Should antidepressants be avoided?
After decades of doctors believing that antidepressants would solve the problem depression, the therapists ended up becoming disillusioned. Undeniable on severe depression, their effectiveness is much more measured when they are prescribed to treat moderate or mild depression. “It appears that antidepressants work in about 60% of cases in 2 to 6 weeks. But in the event of a relapse, the chances of effectiveness decrease and the more you relapse, the more you will relapse” emphasizes Dr. Patrick Lemoine, psychiatrist and doctor of neuroscience.
“For depressions of moderate or mild severity, non-pharmacological approaches have shown certain effectiveness. Moreover, this effectiveness associated with their harmlessness should make them the first-line treatments, drugs then only coming in the event of failure”.
Hygiene of rhythms or chronotherapy
“For some researchers, including myself, depression is largely linked to a chronobiological problem. In other words, we are depressed when our clocks are not on time. A study conducted with Pr Ohayon, from Stanford University shows that many people are depressed because they are morning subjects who behave like evening subjects. For them, chronotherapy can be effective very quickly” explains Dr. Lemoine.
Chronotherapy ranges from simple rhythm hygiene to sleep deprivation for one night, followed by a few days of sleep phase advance.
Light therapy for seasonal depression
In case of seasonal depressionlight therapy, which consists of exposing oneself for 30 minutes in the morning upon awakening to the light of a 10,000 lux lamp, is “the only method that has proven its effectiveness. More than 85% of people with bulimia mellitus, weight gain and hypersomnia are cured in 4 to 14 days”.
Of course, you should consult your doctor before starting this type of treatmentbecause it is necessary that the diagnosis be certain. In fact, in non-seasonal lows, light had little or no effect.
hypnotherapy
“Quite close in its objectives to cognitive and behavioral therapies, hypnosis has its place in the modern therapeutic arsenal” insists Dr. Lemoine. “hypnotherapy is a particularly intense altered state of consciousness, a trance during which the brain is able to reset its programs”.
Seismotherapy or electroconvulsive therapy (ECT)
In cases of melancholic depression, particularly in the elderly, electroconvulsive therapy is by far the most effective: about 86% positive results in 2 to 4 weeks. It is also the best tolerated and the least dangerous. The World Health Organization also makes it the treatment of choice for somatic fragility in pregnant women.
“It’s a much gentler technique than we imagine. In any case, gentler than many chemical treatments” explains the doctor. ECT is now performed under light and ultra-short general anesthesia (less than one minute).
Cognitive-behavioral therapy (CBT)
The initial idea of this approach uses three variables: cognitions, cognitive processes, depressogenic patterns. The cognitive part therapy consists in helping the patient to identify the flow of his negative thoughts (“I’m not good enough”, “everything is going wrong”, “no one likes me”…) and their harmful effects.
The patient perceives his therapist as being able to bring him help and support (the therapist is active and directive) and he also has the feeling of a common work (the patient is collaborative).
Mindfulness meditation
Located at the crossroads of cognitive therapies and oriental meditation practices, the therapy of mindfulness meditation is a stress management method created in the 1980s by John Zabat-Zinn and popularized in France by Dr. Christophe André, psychiatrist at Sainte-Anne Hospital in Paris. From a structured program (8 sessions of 2 hours) the patient will decrease his cognitive reactivity, reduce his ruminations and use mindfulness to identify his mental states and adopt strategies to avoid the onset of depression.“As such, mindfulness meditation can be considered a vaccine against depression” says Dr. Gérard Ostermann.
Learn more : Heal your head without medication or almost, Dr. Patrick Lemoine, ed. Robert Laffont
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