Psychotherapeutic depression treatment

At best, depression should be treated with psychotherapy and, in more severe cases, with medication. Various psychotherapeutic therapy methods are suitable for treating depression. Cognitive behavioral therapy has proven to be particularly effective in bringing about a rapid reduction in symptoms. This is a therapeutic procedure that specifically addresses the patient's symptoms and addresses the patient's individual problems so that personal suffering is reduced and an active everyday life is possible again. To this end, various steps are taken in structured therapy sessions to treat the clinical picture of depression. The patient should increase their activity, work on their social contacts, learn to give up false beliefs about themselves and learn problem-solving strategies for everyday life and for future crises. During therapy, problems are analyzed, exercises are carried out, homework is assigned and discussed.

Pharmacological depression treatment

Depression is treated medically with so-called antidepressants. In Germany there are around 30 approved active ingredients2 that are used for this purpose. Most antidepressants do not work immediately, but usually take effect after three to six weeks. The drugs aim to increase the concentration of the important messenger substances (neurotransmitters) norepinephrine and serotonin in the brain. However, their mode of action and their side effects differ greatly. An exception is the newly approved esketamine nasal spray, which has a significantly faster effect via NMDA receptors in the brain. Depending on the situation, other illnesses and medications taken, a specific antidepressant is selected for the patient in consultation with psychiatric professionals.

Treatment-resistant depression – When treatment doesn’t work

If there is no improvement in depressive symptoms as a result of psychotherapeutic and drug treatments, it is referred to as therapy-resistant depression. Depending on the definition, treatment-resistant depression can also exist if two attempts at drug treatment have failed.3 In some cases, it may happen that the therapy was not carried out correctly and therefore did not work. In such cases one speaks of “pseudotherapy resistance”.