Complementary therapy methods | Therapy of depression

Complementary therapy methods

Sleep deprivation is not a method of torture, but rather the intentional staying awake for a whole night. In more than half of the patients examined, a marked improvement in mood was already noticeable one day after the first sleep deprivation therapy. But beware: the very next day a depressive relapse can occur, especially if the patient meets his need for sleep during the day.

A sleep deprivation therapy should therefore only be carried out under medical supervision. The best conditions for this are of course provided by in-patient therapy in a hospital. This therapy method, which is used in addition to others, is based on the knowledge that a session of about half an hour in front of a light source with at least 10,000 lux can bring the depressive person significant improvement.

To my knowledge, the actual effectiveness has not yet been significantly proven. Sleep disorders have been described as possible side effects. Light therapy is one of the non-drug therapies that are successfully used to treat depression.

Especially for patients who tend to develop depressions mainly in the darker winter months, light therapy can be very helpful. This is called seasonal depression. But also with depressive patients whose illness is independent of the season, light therapy shows success.

Light therapy should be applied shortly after awakening and usually lasts about half an hour. The recommended duration depends on the light intensity of the lamp. Recommended light intensities are between 2500 and 10,000 lux.

For comparison: a normal lamp for interior lighting has only about 300 to 500 Lux. The affected person sits down in front of a lamp that imitates daylight at some distance. The mechanism of action of light therapy has not yet been conclusively researched.

However, there are indications that light exposure leads to a reduction of the body’s own messenger substance melatonin. Melatonin is a sleep-inducing hormone and is produced more often in the dark. An excess of melatonin in the body can promote the development of depression.

The exposure to light is also said to increase the concentration of the neurotransmitter serotonin in the body. This is important in that a lack of serotonin is present in depression. Light therapy has few side effects.

There are, however, some groups of patients who should exercise caution. Certain skin diseases such as lupus erythematosus can be aggravated by light. Patients with previous eye diseases are also well advised to consult their ophthalmologist before starting light therapy.

Occasionally, headaches and dry eyes can occur during light therapy. Who does not know the pictures of Jack Nicholson in the “cuckoo’s nest” when he gets his “electric shocks”? Most patients are quite rightly unsettled by this and by a lot of hearsay and even more dubious sources of information on the internet.

Here is the truth as it is practiced in this country of ours. First of all, the patient, who is usually seriously ill, is put into a state of short anaesthesia with muscle relaxation by an anaesthetist. Then a doctor uses an ECT device to artificially provoke an epileptic seizure with the help of electricity.

This procedure is stress- and pain-free for the patient due to the short anaesthesia. Unfortunately, this method has a very bad reputation (wrongly so nowadays). There are too many images in people’s minds from the time when this method was used almost indiscriminately or as a punishment and without anaesthesia.

Contrary to popular opinion, this method does not cause any permanent damage. In fact, this method can be considered one of the safest and with the fewest side effects. The most common side effects are: Lack of concentration on the day of therapy, possible confusion after awakening from anesthesia, headache and nausea.

Nowadays, ECT is generally (in Germany) used in patients with severe depression with psychotic symptoms or with so-called catatonic schizophrenia (see chapter on schizophrenia), who do not experience sufficient improvement under drug therapy. This can bring improvement to almost 60% of patients.The therapy is carried out in 8-12 sessions and may have to be repeated after a few months, because, and this should not be concealed here, the relapse rate after about 6 months can be described as high. In a few patients, the time to relapse is much shorter, so that it may be necessary to take the path of maintenance ECT.

Here, ECT sessions are performed at defined intervals (1-4 weeks). In the treatment of depression, non-drug therapy methods include light therapy, sleep deprivation therapy or awake therapy and electroconvulsive therapy in addition to psychotherapy. Hypnotherapy has not yet been mentioned in the guidelines for the treatment of unipolar depression.

Also meditation has not been included in the guidelines for the treatment of depression. Individual people report that meditation has helped them to overcome their depression. Without scientific studies, however, its effectiveness cannot be sufficiently proven.

In general, every person affected should decide for themselves what is good for them. It is important, however, that for moderate and severe depression, a basic therapy, usually consisting of psychotherapy and drug therapy, is initiated. Other forms of treatment such as hypnotherapy or meditation can be tried out.