Which Treatment is Best for Depresssion?

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The People and Their Problems
Joan can’t understand why she feels down and despondent. Just last week she was feeling so wonderful that she decided to quit her job so she could leave for the Himalayas. She just knew she could climb Mt. Everest.
Tom’s friends say he has a drinking problem. He said he can stop whenever he wants, but secretly he doubts it. Is booze slowly destroying his life?

Melissa is unable to sleep, has lost 15 lbs, and cannot concentrate on her studies. She is beginning to feel worthless and suicidal. Barry believes everyone in the hospital is plotting to kill him. He has already punched two nurses, stabbed his psychiatrist in the leg with a fork, and tried to jump out the window. Despite his many drug treatments, he is getting more psychotic and violent. Everyone is afraid of him.

Archie is such a perfectionist that it drives others and himself crazy. He always hears himself thinking, “It has to be perfect or it is no good! YOU should always be the best or you are no good!” Anna has this recurring dream about a prince who is searching for her, but she is being held captive by a evil witch. Sometimes it is so scary it wakes her up. The dream started on the anniversary of her father’s death. What does it mean? Does it have something to do with her feeling anxious lately? Susan realizes she just has to get over this fear of flying as soon as possible! When she gets the promotion, she will have to travel often.

Lyle is bored and unsatisfied with his life. He has his health, a good job, friends, and a happy family – so why does he feel so unfulfilled? Why does he feel something is missing? Martha says, “Joe is a lazy slob! All is does is lay around, drink beer, and watch the games. He doesn’t pay any attention to me or help around the house.” Joe says, “Martha is such a bitch! Nag, nag, nag!”

Sharon has problems relating to other people. She really wants to know what she does wrong. She really wants to know what other people think of her.

Willy says he feels so nervous and “hyped-up” that he can’t even sit still to talk about what’s bothering him – in fact it’s sometimes even difficult to talk at all without blocking or stumbling over his words. Harry believes he is the Emperor of Rome because a voice in his lawnmower told him so. Mr. and Mrs. Smith can’t stop complaining about their little Johnny. “He won’t listen to us, he fights at school, and he’s wetting his bed. Why can’t he be a good kid like his big brother?” Sam keeps sinking deeper and deeper into depression. He won’t take his pills. He doesn’t talk or respond to anything. He just lies there all day and stares off into space.

The Treatments

I. Somatic (biological) Treatments
A. Drugs (“psychopharmacology”)
1. Antipsychotic drugs
….. (major tranquilizers – e.g., the phenothiazines, such as thorazine)
2. Antidepressant drugs
….. (e.g., tricyclics like elavil; MAO inhibitors)
3. Anti-anxiety drugs
….. (minor tranquilizers: benzodiazipines like valium; barbiturates
4. Mood swing drugs (e.g., lithium)
B. Psychosurgery, e.g., the frontal lobotomy
C. Electro-convulsive treatment (“ECT”)

II. Individual Psychotherapy
A. Psychoanalytic therapy
B. Humanistic/Existential Therapy
C. Cognitve Therapy
D. Behavioral Therapy
E. Child therapy
Note: the distinction between “insight” and “action” therapies
Note: most therapists describe themselves as “eclectic”

III. Couples/Marital Therapy
(couples/marital may be based on psychoanalytic, humanistic, cognitive, or behavioral theories, or combinations thereof)

IV. Group Approaches
A. Group therapy
B. Family therapy
C. Self help groups

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