The American Psychiatric Association (not to be confused with the American Psychological Association) has released new treatment guidelines for depression. According to Medscape Today, the guidelines include:
- A clinician- and/or patient-administered rating scale for psychiatric symptoms to help with treatment strategies;
- A recommendation for the use of electroconvulsive therapy (ECT or "shock therapy") to treat depression if many other treatments have been tried unsuccessfully, along with monoamine oxidase inhibitors (MAOIs), transcranial magnetic stimulation, and vagus nerve stimulation as other potential options;
- Aerobic exercise or resistance training to improve mood symptoms, especially in older adults with other physical or mental illness; and
- Consideration of long-term maintenance treatment, especially for patients at risk for recurrence.
It's worth noting that Reuters reported that first suggestion as follows: "Doctors should use rating scales to assess their patients' conditions and tailor treatment according to the severity of symptoms. They can adjust various strategies such as medication, healthy behaviors, exercise and therapy." This implies that current treatment for depression takes a one-size-fits-all approach, which of course is not at all true. Doctors already tailor treatment to patients. The important part of this recommendation is the use of rating scales for various symptoms.
Going by the DSM-IV guidelines, if you meet more than a certain number of criteria you are diagnosed with depression. The new approach gets rid of the "has depression/doesn't have depression" binary and replaces it with scales that measure the severity of your symptoms. Some of the questions might look like this: How unhappy do you feel on an average day? How often do you have difficulty getting out of bed in the morning? How frequently do you think about suicide? Using rating scales like this, doctors can get a much better idea of what sort of treatment will be useful, and can also provide treatment to people who have a few signs of depression but would not be "diagnosable" under the old guidelines.
These guidelines hadn't been updated in over ten years, so I'm glad to see that the APA isn't waiting for the DSM-V to release this very important update that will hopefully improve diagnosis and treatment for many, many people who suffer from depression.