How Is Depression Diagnosed?

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However, ADMs seem to be symptom-suppressive rather than curative (Hollon et al., 2002). That is, although ADM is effective in the treatment of the acute depressive episode and is preventive so long as its use is maintained, no published findings to date suggest that ADMs reduce future risk of depressive episodes once their use is terminated. This suggests that causal mechanisms of depression are unchanged by ADM treatment, and so patients are left with an elevated risk for subsequent episodes if they stop taking their medications.

Cognitive therapy

CT is the best-known and most widely tested of a larger family of cognitive behavioural interventions. Like ADM, it is a safe and efficacious treatment for acute episodes of major depressive disorder. CT is based on the premise that inaccurate beliefs and maladaptive information processing (forming the bases for repetitive negative thinking) have a causal role in depression. Cognitive behavioural therapy (CBT) aims to help you understand your thoughts and behaviour and how they affect you. CBT recognises that events in your past may have shaped you, but it concentrates mostly on how you can change the way you think, feel and behave in the present (Goldapple et al., 2004). This ‘cognitive model’ posits that when maladaptive thinking is corrected, both acute distress and the risk for subsequent symptom return will be reduced. In CT, therapists aim to help patients acquire the abilities to, first, identify the thoughts and images that accompany and precede the experience of upsetting emotions; second, distance themselves from the beliefs that are embedded in, or implied by, these thoughts and images; third, question, often through experiments, the validity of their beliefs (for example, what is the evidence for this belief? Are there alternative explanations for the event that triggered the beliefs?); and fourth, identify the themes in the content of the thoughts and images that occur across a range of situations (DeRubies, 2008).