Depression

Other treatments for depression

When depression is severe and medication has failed and/or the risk of suicide is high, other therapies are often needed.

Electroconvulsive therapy

Electroconvulsive therapy, or ECT, is used when attempts to treat severe depression through medication have not been effective. Done in a hospital, usually at a rate of three treatments per week, electroconvulsive therapy involves sending a carefully controlled electric current to the brain. This current then induces a seizure. Because patients are given anesthesia and muscle relaxants, they are not awake during the procedure and do not experience any sensations or body movements.

Having greatly improved since it was first used, electroconvulsive therapy is recognized today as an effective and humane treatment for mental illness. It is quick acting, and improvements are usually noted after only a few treatments. Generally, patients require between 8 to 12 treatments.

Phototherapy (light therapy)

Often used in the treatment of Seasonal Affective Disorder (SAD), phototherapy involves exposing a patient to special forms of bright light for a period of about two hours a day. This exposure increases the production of certain chemicals in the brain that relieve the symptoms of depression. This treatment is ineffective when simply ordinary light is used and should only be administered by a trained physician.

Hospitalization

Dealing successfully with depression depends on early intervention and prompt treatment. Because depressed people may occasionally have suicidal thoughts, delusions, or hallucinations, patients are sometimes hospitalized. Hospitalization allows health professionals to assess and diagnose a patient's condition. Medications are started and support is given, thereby reducing the risk of suicide and other harmful behaviors. The care received in a hospital setting can help patients begin to deal with the problems contributing to their depression.

Following hospitalization, patients often need time to recuperate both mentally and physically. This means ensuring proper rest, good nutrition, regular exercise, and concentrating on reducing stress.

Because family roles and responsibilies often shift when a patient is hospitalized, the return home may require some adjustments. Family members may be reluctant to relinquish responsibility to the patient out of fear he or she may suffer a relapse. Conversely, some families may expect too much and may expect life to return to normal right away. It's important that everyone in the family clearly state his or her expectactions. Patience, understanding, and support are also very important.

For some patients, alternative housing may be needed to ease the transition from an ordered environment to a less structured one — a transition that could otherwise cause problems if the patient is returning to an unstructured and isolated environment. Halfway-houses, participation in a day program, or living in supported housing are all ways of making the transition more successful.

Early release is a sad fact of today's health care system. Often, patients are released from hospital much sooner than in the past and sometimes before they are completely ready. If you or the person you're caring for has been released from hospital after only a short stay, the following suggestions will likely help:

• Ask questions and be sure to discuss your concerns with hospital staff working with you on the discharge plan. Ask specific questions about what to expect after release and what type of support will be needed.
• Be sure you fully understand what symptoms or changes in condition should cause concern.
• Request a list of resource people and telephone numbers to call if you have concerns or questions. Community-based support professionals provide support and treatment for people after they've been hospitalized.