Can antidepressants help stabilize mood?

Psychiatry, Psychosomatics & Psychotherapy

The essential basis of treatment is the use of antidepressant medication, the implementation of psychotherapy or a combination of both measures. Psychotherapy is just as effective as medication in mild and moderate depressive phases. However, psychotherapy takes more time than an antidepressant to take effect. In severe depressive episodes, according to current knowledge, a combination therapy is more effective than pharmacotherapy or psychotherapy alone. In mild depression (mild depressive episodes, dysthymias, antidepressant drugs are less effective than in severe depression, which is why psychotherapy should be preferred.

Whether an outpatient treatment is possible or an inpatient stay is necessary depends, among other things, on the type and severity of the depression and the individual risk of suicide. In the case of psychotic depression, for example, hospitalization is usually unavoidable. The treatment of depressive illness is subject to different goals depending on the phase of the illness the person concerned is in:

1. Acute therapy for depression

Acute therapy should begin as soon as an acute phase of illness occurs. It will continue until the acute symptoms of depression have improved significantly; it therefore usually lasts four to eight weeks. The focus during acute therapy is on providing information about the disease and the planned therapy concept, as well as the need to take medication. In addition to this so-called psychoeducation, contact with the doctor also plays a very important role in this phase - he is available to those affected for any questions and encourages you to continue the treatment and take any medication you may have prescribed on a regular basis. Those affected should know that the effects of antidepressant medication often take a few days to weeks to take effect. In this phase, accompanying sociotherapeutic measures are also introduced.

2. Maintenance therapy for depression

Maintenance therapy follows acute therapy and is intended to stabilize the patient's condition to such an extent that there is no relapse. Psychiatrists understand relapse to be the reappearance of signs of illness before real recovery has occurred. If symptoms reappear after the original state of health has been restored, doctors speak of a relapse. The goal of maintenance therapy is to maintain this stable state for at least four to six months. It is important to recognize possible warning signs of a relapse at an early stage and to know mechanisms for averting it. A trusting doctor-patient relationship forms the basis of successful therapy.

3. Relapse prevention (relapse prophylaxis) in the case of depression

The prevention of a relapse begins as soon as the mood of the person concerned has normalized again. In the long term, it is intended to prevent another acute episode of the disease from occurring. How long this so-called relapse prophylaxis is carried out depends, among other things, on the number and severity of the depressive episodes. In general, the doctor's prescribed therapy must not be discontinued independently and a regular rhythm of rest / activity should be achieved and maintained in everyday life. In the event of an impending relapse, early intervention measures learned in psychotherapy should take effect.

Many depressed patients are helped by a detailed daily schedule as well as a list of possible pleasant activities and an overview of daily routine tasks: Set yourself concrete goals and be proud of every success, no matter how small. The best way to keep track of your progress is to keep a mood journal.

The involvement of the partner and family members often plays a major role in the treatment of depressive illnesses. The relatives should be informed in detail about the appearance, the treatment options and the prognosis of the disease (psychoeducation). Because only with well-founded knowledge can they support the patient, motivate them to continue treatment and help protect against relapses.