Treatments for Anxiety and Depression

February 7, 2019

 

Some common signs of depression are being plagued with feelings of profound sadness and hopelessness, extreme mood swings, a total loss of interest in activities they previously enjoyed, drastic changes in sleep patterns (insomnia or sleeping all the time) or in appetite. Depression is very common, and it is estimated that 20% to 25% of women and 7% to 12% of men will experience depression over the course of their life. Depression can be experienced in episodes (either mild, moderate, or severe) or a chronic condition, usually mild.

 

Frequent panic attacks, obsessive thoughts, a paralyzing phobia, or unrelenting worries, are classic symptoms of an anxiety disorder. According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental illness in the U.S., affecting 18% of the adult population. Anxiety disorders is an umbrella term which includes generalised anxiety disorder (GAD), panic disorder, phobias, social anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). The duration of symptoms typically classifies it as a chronic disorder.

 

Anxiety and depression often go hand in hand. Some people also experience both together, and each condition can trigger the other. In fact, almost half of all people with major depression also suffer from severe and persistent anxiety.

 

 

Depression and anxiety can take different forms, and symptoms and severity vary from one person to the next. And just as there are a number of ways which people experience depression and anxiety, there are also a number of ways to treat anxiety and depression, both separately and when they appear together.

 

When it comes to treating anxiety and depression, there is no "one size fits all" treatment procedure. Often, a mix of different types of treatments will prove the most effective, and what works for one person might not work for another. However, with effective treatment, anxiety and depression can be managed and the person experiencing it can regain control of their life.

 

 

A licensed mental health professional can help tailor each treatment option to meet each person's specific needs, symptoms, and diagnosis. If you suspect you are suffering from depression, anxiety or a combination of the two, it is important to speak with your doctor for diagnosis and treatment options.

 

 

 

Types of Treatment for Depression and Anxiety

 

Let’s review and compare some of the common therapies used to treat anxiety and depression.

 

 

Medication

 

 

There are several types of medication that can be prescribed for the treatment of depression and anxiety disorder. Medications may take up to 4 weeks before their impact is noticeable. During this period, concentration, sleep, and appetite will gradually improve as symptoms decrease. In some cases, a patient may need to try different medications before finding one that works best for them. However, it is important to give the medication time before concluding that it is not effective.

 

When symptoms of anxiety disorders occur together, one common form of treatment is with antidepressants like serotonin-norepinephrine reuptake inhibitor (SNRI) and selective serotonin reuptake inhibitor (SSRI) medications. While they are known as anti-depressants, these medications have been found to be effective in managing symptoms of anxiety disorders as well. Medications such as beta-blockers and benzodiazepines (BZDs) can also be prescribed for the treatment of anxiety disorder.

 

One downside to medications is that they can have side effects. People using antidepressants may experience headaches, sexual dysfunction, drowsiness and nausea. The use of BZD’s can cause sedation, ataxia, as well as difficulties with concentration, memory, and balance. BZD's are also an addictive substance, and may not be suitable for individuals with a history of substance abuse. Although side effects are often mild and tend to lessen over time, they can be unpleasant or uncomfortable. As with all medications, some individuals will experience more serious reactions or side effects than others, and some will be more responsive to the medication.

 

Nevertheless, the risks of untreated depression or anxiety disorder far outweigh the side effects of the antidepressant medications in most people. One of the biggest mistakes people make with medication is giving up too early, before the medication has a chance to take effect, and in stopping their medication without consulting their doctor first. Many people start taking medication, and then, once they begin to feel better, stop their medication on their own. Medication should always be taken as prescribed, and you should always speak to your doctor before changing a dose or stopping medication. 

Neurofeedback

 

Neurofeedback, also known as EEG (electroencephalogram) biofeedback, is a therapeutic intervention that uses EEG technology to train the brain to function better. This treatment method is designed to gradually train your brain in order to return it to normal functioning. When your brain cells interact with one another, electrical impulses called brain waves are created. These brain waves are indicative of your overall brain function and reflect your inner state (to read more about brain waves see here). People suffering from anxiety and depression often have different patterns of brain waves than those who are not experiencing these challenges.

 

At times, your brain can get overstimulated or understimulated, and you may experience certain chronic emotions capable of altering your normal way of life. Neurofeedback can help with these brain imbalances.

 

So how does Neurofeedback work? This therapy uses a computerized program to assess an individual's brainwave frequencies and give feedback on the brain activity which targets areas of dysfunction. The program then uses visual or sound signals (often in the form of games or videos) to train the central nervous system to regulate and reorganize brain signals. As a result, individuals can learn to improve their brain function, directly helping to alleviate symptoms of depression, anxiety, and other neurological disorders.

 

The average neurofeedback therapy program will involve sessions of 40 minutes each twice or three times a week for twenty to thirty weeks with the use of sensors which are attached to your scalp. Myndlift offers neurofeedback (EEG biofeedback) equipment with powerful clinical control which provides patients with an affordable and safe way to train their brain using EEG feedback anytime, anywhere.

 

With Myndlift, your neurofeedback therapist can easily monitor your brainwave data and training progress with real-life metrics remotely. Your therapist will set up a customized training program for you, based on your symptoms and treatment goals. The training is done on a mobile phone or tablet, by watching videos or games while wearing a lightweight headset and a single electrode connected using paste to your head. You can do your training regularly in the comfort of your own home, as often as recommended by your therapist, without the need to visit the clinic multiple times a week.

 

Neurofeedback will help you train your brain to achieve a calmer, more relaxed, focused and more efficient state. With repetitive training sessions, you will learn how to guide your brain to more desirable and controlled patterns, and, with dedicated practice, you will begin to notice an improvement in your mental health. Neurofeedback is non-invasive and doesn’t involve putting any chemicals or medications into your body. As with all treatments, neurofeedback is not a good fit for everyone. To learn more and see if neurofeedback can help you, visit our providers page to find a Myndlift clinician near you.

 

 

Eye Movement Desensitization and Reprocessing (EMDR)

 

 

EMDR therapy is a direct psychotherapy treatment that is used to help people cope with depression, anxiety, and other emotional trauma. The method was introduced in 1987 by a psychologist named Francine Shapiro. Over the years, research has shown it to be effective and helpful in treating some mental health disorders.

 

Unlike other psychotherapeutic approaches, EMDR does not rely solely on talk therapy to treat neurological disorders, but rather combines it with the patient's own rapid, rhythmic eye movements.

 

EMDR therapy is typically broken down into 8 phases:

 

Phase one: History and treatment planning

Phase two: Preparation

Phase three: Assessment

Phases four: Desensitization

Phase five: Installation

Phase six: Body Scan

Phase seven: Closure

Phases eight: Re-evaluation

 

This technique involves recalling traumatic memories while engaging in side-to-side eye movement or other sensory input such audio stimulation or finger tapping to unblock memories that have been stagnant especially as a result of distress due to the individual blocking off the memory, like in cases of PTSD. With this technique, these memories are unblocked so that you can heal from the emotional distress associated with that memory. In a sense, EDMR reprograms your brain and as you go through the various phases of treatment, it can also help to enhance your beliefs and perspectives to improve your self-esteem.

 

In addition to isolating a past memory which could be a contributing factor to your anxiety or depression, EDMR also focuses on current situations which affect your mental wellbeing, while helping you build mental health skills you may need for the future. EDMR therapy may be considered to produce results rapidly, especially when compared to other forms of therapy. On average, the program takes about 12 separate sessions, however, as with many types of neurological therapies, some people may start seeing improvements more quickly than others.

 

 

Behavioral Therapy

 

Behavioral therapy is a type of therapy which seeks to analyze and change unhealthy and self-destructive behaviors. The concept of behavioral therapy is based on the idea that every human being is born with a mentally clean slate and all ideas and behaviors are learned from the environment. If mental health disorders are a result of maladaptive learning, then these undesirable behaviors can also be unlearned with the help of a professional.

 

The end goal of this therapy is to eliminate unhealthy behavioral patterns while reinforcing the desirable ones. Some forms of behavioral therapy include cognitive behavioral therapy, which focuses on how a person’s thoughts and beliefs influence their actions and moods. Similarly, cognitive behavioral play therapy is commonly used with children in order to improve communication and observe the root of problematic behaviors. Systematic desensitization, also called exposure therapy, is based in classical condition and frequently used to treat phobias, where people are taught to replace one response with a healthier one. Aversion therapy is another form of behavioral therapy, which aims to associate a pleasurable stimulus (such as alcohol or drug abuse) with an extremely unpleasant stimulus as a deterent.

 

The main difference between other forms of psychotherapy and behavioral therapy is that it is action based. In other words, the behavioral therapists focus more on how to change the person’s behaviors than in psychoanalyzing the individual. The same way a certain maladaptive behavior was learned is the same way a desirable which will eliminate the problem will be learned.

 

Behavioral therapy is a general name for various types of therapies which include cognitive behavioral therapy, applied behavioral therapy, social learning theory, system desensitization, and aversion therapy. Behavioral therapy is largely considered as an effective means of treating depression, anxiety, phobias, eating disorders and a wide range of other psychological disorders.

 

 

Transcranial Magnetic Stimulation (TMS)

 

Transcranial magnetic stimulation (TMS) is a non-invasive form of neurostimulation. Non-invasive in this context means that the technique does not involve putting a foreign object or substance (like an intravenous lines or anaesthesia) into your body. This technique is used in measuring the connection between the central nervous system and skeletal muscle to evaluate the extent of damage done in a wide variety of diseases such as motor neuron disorders, multiple sclerosis, and stroke. Repetitive transcranial magnetic stimulation (rTMS) is used as a therapy to treat depression. It is generally used for severe cases when other forms of therapy have shown to be ineffective.

 

 

 

 

 

In this procedure, a TMS device (a small electromagnetic coil operated by a computer program) is used to apply short, powerful magnetic fields via electromagnetic induction to parts of the brain involved in mood regulation. This would be on the left side of the brain’s prefrontal cortex. This causes an electric current to flow in a small targeted region of the brain, activating the brain cells to release neurotransmitters which in turn affect the activity of the CNS. The energy produced by TMS are similar in strength and type to the magnetic fields produced by a magnetic resonance imaging machine (MRI).

 

The treatment coils are attached to the scalp and the magnetic field they produce only reach about 2 to 3 centimetres into the brain. Although it is non-invasive, TMS is not without side effects. Headaches are frequently reported during or after the treatment and while seizures are not common, TMS patients may experience them in some cases. TMS is not recommended for people with a history of head injury and epileptic patients. Results of the therapy may not be noticeable until after a few weeks of treatment, generally five or six weeks.

Comparing Different Treatment Options

 

Each treatment technique listed above is not without its own drawbacks. Some, such as medication and TMS, come with several side effects that could affect the health of the patient. Most treatments take between a few weeks to a few months for signs of progress to become apparent. Others are not suitable for people with a pre-existing health condition that may affect the treatment procedure, for example, TMS is not recommended for epileptic patients, as the electric current produced in the process may potentially be harmful. 

 

Anxiety disorders and depression can be treated with psychotherapy approaches, medications, or both. Research has shown treatment is most effective when it is a combination of therapy and medications. Medications are not usually used as the first line of treatment, especially in young adults and adolescents. Behavioral therapy, on the other hand, will help you develop an awareness of your behaviors and try to change them, while neurofeedback is a form of personalized therapy which can help reprogram your brain towards a more desirable state. 

 

 

All of these treatment options will vary in efficacy from person to person, and some can be used in conjunction with others. Often, for depression and anxiety, a combined or holistic treatment plan will be most effective, taking into consideration other medical conditions, lifestyle, time and money required for each type of treatment, and how extremely the symptoms are interfering with your life. The length of time spent in any therapy will depend on the severity of your depression or anxiety disorder. A health professional can help you determine the most effective treatment option and customize each one to suit the type and severity of your mental health condition. 

 

 

 

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