Overcoming depression - Revision history

Jsinick at 04:16, 17 February 2014

2014-02-17T04:16:41Z

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	The research on the efficacy of different depression treatments is only moderately strong. We're not confident in our remarks below: they reflect an attempt to come to the best conclusion possible with the evidence available.		The research on the efficacy of different depression treatments is only moderately strong. We're not confident in our remarks below: they reflect an attempt to come to the best conclusion possible with the evidence available.

	* ~~Our top general recommendation~~ for ~~overcoming~~ depression ~~is ''cognitive~~ behavioral therapy'' (CBT), ~~though in individual cases other treatments will be superior~~.		* Any given treatment of depression only works for a fraction of depressed people, suggesting that causes of depression may be diverse.
	* ~~If your depression is sufficiently debilitating so that recovering from it is higher priority for you than other things, it~~'s worth experimenting with different treatment methods to see which works best for you, with the ~~possibility~~ of antidepressants.		* Cognitive behavioral therapy (CBT) stands out for its combination of efficacy, potential for producing lasting changes, low cost, and absence of averse side effects.
	* Combining ~~treatments~~ may be more impactful than applying one individually		* It's worth experimenting with different treatment methods to see which works best for you, with the possible exception of antidepressants.
			* Combining treatment methods may be more impactful than applying one individually.

	==Cognitive behavioral therapy==		==Cognitive behavioral therapy==

Jsinick: /* Antidepressants */

2014-02-17T03:57:49Z

Antidepressants

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	If you're an adolescent, the case for using an antidepressant is weakened by the fact that antidepressants are thought to increase the risk of suicide in adolescents. For example, the above Cochrane review found that antidepressants increased suicide rates by 58%. The Food and Drug Administration requires that manufacturers of antidepressants include a warning that antidepressants can increase the risk of suicide in children, adolescents and adults under age 25. See [http://en.wikipedia.org/wiki/Antidepressants_and_suicide_risk antidepressants and suicide risk] for more information. The size of the increased risk in ''absolute'' terms varies from person to person, because some people are more likely to commit suicide than others. But in a given case, the increased risk of suicide may not be worth the potential benefits.		If you're an adolescent, the case for using an antidepressant is weakened by the fact that antidepressants are thought to increase the risk of suicide in adolescents. For example, the above Cochrane review found that antidepressants increased suicide rates by 58%. The Food and Drug Administration requires that manufacturers of antidepressants include a warning that antidepressants can increase the risk of suicide in children, adolescents and adults under age 25. See [http://en.wikipedia.org/wiki/Antidepressants_and_suicide_risk antidepressants and suicide risk] for more information. The size of the increased risk in ''absolute'' terms varies from person to person, because some people are more likely to commit suicide than others. But in a given case, the increased risk of suicide may not be worth the potential benefits.

	If you're under 25 years old, particularly if you're an adolescent, seems reasonable to try other methods of treatment before considering antidepressants.		If you're under 25 years old, particularly if you're an adolescent, it seems reasonable to try other methods of treatment before considering antidepressants.

Jsinick: /* Antidepressants */

2014-02-17T03:57:37Z

Antidepressants

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	==Antidepressants==		==Antidepressants==

	The Cochrane review [http://www.ncbi.nlm.nih.gov/pubmed/23152227 newer generation antidepressants for depressive disorders in children and adolescents] found that anti-depressants increased recover rates from 38.0% to 44.8% (over a specified duration) relative to a placebo. This understates the capacity for anti-depressants to reduce depression, because placebo treatment is also better than no treatment, and if one anti-depressant doesn't work, ~~one~~ can try another one.		The Cochrane review [http://www.ncbi.nlm.nih.gov/pubmed/23152227 newer generation antidepressants for depressive disorders in children and adolescents] found that anti-depressants increased recover rates from 38.0% to 44.8% (over a specified duration) relative to a placebo. This understates the capacity for anti-depressants to reduce depression, because placebo treatment is also better than no treatment, and if one anti-depressant doesn't work, you can try another one.

	If you're an adolescent, the case for using an antidepressant is weakened by the fact that antidepressants are thought to increase the risk of suicide in adolescents. For example, the above Cochrane review found that antidepressants increased suicide rates by 58%. The Food and Drug Administration requires that manufacturers of antidepressants include a warning that antidepressants can increase the risk of suicide in children, adolescents and adults under age 25. See [http://en.wikipedia.org/wiki/Antidepressants_and_suicide_risk antidepressants and suicide risk] for more information. The size of the increased risk in ''absolute'' terms varies from person to person, because some people are more likely to commit suicide than others. But in a given case, the increased risk of suicide may not be worth the potential benefits.		If you're an adolescent, the case for using an antidepressant is weakened by the fact that antidepressants are thought to increase the risk of suicide in adolescents. For example, the above Cochrane review found that antidepressants increased suicide rates by 58%. The Food and Drug Administration requires that manufacturers of antidepressants include a warning that antidepressants can increase the risk of suicide in children, adolescents and adults under age 25. See [http://en.wikipedia.org/wiki/Antidepressants_and_suicide_risk antidepressants and suicide risk] for more information. The size of the increased risk in ''absolute'' terms varies from person to person, because some people are more likely to commit suicide than others. But in a given case, the increased risk of suicide may not be worth the potential benefits.

	If you're under 25 years old, particularly if you're an adolescent, seems reasonable to try other methods of treatment before considering antidepressants.		If you're under 25 years old, particularly if you're an adolescent, seems reasonable to try other methods of treatment before considering antidepressants.

Jsinick: /* Light therapy */

2014-02-17T03:56:57Z

Light therapy

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	==Light therapy==		==Light therapy==

	If your depression is seasonal in nature, you may benefit from [http://en.wikipedia.org/wiki/Light_therapy light therapy] According to [http://journals.psychiatryonline.org/article.aspx?articleid=177447 The Efficacy of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-Analysis of the Evidence] "randomized, controlled trials suggests that bright light treatment and dawn simulation for seasonal affective disorder and bright light for nonseasonal depression are efficacious, with effect sizes equivalent to those in most antidepressant pharmacotherapy trials.		If your depression is seasonal in nature, you may benefit from [http://en.wikipedia.org/wiki/Light_therapy light therapy] According to [http://journals.psychiatryonline.org/article.aspx?articleid=177447 The Efficacy of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-Analysis of the Evidence], ''randomized, controlled trials suggests that bright light treatment and dawn simulation for seasonal affective disorder and bright light for nonseasonal depression are efficacious, with effect sizes equivalent to those in most antidepressant pharmacotherapy trials.''

	The Cochrane review [http://www.bibliotecacochrane.com/pdf/CD004050.pdf Light therapy for non-seasonal depression] finds that even for non-seasonal depression, light therapy reduces depression on average, though the effect is modest.		The Cochrane review [http://www.bibliotecacochrane.com/pdf/CD004050.pdf Light therapy for non-seasonal depression] finds that even for non-seasonal depression, light therapy reduces depression on average, though the effect is modest.

Jsinick: /* Talk therapy */

2014-02-17T03:56:04Z

Talk therapy

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	* you trust to the point of feeling comfortable sharing your emotions		* you trust to the point of feeling comfortable sharing your emotions

	Some reasons to think that talking with a friend may not carry ~~th fulle~~ benefits of talking with a therapist are		Some reasons to think that talking with a friend may not carry the full benefits of talking with a therapist are

	* '''Conflict of interest''' — Your friend may be biased for reasons having to do with your pre-existing relationship – for example, he or she might be unwilling to ask certain questions or offer certain feedback out of concern of offending you and damaging your friendship.		* '''Conflict of interest''' — Your friend may be biased for reasons having to do with your pre-existing relationship – for example, he or she might be unwilling to ask certain questions or offer certain feedback out of concern of offending you and damaging your friendship.

Jsinick: /* Exercise */

2014-02-17T03:55:18Z

Exercise

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	It's widely believed that exercise alleviates depression. There's an intuitive basis for thinking this: exercise often gives one a [http://en.wikipedia.org/wiki/Endorphins#Runner.27s_high runner's high].		It's widely believed that exercise alleviates depression. There's an intuitive basis for thinking this: exercise often gives one a [http://en.wikipedia.org/wiki/Endorphins#Runner.27s_high runner's high].

	In the Cochrane review [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004366.pub5/abstract Exercise for depression], the authors find that on average studies show a moderate-sized effect, but that when one restricts consideration to the highest quality studies, one sees a significantly smaller effect.		In the Cochrane review [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004366.pub5/abstract Exercise for depression], the authors find that on average, studies show a moderate-sized effect, but that when one restricts consideration to the highest quality studies, one sees a significantly smaller effect.

	The main downside to exercise is that it takes time, but if alleviating depression is sufficiently high priority for you, it's worth prioritizing exercise over other things.		The main downside to exercise is that it takes time, but if alleviating depression is sufficiently high priority for you, it's worth prioritizing exercise over other things.

Jsinick: /* Cognitive behavioral therapy */

2014-02-17T03:54:42Z

Cognitive behavioral therapy

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	According to [http://stantatkin.com/wp-content/uploads/2012/09/CogBehav-Therapy-Butler06.pdf The empirical status of cognitive-behavioral therapy: A review of meta-analyses], there's a strong base of evidence that CBT has a large effect of reducing depression on average. There's evidence that the benefits extend beyond the duration of the treatment. Studies generally seem to show that CBT is as effective as antidepressants at reducing depression (some find that CBT is more effective, but the evidence is unclear).		According to [http://stantatkin.com/wp-content/uploads/2012/09/CogBehav-Therapy-Butler06.pdf The empirical status of cognitive-behavioral therapy: A review of meta-analyses], there's a strong base of evidence that CBT has a large effect of reducing depression on average. There's evidence that the benefits extend beyond the duration of the treatment. Studies generally seem to show that CBT is as effective as antidepressants at reducing depression (some find that CBT is more effective, but the evidence is unclear).

	CBT has the advantage that one can learn to do the exercises on one's own, without the expense of a therapist or a psychiatrist. The evidence for the efficacy of self-help CBT materials is weaker, but [http://www.nrepp.samhsa.gov/pdfs/cbt_review2.pdf The clinical effectiveness of CBT-based guided self-help interventions for anxiety and depressive disorders: A systematic review] finds that for ''self-selected'' users of self-help CBT materials, the treatment was efficacious.		CBT has the advantage that one can learn to do the exercises on one's own, without the expense of a therapist or a psychiatrist. The evidence for the efficacy of self-help CBT materials is weaker than the evidence for the efficacy of therapist-administered CBT, but this may reflect insufficient commitment on the part of patients who were assigned to use self-help CBT materials. [http://www.nrepp.samhsa.gov/pdfs/cbt_review2.pdf The clinical effectiveness of CBT-based guided self-help interventions for anxiety and depressive disorders: A systematic review] finds that for ''self-selected'' users of self-help CBT materials, the treatment was efficacious.

	Our recommendation for learning CBT on your own is [http://www.amazon.com/Feeling-Good-New-Mood-Therapy-ebook/dp/B009UW5X4C/ref=sr_sp-atf_title_1_1?ie=UTF8&qid=1392587360&sr=8-1&keywords=feeling+good+new+mood+therapy Feeling Good: The New Mood Therapy] by David Burns.		Our recommendation for learning CBT on your own is [http://www.amazon.com/Feeling-Good-New-Mood-Therapy-ebook/dp/B009UW5X4C/ref=sr_sp-atf_title_1_1?ie=UTF8&qid=1392587360&sr=8-1&keywords=feeling+good+new+mood+therapy Feeling Good: The New Mood Therapy] by David Burns.

Jsinick: /* Cognitive behavioral therapy */

2014-02-17T03:52:33Z

Cognitive behavioral therapy

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	According to [http://stantatkin.com/wp-content/uploads/2012/09/CogBehav-Therapy-Butler06.pdf The empirical status of cognitive-behavioral therapy: A review of meta-analyses], there's a strong base of evidence that CBT has a large effect of reducing depression on average. There's evidence that the benefits extend beyond the duration of the treatment. Studies generally seem to show that CBT is as effective as antidepressants at reducing depression (some find that CBT is more effective, but the evidence is unclear).		According to [http://stantatkin.com/wp-content/uploads/2012/09/CogBehav-Therapy-Butler06.pdf The empirical status of cognitive-behavioral therapy: A review of meta-analyses], there's a strong base of evidence that CBT has a large effect of reducing depression on average. There's evidence that the benefits extend beyond the duration of the treatment. Studies generally seem to show that CBT is as effective as antidepressants at reducing depression (some find that CBT is more effective, but the evidence is unclear).

	CBT has the advantage that one can learn to do the exercises on one's own, without the expense of a therapist or a psychiatrist. It'~~s also superior to anti~~-~~depressant medications in that it doesn~~'~~t have negative side effects. In particular, it probably doesn~~'~~t increase risk~~ of ~~suicide in young people as antidepressants do~~.		CBT has the advantage that one can learn to do the exercises on one's own, without the expense of a therapist or a psychiatrist. The evidence for the efficacy of self-help CBT materials is weaker, but [http://www.nrepp.samhsa.gov/pdfs/cbt_review2.pdf The clinical effectiveness of CBT-based guided self-help interventions for anxiety and depressive disorders: A systematic review] finds that for ''self-selected'' users of self-help CBT materials, the treatment was efficacious.

	Our recommendation for learning CBT on your own is [http://www.amazon.com/Feeling-Good-New-Mood-Therapy-ebook/dp/B009UW5X4C/ref=sr_sp-atf_title_1_1?ie=UTF8&qid=1392587360&sr=8-1&keywords=feeling+good+new+mood+therapy Feeling Good: The New Mood Therapy] by David Burns.		Our recommendation for learning CBT on your own is [http://www.amazon.com/Feeling-Good-New-Mood-Therapy-ebook/dp/B009UW5X4C/ref=sr_sp-atf_title_1_1?ie=UTF8&qid=1392587360&sr=8-1&keywords=feeling+good+new+mood+therapy Feeling Good: The New Mood Therapy] by David Burns.

Jsinick at 03:31, 17 February 2014

2014-02-17T03:31:46Z

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	* Our top general recommendation for overcoming depression is ''cognitive behavioral therapy'' (CBT), though in individual cases other treatments will be superior.		* Our top general recommendation for overcoming depression is ''cognitive behavioral therapy'' (CBT), though in individual cases other treatments will be superior.
	* If you have the resources (in terms of time and money) combining treatment methods may be more impactful than using just one.
	* If your depression is sufficiently debilitating so that recovering from it is higher priority for you than other things, it's worth experimenting with different treatment methods to see which works best for you, with the possibility of antidepressants.		* If your depression is sufficiently debilitating so that recovering from it is higher priority for you than other things, it's worth experimenting with different treatment methods to see which works best for you, with the possibility of antidepressants.
			* Combining treatments may be more impactful than applying one individually

	==Cognitive behavioral therapy==		==Cognitive behavioral therapy==

Jsinick at 03:30, 17 February 2014

2014-02-17T03:30:28Z

← Older revision		Revision as of 03:30, 17 February 2014
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	Depending on the friend and on the nature of help that you need, these factors may be non-issues, but they're worth considering when deciding between seeing a therapist and talking with a friend.		Depending on the friend and on the nature of help that you need, these factors may be non-issues, but they're worth considering when deciding between seeing a therapist and talking with a friend.

			==Light therapy==

			If your depression is seasonal in nature, you may benefit from [http://en.wikipedia.org/wiki/Light_therapy light therapy] According to [http://journals.psychiatryonline.org/article.aspx?articleid=177447 The Efficacy of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-Analysis of the Evidence] "randomized, controlled trials suggests that bright light treatment and dawn simulation for seasonal affective disorder and bright light for nonseasonal depression are efficacious, with effect sizes equivalent to those in most antidepressant pharmacotherapy trials.

			The Cochrane review [http://www.bibliotecacochrane.com/pdf/CD004050.pdf Light therapy for non-seasonal depression] finds that even for non-seasonal depression, light therapy reduces depression on average, though the effect is modest.

	==Antidepressants==		==Antidepressants==