The first step in the treatment of a depressive disorder is to make an accurate diagnosis. To do this, the practitioner must conduct a thorough examination considering the symptoms and signs, the precipitants of symptoms, the person’s life experiences and personality, current medications (including those for non-psychiatric reasons), the medical history, the social history, the family history, and the stressors impacting that person’s life. The practitioner’s experience in treating depressive disorders is important so that the right questions are considered. If the person has not already been evaluated for depression caused by an underlying general medical condition, laboratory testing is conducted to rule out common general medical disorders that have depression as a symptom.
The second step is to relieve the severity and frequency of the manifestations of the depressive disorder. This is the reason that the person seeks treatment and is a prerequisite for restoring adequate social and occupational functioning. Medications may be necessary. There are also certain techniques that an individual can learn to lessen the severity of depression. The practitioner’s experience in treating depressive disorders is valuable in determining which medications and techniques are likely to help different patients with different types of depressive disorders and which general medical illnesses or medications will have an added impact.
The next step is to address underlying causes of the depression. There are learned patterns of responses to stressors. Understanding these patterns directs the psychotherapeutic strategy. Once the underlying causes are addressed, it may be possible to reduce or stop the medication. In other cases, an individual may require medication treatment on a longer-term basis. In addition to individual therapy, group therapy may be a treatment modality that would increase the individual’s chances of recovery.