Another biological treatment for depression that is a more controversial biological therapy than chemotherapy, is electro-convulsive therapy (ECT). It consists of the patient being given an electric shock of about one-hundred to one-hundred and fifty volts in a course of about six to twelve treatments, administered two or three times a week. This treatment was used more frequently in the past, but today it is usually used for more severe depression that has not responded to other treatment. A clinical study has suggested that ECT is the most effective treatment for severe depression, showing the most improvement in quality of live. Pagnin et al (2008) conducted a meta-analysis of trials regarding the effectiveness of ECT in comparison with simulated ECT, simulated ECT, placebo, or antidepressant drugs. Pagnin concluded that ECT is a valid therapeutic tool for treating depression, including severe and resistant forms. However, long-term memory loss and short-term confusion have been caused by certain types of ECT, so particularly in the case of long-term memory loss, it could be said that the treatment may not be worth the negative effects.
Psychoanalysis is a psychodynamic treatment for depression, based on the assumption that depression is linked to childhood conflicts. In the therapy, the therapist aims to access the patient’s unconscious mind in order to establish the cause of the depression. There are two primary techniques used in this therapy; free association, wherein the client is encouraged to talk about whatever comes into their head when presented with images for example, and dream analysis, wherein the content of dreams are analysed by the therapist. In 2006, Barley reported on three controlled trials of psychodynamic therapy, and compared them with no active treatment for depression, His findings were inconsistent; two trials found benefit at some point within the trial, but the third showed no difference in the trial period. Therefore it suggests that psychoanalysis can be an effective treatment for some individuals suffering from depression, but not all, although this may be due to the cause of depression being different for each person; one person’s depression may be ultimately caused by childhood trauma, and they would be more likely to benefit from psychoanalysis, whereas someone else’s depression may be mainly due to biological factors, so psychoanalysis wouldn’t be very useful for them. Some issues with psychoanalysis are that it can be a lengthy process, requiring commitment from the patient, which may be difficult, and also, it is very costly, so many are unable to access this treatment. It has been said that psychoanalysis is better than no treatment, but not necessarily as effective as treatments like chemotherapy. Psychoanalysis may speed up recovery rates, but it is unclear as to whether this is due to the psychoanalysis or whether the depression improved due to other factors, ie. Is it catharsis, or just the fact that ‘talking’ can help?
Image: http://psychoanalyticresearch.org/what-happens-in-a-psychoanalysis/
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