In general, the severe depressive illness, particularly that is a recurrent, will require antidepressant medications along with psychotherapy for the best result.
Who can help in depression treatment?
Mental health professionals, such as a psychiatrist, psychologist, or clinical social worker who is in close communication with the physician providing diabetes treatment, should manage treatment for depression for diabetics. If you need antidepressant medication, then it is very much important to avoid potential harmful drug interactions.
Treatment options for depression
- Psychotherapy (talk therapy),
- Antidepressant medication,
- Electroconvulsive therapy (ECT),
- Transcranial magnetic stimulation (TMS)
Medical study shows that depression leads to drop in physical and mental functioning, so a person is less likely to follow a required meal or medication plan. Treating depression with psychotherapy (“talk” therapy), antidepressant medications, or a combination can improve a patient’s mood, well-being, and their ability to manage diabetes.
Psychotherapy for depression
Psychotherapy is often the first treatment option recommended for depression. Simple called as "talk therapy,” the word psychotherapy actually involves a variety of treatment techniques.
During psychotherapy, a person with depression talks to a licensed and trained mental healthcare professional who helps him or her identify and work through the factors that may be causing their depression. In addition, the healthcare profession works to re-mould you to overcome depression by his convincing talk.
Antidepressant, Medication drugs for depression
Prescription antidepressant medications are generally well tolerated and safe for people with diabetes. However, recovery from depression takes time; medications can take several weeks to work and may need to combine with psychotherapy.
- Tricyclic antidepressants (TCAs); TCAs primarily affect the levels of two chemical messengers in the brain, norepinephrine and serotonin. They can have more side effects than other drugs, so they typically are not the first drugs used.
- Monoamine oxidase inhibitors (MAOIs); MAOIs are most effective for people with depression who not respond to other treatments. Substances in certain foods like cheese, beverages like wine, and medications can interact with an MAOI. So when taking this medication must adhere to strict dietary restrictions. Therefore, this too typically is not the first drug choice.
- Selective serotonin reuptake inhibitors (SSRIs); SSRIs are a newer form of antidepressant; it works by altering the amount of chemicals in the brain called serotonin.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs); SNRIs are a newer form of antidepressant, works by increasing the brain chemicals serotonin and norepinephrine.
Electroconvulsive therapy (ECT)
It can also be known as; electroshock therapy is mostly preferred to treat severe depression. During ECT, a skilled doctor applies a brief electric current through the scalp to the brain. This current induces a seizure. ECT is very effective at treating depression.
ECT is generally preferred, when severe depression and not responsive to other forms of therapies. Alternatively, used when patients pose a severe threat to themselves or others, and it is dangerous to wait until medications take effect.
Transcranial magnetic stimulation (TMS)
TMS creates a magnetic field to induce a very small electric current in a specific part of the brain without seizure or loss of consciousness.
Use TMS to treat milder depression and works best for patients who have failed to benefit other antidepressant treatments. In addition, unlike ECT, administer TMS does not require sedation and on an outpatient basis. Patients undergoing TMS must treat four or five times a week for four weeks.
There is some scientific evidence that St. John's wort is helpful in treating mild to moderate depression. You should discuss with your physician before you try to use any of herbal supplements. Recent study shows St. John’s wort may interact with some other medications taken for diabetes.