Many forms of psychotherapy, including some short-term (10-20 week) therapies,
can help depressed individuals. "Talking" therapies help patients
gain insight into and resolve their problems through verbal exchange with the
therapist, sometimes combined with "homework" assignments between
sessions. "Behavioral" therapists help patients learn how to obtain
more satisfaction and rewards through their own actions and how to unlearn the
behavioral patterns that contribute to or result from their depression.
Two of the short-term psychotherapies that research has shown helpful for some
forms of depression are interpersonal and cognitive/behavioral therapies. Interpersonal
therapists focus on the patient's disturbed personal relationships that both
cause and exacerbate (or increase) the depression. Cognitive/behavioral therapists
help patients change the negative styles of thinking and behaving often associated
with depression.
Psychodynamic therapies, which are sometimes used to treat depressed persons,
focus on resolving the patient's conflicted feelings. These therapies are often
reserved until the depressive symptoms are significantly improved. In general,
severe depressive illnesses, particularly those that are recurrent, will require
medication (or ECT under special conditions) along with, or preceding, psychotherapy
for the best outcome.
HOW TO HELP YOURSELF IF YOU ARE DEPRESSED
Depressive disorders make one feel exhausted, worthless, helpless, and hopeless.
Such negative thoughts and feelings make some people feel like giving up. It
is important to realize that these negative views are part of the depression
and typically do not accurately reflect the actual circumstances. Negative thinking
fades as treatment begins to take effect. In the meantime:
Set realistic goals in light of the depression and assume a reasonable amount
of responsibility.
Break large tasks into small ones, set some priorities, and do what you
can as you can.
Try to be with other people and to confide in someone; it is usually better
than being alone and secretive.
Participate in activities that may make you feel better.
Mild exercise, going to a movie, a ballgame, or participating in religious,
social, or other activities may help.
Expect your mood to improve gradually, not immediately. Feeling better takes
time.
It is advisable to postpone important decisions until the depression has
lifted. Before deciding to make a significant transition—change jobs, get
married or divorced—discuss it with others who know you well and have a more
objective view of your situation.
People rarely "snap out of" a depression. But they can feel a
little better day-by-day.
Remember, positive thinking will replace the negative thinking that is part
of the depression and will disappear as your depression responds to treatment.
Let your family and friends help you.
How Family and Friends Can Help the Depressed Person
The most important thing anyone can do for the depressed person is to help him
or her get an appropriate diagnosis and treatment. This may involve encouraging
the individual to stay with treatment until symptoms begin to abate (several
weeks), or to seek different treatment if no improvement occurs. On occasion,
it may require making an appointment and accompanying the depressed person to
the doctor. It may also mean monitoring whether the depressed person is taking
medication. The depressed person should be encouraged to obey the doctor's orders
about the use of alcoholic products while on medication. The second most important
thing is to offer emotional support. This involves understanding, patience,
affection, and encouragement. Engage the depressed person in conversation and
listen carefully. Do not disparage feelings expressed, but point out realities
and offer hope. Do not ignore remarks about suicide. Report them to the depressed
person's therapist. Invite the depressed person for walks, outings, to the movies,
and other activities. Be gently insistent if your invitation is refused. Encourage
participation in some activities that once gave pleasure, such as hobbies, sports,
religious or cultural activities, but do not push the depressed person to undertake
too much too soon. The depressed person needs diversion and company, but too
many demands can increase feelings of failure.
Do not accuse the depressed person of faking illness or of laziness, or expect
him or her "to snap out of it." Eventually, with treatment, most people
do get better. Keep that in mind, and keep reassuring the depressed person that,
with time and help, he or she will feel better.
