Danica DiFrancesco

Depression

03/08/2015

Depression is a mood disorder that causes a persistent feeling of sadness and loss of
interest. Also called major depression, major depressive disorder or clinical depression, it affects
how you feel, think and behave and can lead to a variety of emotional and physical problems.
You may have trouble doing normal day-to-day activities, and depression may make you feel as
if life isn't worth living. More than just a bout of the blues, depression isn't a weakness, nor is it
something that you can simply "snap out" of (Mayo Clinic, 2014). According to the World
Health Organization, depression affects more than 350 million people worldwide, including me,
so it is a relatively common condition, however, it is also relatively undiagnosed and if it is
untreated, it can have major repercussions. There are treatments for depression, and what works
best for some people may not work best for others. The treatments that will be discussed in this
paper are medication, psychotherapy, and meditation.
For many people, their first step in treatment is to see a medical doctor. While this can be
effective in ruling out any other health conditions that may be related, most doctors prescribe
antidepressants (typically an SSRI nowadays) and send patients on their way, asking them to
come back after a certain amount of time to see if it is working. Antidepressants can help jumpstart mood and give people the boost they need to get over the symptoms of their depression.
This often allows them to start doing the things they enjoy again and make better choices for
themselves, which also helps contribute to a more positive mood (Greenlaw,2010). This is done
by balancing the neurotransmitters in the patients brain which can help stabilize their mood and
give them a better quality of sleep.
On the downside, a study published in the Journal of the American Board of Family
Medicine stated in a group of people who had been given antidepressants by a family practice
doctor as treatment, 21.3% screened positive for bipolar disorder using the Mood Disorder

Danica DiFrancesco

Depression

03/08/2015

Questionnaire. This means that a percentage of people suffering from bipolar disorder were not
receiving effective treatment. So while going to a doctor may be helpful, it may not be the best
first course of action. Instead, opting for a professional more trained in mental health may be
more effective. As far as the patients that are correctly diagnosed and prescribed antidepressants,
the big question is, is it really the best way to treat depression?
In all reality, while pills seem to be the fix to everything in this day and age, they are
simply treating the symptoms, not the underlying problem. This is the case with antidepressants
as well. While it is fantastic they can help people be able to cope with what they may be going
through or with certain psychological disturbances, it is not all that beneficial in the long run.
The underlying problem frequently still exists, even if the medication helps lessen symptoms
instead of increasing them- which it has a possibility of doing. According to the World Health
Organization, antidepressants can be an effective form of treatment for moderate-severe
depression but are not the first line of treatment for cases of mild depression. They should not be
used for treating depression in children and are not the first line of treatment in adolescents,
among whom they should be used with caution. This is due to a side-effect of suicidal thoughts
that is especially prevalent in children and adolescents. Antidepressants are not recommended
for the initial treatment of mild depression, because the risk [to] benefit ratio is poor.
(Patient.co.uk). The magnitude of benefit of antidepressant medication compared with placebo
increases with severity of depression symptoms and may be minimal or nonexistent, on average,
in patients with mild or moderate symptoms. For patients with very severe depression, the
benefit of medications over placebo is substantial (The Journal of American Medical
Association, 2010).

Danica DiFrancesco

Depression

03/08/2015

Another treatment that seems to have fewer side effects is psychotherapy. Many
research studies have demonstrated that psychotherapy, or talk therapy, is effective for treating
depression and relieving symptoms experienced by individuals who suffer from depression.
Psychological treatments may prevent a person with milder depression from becoming more
severely depressed. And although a past history of depression increases the risk of future
episodes, there is evidence that ongoing psychotherapy may lessen the chance of recurrence
(American Psychological Association, 2010). In this type of therapy, a mental health
professional will typically help the patient determine their life factors that are contributing to
their depression as well as ways to solve or improve those situations. They frequently help
patients identify negative and destructive thought patterns that contribute to their negative
feelings and give them tools to work through future recurrences, if that does happen. However, it
is necessary to chose a psychotherapy path that does not focus on the negative rumination a
person is doing or the introspection they are doing- such as is done in psychodynamic
counseling, as these types of focused dissections can sometimes make the depression worse than
if it had just not been treated at all (Tyrrell and Elliot, 2015). The most effective forms of therapy
in the treatment of depression seem to be cognitive based therapy, behavioral therapy,
interpersonal therapy, and solution based therapy.
One other form of treatment for depression is meditation as a stress reduction technique,
in specific, mindfulness meditation. Mindfulness may enhance attention regulation, body
awareness, emotional regulation, and changes in self-perspective, which may all play a role in
depression. On a purely biological level, MRI studies have shown that meditation is linked to a
reduction in activity in the amygdala, the brain area that governs the stress response, and to
reduced activity in the default mode network, the brain network thats on when your mind is

Danica DiFrancesco

Depression

03/08/2015

wandering from thought to thought, which is often linked to feelings of unhappiness and stress
(Walton, 2014).
While many people assume meditation is similar to cognitive based therapy, in that it
helps people recognize their thoughts and change them that is not the intent of it, according to
Jon Kabat-Zinn. In his book, Wherever You Go, There You Are, he mentions Meditation does
not involve trying to change your thinking by thinking some more. It involves watching though
itself By watching your thoughts without being drawn into them, you can learn something
profoundly liberating about thinking itself, which may help you to be less of a prisoner of those
though patterns If we decide to think positively, that may be useful, but it is not meditation. It
is just more thinking. For a study that was recently done, researchers had patients practice
mindfulness meditation for at least 2.5 hours per week for eight weeks. Its effects seemed to be
as effective as medication in the treatment of depression. Mindfulness meditation, the type that
showed the most promise [and the type that Jon Kabat-Zinn is referring to], is typically practiced
for 30 to 40 minutes a day. It emphasizes acceptance of feelings and thoughts without judgment
and relaxation of body and mind (Johns Hopkins Medicine, 2014.)
In conclusion, it seems all three of the aforementioned treatments are effective in certain
aspects. However, they each have their own benefits and drawbacks. Antidepressant
medications, specifically SSRIs, have many side effects, require continual upkeep and financial
investment, and they only treat the symptoms. The medications frequently do help people with
moderate to severe depression get over the hump they need to get further treatment that they may
not have the will to do otherwise. Psychotherapy requires time to attend appointments, the cost
of said appointments, and it requires a therapist or professional able to assist in a form of therapy
most effective for treating that patients depression. Psychotherapy can help prevent recurrences

Danica DiFrancesco

Depression

03/08/2015

by helping people change their situations and thought patterns. Meditation requires time,
continual work to increase effectiveness, and the patience to allow it to work. Meditation does
not necessarily require any funds and it also may help people with depression change their
thought patterns by allowing them to accept their thoughts and let them go, instead of becoming
attached. In most research, a combination of two or all three of these techniques seems to be
most effective in treating people suffering from depression and preventing relapses.

Danica DiFrancesco

Depression

03/08/2015

Mayo Clinic. (2014, Feb.) Depression: Major Depressive Disorder. Retrieved from
http://www.mayoclinic.org/diseases-conditions/depression/basics/definition/con-20032977
World Health Organization. (2012, Oct). Depression. Retrieved from
http://www.who.int/mediacentre/factsheets/fs369/en/
Hirschfeld, R. et al. (2005, Aug.) Screening for Bipolar Disorder in Patients Treated for
Depression in a Family Medicine Clinic. Retrieved from
http://www.jabfm.org/content/18/4/233.short
Patient.co.uk. Depression. Retrieved from http://www.patient.co.uk/doctor/depression-pro
Fournier, J. et al. (2010, Jan.). Antidepressant Drug Effects and Depression Severity: A PatientLevel Meta-analysis. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=185157
Greenlaw, E. (2010, July). How Your Depression Medicine Can Affect Your Life. Retrieved from
http://www.webmd.com/depression/features/antidepressant-effects?page=1
American Psychological Association. (2010, July). Understanding Depression and Effective
Treatment. Retrieved from http://www.apa.org/helpcenter/understanding-depression.aspx
Tyrrell, M. and Elliott, R. (2015.) Overcoming Depression- Counseling and Therapy.
http://www.clinical-depression.co.uk/dlp/treating-depression/alternative-treatments-fordepression/
Walton, A. (2014, Jan.) For Depression Treatment, Meditation Might Rival Medication.
Retrieved from http://www.forbes.com/sites/alicegwalton/2014/01/07/for-depression-treatmentmeditation-might-rival-medication/
Kabat-Zinn, J. (2005). Wherever You Go There You Are: Mindfulness Meditation in Everyday
Life. New York: MJF Books.

Danica DiFrancesco

Depression

03/08/2015

Johns Hopkins Medicine. (2014, Jan.). Mediation for Anxiety and Depression? Johns Hopkins
Research Suggests Meditation May Reduce Symptoms. Retrieved from
http://www.hopkinsmedicine.org/news/media/releases/meditation_for_anxiety_and_depression