Program of daily activities, exercise and nutrition program and regular sleep.
Deal with concrete, practical issues.
Care in the use of empathy - may deepen depressive states.
Cognitive-Behavioural Therapy (CBT)
Depression is most commonly treated with a combination of CBT and drug therapy.
CBT aims to correct negative thinking patterns and provide a daily routine which
reinforces positive activities, particularly those which include an element of
socialisation and self-care.
Psychotherapy which aims to find and manage the root cause of depression (eg early
childhood trauma such as sexual abuse) is normally not indicated, particularly during
periods of detoxification as this may exacerbate depression and elevate the risk of
self-harm or suicide.
A range of anti-depressant medication may be prescribed. Clients should be aware
that these medications often take several days before their full effect is felt and
treatment should be continued for several weeks after symptoms disappear.
The period when mood is first lifting is particularly dangerous, as it is during this
time that energy and motivation may be elevated enough to complete a suicide attempt. Some
anti-depressants can be lethal if taken in overdose, particularly if mixed with depressant
drugs such as alcohol, benzodiazepines or heroin.
Other drug therapy may include Lithium (if bipolar affective disorder) and anti-anxiety
medication if accompanied by anxiety or agitation.
The nature of possible interactions with non-prescribed and prescribed substances
should be investigated with medical or pharmacy staff and subsequently discussed with the
Family members may require support as clients in their own right. They may also play
a key role as an extension of the therapy team. Where children are involved, a
careful assessment of child safety is required, generally by someone specifically trained
in this area such as a child protection worker.
Support groups exist for those with depression, drug use problems and for those with
both mental illness and substance use problems. Support groups also exist for family and
friends of those with mental illness and/or drug use problems.