It is the most common mental illness in Switzerland and its prevalence is constantly increasing. Sadness, loss of momentum and pleasure, fatigue, feelings of guilt and worthlessness, dark thoughts, etc. characterize depression. To dissipate this dullness of the soul and regain the desire to live, we recommend psychotherapy, associated or not with medication, mainly antidepressants. Today, alternative and complementary therapies complete the care offer.
From a distance
Regarding psychotherapy first, cognitive and behavioral therapies (CBT) have gradually developed, now allowing support through various electronic media, including emails, telephone interviews, online modules or smartphone applications. . A CBT can thus be followed independently by the patient or with the accompaniment of a therapist. This type of CBT has been shown to be comparable in effectiveness to its face-to-face counterpart. CBT platforms via the Internet, offering questionnaires or videos, are also useful prevention tools, like Stopblues to treat depression in young people aged 16 to 25. This digital device offers this segment of the population the possibility of communicating with other affected people. In general, these remote approaches, which aim to treat and prevent, have the advantage of increasing access to CBT and reducing costs. However, they require the patient’s ability and willingness to engage and self-observe, which requires prior work by the general practitioner to identify patients eligible for these psychotherapy modalities.
In music
Music therapy has also proven itself as a complementary short-term treatment for severe forms of depression, with 12 to 48 sessions over six to twelve weeks. This creative and artistic therapy leads patients to create or listen to music, individually or in groups. In addition to improving the overall functioning of the person, it would also have a positive impact on anxiety. Finally, it has the advantage of being devoid of side effects. Music therapy sessions can be reimbursed by certain complementary insurances as long as the therapist is registered in the Register of Alternative Medicine or the Swiss Foundation for Complementary Medicine.
Meditate
In the prevention of depressive relapse, mindfulness meditation is now a recognized and reimbursed approach if it is part of cognitive therapy.
The use of plants
In herbal medicine, to date, St. John’s wort is the only herb that can be prescribed as a sole treatment for mild depression. Its effectiveness has been demonstrated and its reimbursement is guaranteed by basic health insurance. But other plants would have interesting virtues against depression and can now be offered as complementary treatments. These are extracts from Rhodiola rosea (or golden root) and glycyrrhizic acid. The first grows in the high altitudes of Europe and Asia. Its extracts have been used for decades in traditional medicine. Its mechanism of action is not clearly understood, but it seems to have the ability to influence the levels and activity of serotonin, dopamine and norepinephrine in the central nervous system. Glycyrrhizic acid, extracted from the roots of Glycyrrhiza glabra, would have an inhibitory action in the triggering and amplification of the neuro-inflammation present in depression. There are few contraindications to the use of these plants, but they are not recommended as first-line treatment due to limited studies on the subject.
The benefits of light therapy
Light therapy is recommended as a first-line treatment for seasonal depression, a form of depression that occurs in autumn and winter due to reduced light. This method consists of exposing yourself every day for about 20 to 30 minutes to 10,000 lux (daylight intensity) using a suitable lamp. Note that a prior consultation with the ophthalmologist is necessary in the event of ophthalmic pathology. This treatment, whose effectiveness is estimated at around 60%, can be covered by basic health insurance. The doctor must provide a medical prescription specifying the diagnosis of seasonal depression and mentioning the purchase or rental of the device.
_____
*Adapted from Kamdem, G., B., et al. New developments in non-pharmacological treatments for depression. Make way for a more integrative approach. Reef Med Suisse. 2022; 8 (797): 1809-1811.
Appeared in Planète Santé magazine N° 48 – March 2023