Rehab for Depression
Depression is often treated on an outpatient basis, but there are many patients who benefit from staying for 30 days or longer in a residential mental health rehab facility. This opportunity gives patients with depression a safe place to go through treatment, to find the most effective antidepressant, and to learn how to live with this chronic illness. Rehab may be especially beneficial for depression patients with severe symptoms, who may be suicidal, or for whom outpatient treatment has not been effective.
Rehab is a term that is most often associated with addictive disorders, but for patients with serious mental illnesses this residential, long-term style of treatment can have many benefits. Depression is a mood disorder that persists and is not possible to recover from without dedicated treatment. Most patients are treated through therapy and medications on an outpatient basis, but residential care for depression is also a possibility.
Some of the reasons a person struggling with depression might choose rehab over outpatient care include not having a safe, supportive place to stay, the presence of severe symptoms, having attempted suicide in the past, or simply wanting to spend time devoted to treatment without the distractions of work, relationships, and responsibilities. Treatment for depression is ongoing because this is a chronic illness, but rehab can be a good way to jumpstart that treatment and to learn practical tools that can be used in everyday life going forward.
What is Major Depression?
Major depression, or major depressive disorder, is often referred to as just depression. It is more than feeling down, though. It is a serious and often severe mental illness and mood disorder that is characterized by a depressed mood. This mood persists for two weeks or longer and affects many aspects of a person’s life, from the ability to work to the state of personal relationships. Mental health professionals diagnose depression when at least five of the following symptoms are present:
- A persistent low and depressed mood that lasts for two weeks or longer and is present on most days
- A loss of interest in normal activities or those that were once enjoyable
- Changes in weight that were not planned and result from loss of appetite or overeating
- Changes in sleep patterns, either insomnia or sleeping more than normal
- Unusual changes in affect and behaviors, either agitation and irritability or apathy and lack of emotion
- Severe fatigue
- Feelings of guilt, shame, worthlessness
- Difficulty thinking, making decisions, or concentrating on tasks
- Persistent thoughts of death and suicide, suicidal behaviors
Before any treatment plan can be designed for a patient with depression, there has to be an evaluation or diagnosis. Mental health professionals make diagnoses based on interviews and observations, as well as medical history and examinations.
Residential Rehab to Treat Depression
Treatment for depression is individualized to be most effective, but almost always includes a combination of some type of therapy and the use of medication. Most people with depression have enough function in their lives to be able to stay at home and receive treatment on an outpatient basis. However, there are many good reasons to choose a rehab facility for care, and there are some types of patients for whom this setting may be a better option. Some reasons to choose residential care for depression include:
- Severe or acute symptoms
- A significant risk a patient will harm himself or herself
- Very low ability to function at home
- Not having a supportive network at home
- Recurring episodes of depression
- Symptoms that haven’t responded well to outpatient treatment
- The presence of other mental illnesses or substance use disorders that need to be addressed
Finding the Right Antidepressant
Antidepressant medications require several weeks to take effect, which is one reason rehab is a good choice for depression treatment. A residential facility gives a patient a safe place in which to find the right medication. There are several options for antidepressants, and some work better for certain patients than others.
There are several different classes of antidepressants that can be used to treat depression, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants, and monoamine oxidase inhibitors. SNRIs and SNRIs are usually used first. These newer drugs typically cause fewer side effects.
Only when the newer medications don’t work well or stop working does it make sense to try the other medications. Finding the right antidepressant, or combination of two, takes time. It requires finding a balance between symptom relief and side effects. Having several weeks in a rehab facility gives patients and their doctors a chance to find this balance while also going through other types of treatment.
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Therapy in Rehab
While medications play an important role in managing depression, the best treatment includes therapy as well. At a rehab facility patients have access to several different types of therapy provided by experts who have experience in guiding patients through them. Some examples of types of therapy used in residential settings to treat depression are:
- Individual psychotherapy. One-on-one psychotherapy is the classic type of talk treatment that helps patients explore their emotions and experiences that underlie negative feelings and behaviors. This examination of one’s inner life sets the stage for making positive changes.
- Cognitive behavioral therapy. CBT is more action oriented and is focused on setting and achieving goals, changing negative thoughts and behaviors, and generally being more aware of one’s unhealthy and unproductive patterns.
- Relational therapy. Depression, like other mental illnesses, can wreak havoc on interpersonal relationships. Relational therapy can help a patient learn how their relationships, life experiences, and emotions are all connected and to take steps to develop healthier relationships.
- Family therapy and education. Therapy that involves a patient’s family is a great way to help educate those people most important in the patient’s life about depression and about how to support a struggling family member.
- Trauma-focused therapies. Traumatic experiences often underlie mental illnesses, and there are therapies that specifically focus on processing and reframing these traumas to help improve symptoms.
Other Aspects of Treatment in Rehab
One of the benefits of getting care for depression in a residential setting is that it gives patients a chance to experience a variety of types of supplemental treatments and to learn strategies and coping mechanisms for life after rehab. Group support, for instance, is often built into residential facilities. Patients have a chance to support each other, to share experiences and advice, and to practice healthy relationship skills while in treatment.
Many rehab facilities also offer a number of alternative or creative therapies that act as a supplement to the more traditional types of therapies. These may include art therapy, music therapy, animal therapy, movement therapy, or writing therapy. Holistic and alternative medicine may also be offered, including acupuncture, meditation, or massage therapy.
Also important in residential treatment is a holistic approach to overall lifestyle. Patients can learn skills and strategies for living a lifestyle that is more conducive to wellness. For instance, they may learn about healthy eating and how diet impacts mood. Exercise, stress management, and trigger avoidance may also be addressed during treatment, along with the development of a plan for how to live and continue treatment after the stay in rehab is complete.
The outlook for depression is largely positive for those who seek out a diagnosis and who commit to an ongoing treatment plan. Most patients start to feel better with treatment and are able to function again, having fewer or less intense episodes of depression. Rehab for depression is not always the obvious choice, but for patients who can afford this intensive care and who are able to spend the time dedicated to treatment, the outcomes are largely positive.