Treatment in hospital

TESS

During your admission to hospital, you may be offered various forms of treatment, which are described in more detail below.

Psychoeducation

Psychoeducation means that you are educated about your illness by explaining to you things such as:

• what it means to suffer from depression
• the typical development of the illness
• treatment options
• the effects and side-effects of the medicines

This process often consists many discussions. It is effective because you gain an insight into your illness and you also get a good idea of how you will recover from the illness.

Environmental therapy

Environmental therapy involves giving help to enable people to live with the illness by providing training in social skills and the ability to perceive reality realistically. Environmental therapy can, for example, involve taking part in shared tasks or activities with others. Environmental therapy can be given by nurses, caregivers, occupational therapists, or social workers in the hospital.

Psychotherapy

In some cases, people with depression receive psychotherapy. In the case of severe depression, however, psychotherapy is not used until later in the development of the illness. In the case of severe depression, patients will be so ill that they will find it difficult to take part in a normal conversation. Patients would therefore find it even more difficult to be active in psychotherapy.

There are several psychotherapeutic treatment methods; cognitive psychotherapy is often used. The psychotherapy treatment can be individual or group-based.

Medicine

If your depression becomes so serious that you are hospitalized, treatment using medicine will almost always be necessary. There are two types of medicines:

• antidepressants (i.e., medicines which treat the depression itself)
• adjunctive medicines (e.g., anxiety-suppressing medicines, sleeping pills, antipsychotic medicines, and lithium)

Antidepressants are effective in the treatment of depression. The medicine removes the symptoms of the depression in just a few weeks but the treatment will only work if you continue taking the medicine. It is very important to remember this.

The decision as to which treatment you will receive will be based, among other things, on your physical health and the effectiveness and side-effects of the medicine. When you are treated using antidepressants, it will take 2-4 weeks before you notice an effect. If you suffer from severe anxiety and serious sleeping problems, you can use adjunctive medicines such as anxiety-suppressing or sleeping pills during this period.

Treatment using adjunctive medicines must, however, be restricted to a minimum because excessive doses can worsen the depression. The adjunctive medicine can also extend the treatment unnecessarily. Some forms of adjunctive medicines can be addictive if you use them wrongly. The use of adjunctive medicines must therefore be scaled down as the depression eases.

ECT treatment

There is a risk that you may be one of the few people who do not respond to medicines and there are also a few people who cannot cope with the side effects of antidepressants.

For these people, ECT treatment is an alternative. This treatment works faster than treatment using medicines and it is effective if you are having serious suicidal thoughts.