Depression Symptoms Treatment

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Question. I am a 33-year-old male who has suffered from major depression for about 10 years. I was also anorexic and bulimic around age 25. I have been in lengthy therapy several times, but every few years I seem to cycle back into a very depressed, immobilizing state. Medications (Prozac, Zoloft, Paxil, Serzone, anti-anxiety) don’t seem to help. I’ve always been emotional and sensitive. I am interested in hypnotherapy – do you think it might be beneficial? What other treatments might you suggest?

Answer. I don’t want to burst your balloon regarding hypnotherapy, but I know of no credible evidence that it helps depression. In the first place, hypnosis is not really a therapy, but rather a technique used in the context of a broader therapeutic approach, such as psychotherapy and/or medication. While hypnosis may be useful in certain post-traumatic and dissociative disorders, phobic disorders, some chronic pain states, and in the treatment of “habit” disorders like smoking, there’s no research to show that it is helpful either in the treatment of acute depression or the prevention of further episodes.

Since you say you “cycle” into depression, I would certainly make sure that you do not have a cyclical mood disorder, such as bipolar (manic-depressive) disorder. (You did not mention any mood stabilizers in your list of medications, and these might be worth discussing with your psychiatrist.) There are many new medications available for depression, such as venlafaxine (Effexor), mirtazepine (Remeron), and citalopram (Celexa), and the fact that you did not respond well to the ones you mentioned does not mean that you will not respond to these newer agents.

A MAOI (a special type of antidepressant) would also be worth considering. Both ECT (electroconvulsive therapy) and a new technique called TMS (transcranial magnetic stimulation) could be beneficial as well. Any medication should be used in the context of a supportive therapeutic relationship with a mental health professional. You could also benefit from participating in a support group for depressed individuals. And if you have not yet joined the National Depressive and Manic-Depressive Association, I would encourage you to do so. Don’t give up – there is effective help out there!