Depression and MCI: Part 2, Treatment options

Part 1 of this blog topic was inspired by a recent large landmark study confirming the efficacy of antidepressant medications. We reviewed the symptoms of depression in part 1 of this topic, and today’s post is about treatment options.

Medications

As noted in the study, antidepressants are effective for depression. It is important to discuss this with your doctor who knows more about you, your MCI and other medical diagnoses, as antidepressant medications can have side effects. Determine with your primary care physician if a medication is right for you. Your physician may opt to seek a specialty opinion from a Psychiatrist, a physician with specialty in treating mental health disorders such as depression. Note that antidepressants take some time to work—perhaps 4-6 weeks--and you’ll need to check in with your doctor during that time.

Therapy

In addition to medication, however, there are other non-pharmacological treatment options for depression that your doctor may suggest. These therapeutic approaches maybe recommended rather than a medication or in addition to a medication. There are a number of “talk therapy” approaches used by mental health providers, but the one with the most supportive evidence for depression is cognitive behavioral therapy (CBT).

To find a therapist, you may need to first check with your insurance carrier to determine mental health providers available in your area. Your primary care physician may also be able to recommend someone. In addition, the Association for Behavioral and Cognitive Therapies has a “find a therapist” link. This link can help you search for providers in your area who specifically provide treatment with a CBT perspective.

When you contact a possible psychologist or therapist about CBT for depression, I would encourage you to determine if the provider has any knowledge of MCI or memory loss, as they may need to adjust some therapeutic techniques or homework assignments because of your memory loss. This may include providing more information in writing, having you complete homework assignments in written format, and increased repetition of some aspects of the treatment to solidify your understanding and skill building. Written information is quite common in CBT, so these adjustments should not be too difficult for your therapist.

Increase Activity

Finally, an important component of therapeutic treatment for depression in addition to “talk therapy” is “behavioral activation,” which is a therapeutic way of saying “getting out and getting active”. Moderate physical exercise and social engagement help release neurotransmitters in the brain that are important for reversing depression.

Bonus: In addition to helping depression, physical exercise also releases proteins in the brain important for helping keep brain cells healthy, and increased socialization reduces the risk of dementia, so you get double for your effort!

The bottom line is that depression is quite treatable with a number of techniques. So please talk to your doctor. Unfortunately, we often cannot reverse Mild Cognitive Impairment, but treating your depression will help you achieve your best "living with MCI" life possible.