Major depressive disorder Health Article

Treatments

Because MDD can have a devastating impact on a person'slife, the importance of effective treatment cannot be overestimated. Treatment strategies have evolved over the years according to researchers' varying opinions of the underlying causes of depression, but the outpouring of interest in MDD allows treatment providers to select from a variety of tested approaches.

Psychotherapy

Cognitive psychotherapies for depression are based on the belief that depressed people perceive themselves and the world in unrealistically negative ways. Considerable research has been done regarding the cognitive dimension of depression; for example, studies find that depressed people pay more attention to negative events than to positive ones, and that dwelling on unpleasant experiences prolongs and worsens depressive episodes. Cognitive therapists help patients identify the automatic thoughts that lead them to anticipate poor outcomes or to interpret neutral events in negative ways. The patient is also encouraged to challenge negative thoughts by comparing his or her expectations of events with actual outcomes.

Evidence that poor interpersonal relationships may heighten vulnerability to depression, along with findings that depressed adults and depressed children tend to provoke negative reactions from other people, has prompted the use of social skills trainingas a form of treatment. In this type of therapy, patients are trained to recognize actions and attitudes that annoy or distance other people, and to replace these behaviors with more appropriate ones. Social skills training may be particularly helpful to depressed persons who tend to isolate themselves and have lost confidence in their ability to develop healthy relationships. This treatment model promotes the idea that depression is likely to lift when the patient becomes adept at making new friends and establishing rewarding social supports.

Psychodynamic psychotherapyis often effective in treating patients with MDD whose depression is related to unresolved issues from the past, particularly abuse or other painful childhood experiences. The growth of insight into one's emotional patterns, as well as the supportive aspects of this form of therapy, offers considerable relief from emotional pain to many patients.