Why Treatment Protocols For Depression Often Fail

In an era where many clients presenting for treatment of depression are prescribed antidepressant medication by their primary care physician, research now suggests that roughly fifty percent of those patients do not respond to treatment. Many of these patients either experience nothing or manifest the unwanted side effects without the benefit of recovery.

Current research seems to indicate that standard treatment protocols, such as prescribed selective serotonin reuptake inhibitors (such as Prozac), are often ineffective in the treatment of clinical depression. Especially when relied upon as the primary and/or sole mechanism of treatment. In short, it seems that we are finally coming to the realization that effective treatment protocols are idiosyncratic to the clients. That is, a holistic approach is as essential to successful treatment as a particular antibiotic might be to the treatment of a bacterial infection.

In cases of clinical depression where incurred trauma (bullying or sexual abuse) is at the root of the depressive disorder, processing the trauma is essential to the efficacy of the treatment.

In such cases it's essential to note that the brain does not process trauma in the same way that it processes ordinary information. The stuff of which trauma is made gets "stuck" in the brain until the brain has an opportunity to make sense of it and to integrate that into the brain's collection of sensory stimuli.

Historically, the method to facilitate such processing was to have the client repeat the details of the trauma over and over in excruciating detail. More modern techniques, such as EMDR (eye movement desensitization and reprocessing) rely upon a rapid desensitization of trauma via bilateral stimulation. This permeates disasociative barriers (defense mechanisms) in order to allow the brain to process and integrate the traumatic information into the self as a whole, as opposed to compartmentalizing it.

Without the essential addressing of the underlying cause of the depression, medication alone is often either ineffective or band-aid like at best. Unless we change how we see the illness of depression, without the stigma of shame, the manner in which we proceed to formulate treatment protocols will be just as limited as the success we have in treating it.