Changes in Approaches to the Treatment of Depression Over the Past Decade

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For many years depression has been one of the most common health disorders worldwide, causing in many cases significant disability and even suicide. It is generally recognized, that in many cases it is hard for a patient to achieve remission. Such individuals are considered resistant to the treatment, which makes them disproportionally suffer from the burden of disease comparing to other patients. That is why it has always been important to constantly make discoveries and innovations in this area. There are a lot of approaches to the treatment of depression, including not only pharmacological treatment, but also cognitive and interpersonal therapies and even hypnosis. In spite of the fact that over the past decade many approaches to the treatment of depression remained the same, a lot of new methods appeared and replaced some old ones due to the development of neurobiology and improvement in understanding of the fundamental biology of depression.

Depression is clinically characterized by such symptoms as low mood, fatigue, sleep disturbances, guilt complex and suicidal tendencies. The history of investigating this disease starts in Ancient Greece where it was called melancholia (Hofmann et al. 174), which corresponds to the Hippocratic classification of diseases on the base of the four humours. In contemporary classification, according to Wong, Ma-Li, and Licinio, “melancholia is defined as a subtype of major depression” (343). Depression refers to a diagnostic category of the mood disorders, and usually its course is recurrent which means that patients have some periods of recovery. This disease is often misdiagnosed because of vague symptoms, which any person may experience during the course of life without the clear understanding of their reason. According to some researchers, depression starts with “minor depression” that is the main reason for misunderstanding of the disease (Goodwin 261-262).It is important to detect depression in time and select the proper treatment for each case according to the latest approaches to the treatment of this disease.

Over the past decades, the key approach to research and treatment of depression has been the investigation of the effects of different antidepressants. As Goodwin indicates, the thoughts of researchers of a ten-year-ago period were concentrated on physical illnesses, which is associated with depression (259). It has also been stated that brief psychotherapy might be effective for treatment of depression. According to Wong, Ma-Li, and Licinio, structured psychotherapy modalities, such as cognitive-behavioral and interpersonal types, have a positive effect as a treatment of mild cases of depression and combined with antidepressants can be used in severe cases. Nowadays, several options are preferred for each patient. Such options may include switching therapy, augmentation, combination and optimization (Ionescu, Rosenbaum, and Alpert 114).

According to the latest approaches, the patients who are exceptionally resistant to the treatment of depression should be referred to clinical trials, such as medication trial, integrative medicine trial or psychotherapy (Ionescu, Rosenbaum, and Alpert 122). The patients and physicians can officially access the list of trials and chose the appropriate ones. It is stated that the field of depression treatment will be able to advance the approaches to treatment and better understand the nature of this condition only through clinical research that involves participants. Over the past decade, the emphasis was made on scientific studies in such fields as genetics. It was stated that depression is a familial disorder in which first degree relatives have the major risk to suffer from it comparing to the general population (Wong, Ma-Li, and Licinio 348). Therefore, it has been classified as a genetically complex disorder together with such diseases as cancer and heart diseases. However, at the present time there are no association genetic findings to be accepted and confirmed.

The scholars also discuss the effect of mindfulness-based therapy (MBT) on patients who suffer from depression. As a result of a meta-analytic review, Hofmann et al. make a conclusion that MBT has a positive impact on patients with depression (180). This approach is able to help managing processes that appear in multiple disorders by altering a variety of “emotional and evaluative dimensions” (Hofmann et al. 180). Still, the modern approaches state that it is better to combine different types of therapies, which may include treatment with antidepressant drugs combined with a number of psychotherapies, such as cognitive behavioral therapy which teaches people new skills and interpersonal therapy which is focused on teaching social and helping people to build positive and healthy relationships.

It is generally agreed that among the approaches to the treatment of depression there is one that does not changes over the period of time. Antidepressant treatment therapy remains popular and is often selected as a safe and tolerable method of treatment. There are a lot of different antidepressants that can be used for the treatment of depression. In many cases, the patients with depression positively respond to antidepressants. Still, for the most severe cases further studies may be required to examine the reasons of failure to sustain the initial response to antidepressants. One of the major goals for the researchers is the definition of clinically relevant biomarkers that are able to predict the response to an antidepressant ((Ionescu, Rosenbaum, and Alpert, 122).

Nevertheless, while some physicians are trying to invent new types of antidepressants, others are concerned that such factors as society and culture have been often underestimated in past treatments. Thus, Hawton et al. dedicate their study to suicide which is named the most crucial threat when it comes to the depressive disorder (17). This study also analyses the differences between the disposition to suicide among men and women, that might also be significant to detect different approaches to the treatment of depression according to social status and individual features of the patient.

A study by Zupan et al. also outlines modern ways of managing the depression and focus on such mechanism as memory bias (300). The investigators analyze the impact of positive and negative biases on people’s emotional regulation of depression. Zupan et al. state that there is a lack of positive self-referent bias in older patients (309). As a result, such patients are less likely to cope with depressive disorders.

The overall study of different sources from the past 17 years shows that in spite of the fact that over the past decade many approaches to the treatment of depression remained the same, a lot of new methods appeared and replaced some old ones. Mainly it happened due to the recent researches in the discussed field, the development of neurobiology and improvement in understanding of the fundamental biology of depression. It becomes clear that there has been a great improvement in the study of the origin and reasons of depression. It was also proved that such condition as depression can be very threatening and lead to suicide. Thus, modern sources and investigations provide a deeper analysis and more possibilities to study depressive disorders than outdated studies. It can also be stated that present-day researchers pay more attention to the psychological dimension of depression, while older studies have been concentrated on physiological focus. However, despite some divergences in approaches to research and treatment, there is a common opinion that depression has highly negative psychological outcomes that may lead to severe health disorders and the researchers should more thoroughly investigate this condition.

Works Cited

Ionescu, Dawn F., Rosenbaum, Jerrold F., and Alpert, Jonathan E. “Pharmacological Approaches to the Challenge of Treatment-Resistant Depression.” Dialogues in Clinical Neuroscience, vol. 17, no. 2, 2015, pp. 111-122.

Hawton, Keith, et al. “Risk Factors for Suicide in Individuals with Depression: A Systematic Review.” Journal of Affective Disorders, vol. 147, no. 1, 2013, pp. 17-28.

Hofmann, Stefan G., et al. “The Effect of Mindfulness-Based Therapy on Anxiety and Depression: A Meta-Analytic Review.” Journal of Consulting and Clinical Psychology, vol. 78, no. 2, 2010, pp. 169-183.

Goodwin, Guy M. “Depression and Associated Physical Diseases and Symptoms.” Dialogues in Clinical Neuroscience, vol. 8, no. 2, 2006, pp. 259-265.

Zupan, Zorana, et al. “Memory Bias in Depression: Effects of Self-Reference and Age.” Journal of Social & Clinical Psychology, vol. 36, no. 4, 2017, pp. 300-315.

Wong, Ma-Li, and Licinio, Julio. “Research and Treatment Approaches to Depression.” Nature Reviews Neuroscience, vol. 2, no. 5, 2001, pp. 343-351.

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Changes in Approaches to the Treatment of Depression Over the Past Decade

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