therapy can really lead to decreased symptoms and lifted spirits.
Of the five major therapeutic categories, cognitive treatment is undoubtedly the most effective.

The cognitive behavioral theory of depression states that the patient’s excessive self-criticism and rejection is the root of the disorder. Cognitive therapy attempts to correct the negative thoughts and dysfunctional attitudes, therefore eliminating the patient’s pessimism and hopelessness.
The methods of cognitive therapy include gentle questioning, which helps them discover their irrational and maladaptive thoughts. In addition, homework assignments are given to break through the vicious cycle of depression (increased negative thinking leads to increased social isolation which in turn leads back to increased negative thinking).
It should be noted, though, that there are certainly cognitive critics. These people argue that the depressed patient’s pessimistic, negative thoughts are a result of their major depression, but not the cause. However, cognitive therapy triumphs over the other four major forms of therapy.
Psychoanalytic therapy does not work for major depressive disorder because it does not have any real roots in childhood, and even if it did, this form of therapy does not provide any real suggested treatments.
Humanistic therapy could also be effective in treating major depressive disorder. This form of therapy attempts to promote personal growth and acceptance through active listening and reflection. And while this type of introspection is important for the depressed patient, the therapy doesn’t offer any real solutions and takes too long to find a root cause; all the while the patient slumps into a deeper depression.
Because major depressive disorder is not generally a learned behavior, behavioral therapy is usually ineffective. Happiness cannot be classically conditioned through systematic desensitization, progressive relaxation, exposure therapy, flooding or aversive conditioning. Furthermore, operant conditioning does not work either, because the token economy technique does not work with something as abstract as joy.
Finally, the family/group therapy is not usually viewed as an effective therapy for major depressive disorder. Family therapy examines the role of the depressed member in the overall psychological well-being of the whole family and examines the role of the entire family in the maintenance of the depression. However, if someone in my family is diagnosed with depression, the chances that I am not already doing all that I can to help them is pretty slim; thus family therapy isn’t going to tell me anything I don’t already know and will provide few real solutions.
Therefore, the cognitive therapy clearly triumphs; it’s use of small steps to gradually (but still relatively rapidly) change thinking is clearly the way to go to see the most effective results.

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