How is depression assessed and treated?

by Dr. Bob Campbell
Everyone gets sad or feels down now and then. For the most part, this sadness is not depression; it’s just the normal sadness of life. Grief over the death of a loved one is also not depression, although if prolonged normal grief can become depression. What is depression then? Depression is a much more serious condition than the usual sadness or grief; it can be extremely debilitating, and can even lead to suicidal thoughts or attempts. Depression is also surprisingly common – more than 16% of people in the U.S. will get it at least once in their lifetime (Kessler, 2003) – and there have been many famous people who have suffered with it, including Billy Joel, Woody Allen, and the author William Styron, who called it “darkness visible.”
Someone who is depressed often exhibits symptoms such as low energy, changes in sleep habits, significant mood shifts, loss of interest in activities usually enjoyed, hopelessness, or a change in appetite and body weight (up or down). These symptoms commonly cause missed work, low productivity, and relationship difficulties.
The good news is that depression can be effectively treated, and individuals can get better. It may seem straightforward to recognize depression, but it is best assessed by a professional, so that the most appropriate treatment can be initiated. Antidepressant medications have often been prescribed for people who don’t need them, resulting in significant side effects.
Once depression is diagnosed, it can be treated in a variety of ways. Talk therapy has proven to be quite effective for many people, and comes in various types, including cognitive-behavioral therapy (CBT), mindfulness-based cognitive therapy (MBCT), acceptance and commitment therapy (ACT), psychodynamic therapy, Adlerian therapy, and existential therapy. All of these treatment methods are available at Willow, and can be discussed with your therapist. For more severe levels of depression, antidepressant medication may be needed. Research has shown that most severe depressions respond best to a combination of medication and psychotherapy. Rare treatment-resistant depressions can also be treated with electro-convulsive therapy (ECT), which is administered in a hospital, and which has become much more refined and safe over the last several years.

The bottom line is that depression is serious, but can be treated effectively. At Willow, we are committed to providing you with the latest evidence-based treatments to bring hope and joy back into your life.

(For more detailed information, see Kessler, R.C. et al. (2003) 'The Epidemiology of Major Depressive Disorder: Results From the National Comorbidity Survey Replication (NCS-R)', Journal of the American Medical Association 289 (23): 3095-3105.)