Treatment for

Unipolar Depression
Placebo(n.): a harmless pill for the
psychological benefit

- Mentally support
“fo ra n wo , pa t ut ev ti l r !”
- Its effects are component of all therapeutic outcomes
- Feels like taking real drugs
- There are evidences lead to brain activities:
+ 38% in research (2002) have shown reduction of depression
symptoms and increase activity in prefrontal cortex implicated in planning
complex cognitive
behavior, personality
>> associated with changes in neurochemistry expression, decision
making, and moderating
social behavior.

-> Placebo will be usually use for minor depression.

 Cognitive-behavioral Treatment
(no side-effects!!)

- Alternative choice after antidepressant medications and as

effective
“si d es co f ir on h u t , ne ve g sa on f/ si i n / fu s”
- Help people think more adaptively
- How:
+ recognize and record down negative thought
+ help to find other perspective that are not so
negative/tumbledown

-> useful by itself but better in combining with other treatments.

 Cognitive Therapy
- Focus on changing these patterns of thinking and perceiving, and replacing
them with more adaptive ways
- Two of the most used cognitive therapies:
- Albert Ellis’s rational-emotive therapy
- NOT the actual event causes the emotional upset, the person’s
interpretation of the event causes distress.
- Steps: - identifies the client’s faulty or beliefs that lead to
depression -> challenges the client’s validity, pushing the client to
recognize that beliefs are unhealthy

- Aaron Beck’s cognitive therapy

- Principle: Cognitive distortions
- Steps: - turns the clients’ attentions toward a negative view into the
role cognitions play in distress -> change maladaptive patterns to
be more adaptive behaviors
- TRAIN the clients to evaluate negative automatic thoughts
 Antidepressants
Tricyclics

- Block the absorption of the neurotransmitters serotonin and

norepinephrine and increases these in the brain
- Takes approximately 4-8 weeks to relieve depression
- Effective -> relieving symptoms in 60 -85% of depressed people
- Many side effects
- Dry mouth, weight gain, dizziness, blurred vision and sexual dysfunction
 Antidepressants (cont.)
MAO Inhibitors (Monoamine oxidase inhibitors )
- Monoamine oxidase is involved in removing norepinephrine, serotonin and
dopamine from the brain
- MAOIs prevent this from happening, which makes more of these brain
chemicals available to effect changes in both cells and circuits that have been
impacted by depression
- Effective but less frequently prescribed
- Side effects-> lowered blood pressure, liver damage and weight gain.
- Use of MAO typically requires diet restrictions
- can cause dangerously high blood pressure when taken with certain foods or
medications ex). Tyramine
 Antidepressants (cont.)
SSRIs (Selective Serotonin Reuptake Inhibitors)
- Most frequently prescribed antidepressant medications for
adolescent depression
- Reuptake: process when neurotransmitters that are left over
in the synapse are recycled back into the presynaptic neuron
- Leave the neurotransmitter serotonin (help elevate mood) in
the synapse longer
- Side effects: less severe and are not fatal in overdose
- Nervousness, Headaches, Decreased sexual drive
- Diminish after a few weeks
- Cause some adolescents to become SUICIDAL
- Sometimes is used with Zyban and Wellbutrin to lessen the
effect on sexual side effects
 TADS
Treatment for Adolescents With Depression
- Research program supported by the U.S. National Institutes of Health
- Research: The finding examined adolescents who have suffered from
depression. -> Participants were randomly assigned to a type of
treatment - SSRIs Prozac, cognitive-behavioral therapy and placebo
- Result: Short-term: 1st SSRIs Prozac 2nd CBT work best 3rd Placebo
Long-term: The combined group of SSRIs and CBT work best
- Participants in Prozac group - twice as likely to have a serious
suicidal thoughts or intentions

#it_is_estimate_that_12.78%_of_Thai_teenagers_suffer_from_depression
 Electroconvulsive therapy (ECT)
- A series treatment in which electrical current is passed through the brain
causing a seizure
- used to relieve severe depression
- Used only as a last resort
- Conducted for depressed patients who are not responding to psycho
therapy or drug therapy and remain in a severely depressed state.

Effectiveness -> relieving symptoms in 50-80% of severe depressed people and

very effective in treating psychotic depression
 ECT (CONT)
Side Effects

- Memory loss, learning difficulties, disturbances in verbal abilities

- High relapse rate
- 85% of ECT patients relapse into depression
- Can occur within 4 months after the treatment
 Deep Brain Stimulation (DBS)
- For severe depression when other treatments have
failed
- Principle: An area of the prefrontal cortex is abnormal
during depression.
- Steps: Neurosurgeon inserts electrodes into the brain
-> turn on the switch -> make the patients relieve
- Long-lasting benefits
- Difference from other treatments:
- Researchers can alter the current to know that DBS is
effective or not, without patients knowing.
 Psychosurgery
- The use of surgery on the brain to treat people with mental illness
who do not respond to medicine or psychological treatments.
- Used only as a last resort - can find no other way
- Best-known psychosurgery - “Prefrontal Lobotomy”
- surgical procedure in which the nerve pathways in a lobe or lobes of the
brain are disconnected from those in other areas.
- Ineffective and caused changes in the brain’s electrical activity
- Today psychosurgery methods
- more precise
- can focus and target the area in specific part of the brain
 Other Alternative Treatments
E X E R C I S E S S A D Treatment
Regular aerobic exercise can Seasonal Affective Disorder:
reduce the symptoms and - Most likely to appear
prevent recurrence during winter
+ release endorphins - Rate increase with latitude
(happiness hormone) to
reduce perception of pains
-> phototherapy: exposure with
+ regularize bodily high-intensity light source for
rhythms, improve part of each day
self-esteem, provide
social support