Patients who suffer from clinical depression have a lot more options to treat their disorder than what was available 30 years ago. These modalities include biological, psychological and social treatment interventions. There are different professionals that can administer these treatment options and can range from psychiatrists, psychologists, social workers, therapists, life coaches just to name a few.
The role of the psychiatrist is to address the biological component of the disorder. Biological meaning the organic causes of depression stemming from neuropsychological changes inherent in the brain. The biological theories that may contribute to depressive disorders range from the monoamine hypothesis to, more recently, dysfunction in glutamate pathways.
A psychiatrist these days is more accurately called a psychopharmacologist because he uses medications to improve patient functioning and reduce the symptoms of depression. There are several classes of antidepressants, mood stabilizers, antipsychotics, and anti anxiety medications at his disposal.
Once accurately diagnosed, clinical depression can respond within 3-4 weeks if an antidepressant is started. Improvement to remission can be achieved within another 3-4 weeks where the patient is asymptomatic with the disorder. This is a faster time of improvement compared to other interventions which may take several months to see improvement.
The psychiatrist can also help as a coordinator of care. He can refer the patient to a therapist who can address the psychological issues surround the depression. A referral to a addiction or rehab facility can also occur if a co-occuring problem is substance use disorders. Sometimes a referral to a life coach could be helpful in cases where old behaviors need to be replaced with new coping skills as in the case with patients who have severe ADHD.
The psychiatrist has the most extensive training in addressing co-occuring medical problems with depression. A common cause of depression is thyroid dysfunction. Thyroid function tests are helpful in assessing the potential contribution of thyroid disease to the depression. At times, this may be the sole cause of the depression and once treated, improvement is rapidly seen.
In summary, a psychiatrist can be very helpful in treating depression with medications affording rapid improvement within weeks of initiation. He understands the medical complexity of the disorder approaching it with a biological, psychological and social approach.
Dr Jesalva is a psychiatrist. He is in private practice in Thousand Oaks, CA since 1989. He successfully treats very challenging patients with varying co-occurring disorders with medications.