What happens when you see a psychiatrist for depression?

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Most people have heard of psychotherapy, but what does it mean? A Google search quickly gives this definition: “The treatment of mental disorder by psychological rather than medical means.” But how does this play into depression? The American Psychiatry Association (APA) recommends psychotherapy as an initial therapy for mild to moderate depression. But what happens after initial therapy? And what about those with more severe forms of depression?

Let’s back up and define depression. Most people who respond say depression is being sad. And in some ways, they’re right. Depression is a condition characterized by persistent low mood, lack of positive affect and loss of interest in usually pleasurable activities. Note that in addition to being sad, two other features are part of it.

This leads to the question, “What happens when you see a psychiatrist?” Most people know that a psychiatrist usually counsels and prescribes. But what exactly happens? Here is a description of the more successful counseling techniques.

Cognitive behavioral therapy, the most popular short-term therapy for depression, focuses on internal dialogue and ignores the causes. It strives to establish a supportive environment followed by brainstorming what a person can do immediately to help them change what they feel. Education about faulty thinking such as all or nothing, blaming, overgeneralization and recognizing when they occur can help an individual recognize harmful patterns in his life. Discussing thoughts connected to behaviors, as well as focusing on behavior, demonstrates successful recovery. Analyzing reasons for how past experiences influence the present is deemed less useful.

Interpersonal therapy is another short-term therapy used in treating depression. The patient is educated on improving relationships and the importance of stable relationships through communication, emotional expression and assertiveness.

These techniques require active collaboration and daily or weekly assignments. Sometimes patients are not ready to actively participate in psychotherapy and medication is given to jump-start their recovery. Other times, families or spouses of the patient are included in therapy to remove hidden meanings in communication and to educate how family members reinforce the patient’s depression.

Sadly, counseling has only shown short-term effectiveness, but it does reduce symptoms and relapse when combined with antidepressants. Psychotherapy can even be administered over the computer or on the telephone. Interestingly, marital therapy has proven to be as effective as individual or drug therapy for depression. Other forms of therapy that have shown a reduction in depression include massage, meditation and yoga. In children and adolescents, education, supportive treatment and case management can often be sufficient to treat depression. Interestingly, antidepressants have not been shown to improve outcomes in children. But if supportive treatment is insufficient, psychotherapy is necessary, with interpersonal therapy being the most efficacious.