Depression treatment is vary , depend on the concept of the therapy and this make the technique of  "How to deal with depression" are so vary. And mostly the treatment of depression center on the patient conditions and what causes of depression because each patient has their own each causes. The depression itself have some type, you can read here about the different types of depression and here for the physical symptoms of depression.

Treatment of depression

Depression stands as a central part of human experience. Loss, isolation, hopelessness, emptiness and anomie have been recurrent themes in philosophy and literature for centuries. Depression is inescapable and in many ways, insurmountable. But is clinical depression, the abyss of the human spirit, entirely unyielding? Although our attempts to understand and treat clinical depression are of relatively recent origin, recent findings have been promising (DeRubeis & Crits-Christoph,1998; Dobson, 1989; Elkin et al., 1989; Frank, Kupler, Perel, Cornes, & jarrett, l990). Moreover, an emerging body of work suggests that forms of depression may he preventable. at least in some situations (Gillham,Reivich, ]aycox, & Seligman, 1995: Hollon, DeRubeis, & Seligrnan, 1992: Munoz, Ying, Perez-Stable, & Miranda, 1993; Munoz, Mrazek, & Haggerty, 1996).

The recent proliferation of books. chapters, and articles on depression points both to its importance as a feature of` modern society and to the effectiveness of biological and psychosocial approaches for treating it. Moreover. recent developments, including the identification of empirically-supported treatments (Chambless et al., 1996; Kazdin,1996), the increased use of treatment manuals (Chambless & Hollon, 1998), and an emphasis on objectively assessing treatment outcomes (Eisen & Dickey, 1996; Lambert & Brown, 1996) are reshaping graduate education, residency training, and clinical practice {Calhoun, Moras,Pilkonis, & Rehm, 1998}. Given this, it seems timely to consider the relationships between alternative models of depression and the major forms of treatment that are derived from them. The fundamental questions we wish to address are. on the surface, quite simple: What are the most effective treatments for clinical depression and how do they work?

DIMENSIONS OF COMPARISON
Research and clinical experience indicate that a number of forms of treatment, including psychotherapy, can be effective in alleviating depression. But just what is psychotherapy and how does it differ from other forms of social discourse? At its most basic level, psychotherapy may be defined as a trusting interpersonal relationship in which developmental, social, and intra psychic factors associated with personal distress are examined. Positive outcomes are seen as stemming from the additive effects of common or nonspecific factors and theory-specific interventions. Beyond this, however, there is relatively little agreement. Alternative forms of psychotherapy differ dramatically both in the ways in which they conceptualize depression and in the proposed technologies of change.

For the sake of discussion we would suggest that alternative forms of treatment can be compared and contrasted on two levels—the conceptual and the technical. The first refers to the assumptions of the models and their philosophical foundations. This includes assumptions about the nature of psychopathology and the processes of human development and change. These are assumptions that we implicitly accept when we offer a specific form of treatment. The second dimension refers to practical matters. Technical differences between models include assessment strategies, the role of case formulation. clinical goals and strategies, the use of specific techniques, and approaches to understanding the therapeutic relationship. Technical differences, as such, center upon what the treatment looks like in practice. Not surprisingly,conceptual and technical factors often overlap and influence one another. That is to say, how one thinks about depression and human change often influences one`s clinical approach. The selection of a specific intervention for a specific patient should. however challenge us to consider the assumptions we are making about the origins of their distress and the mechanisms of clinical improvement.

There are important conceptual and technical differences between alternative treatment approaches. In an attempt to organize this material. we would suggest that these approaches may usefully be compared along a number of dimensions.


MECHANISMS OF CHANGE IN PSYCHOTHERAPY AND PHARMACOTHERAPY
As noted. outcome studies indicate that both pharmacological and psychosocial treatments can be effective in alleviating clinical depression. Alternative approaches to treatment tend, however, to postulate different mechanisms of therapeutic change. How can we account for the fact that various forms of psychotherapy and various classes of medication can be effective in alleviating clinical depression? One possibility, of course. is that there are alternative pathways to change. In as much as clinical depression is characterized by affective, behavioral, social, cognitive, neurochemicalArkowitz & Hannah, 1989). Effective treatments tend, as a group, to be active,focused, and problem—oriented. Moreover, each has a clear rationale that is shared with the patient, providing the therapist and patient with a common language for understanding the origins of their distress and the actions that must be taken to remediate it. Effective therapies tend to be structured, and encourage active attempts by the patient to address difficulties as they arise. They tend, as well to encourage patients to monitor their progress, and to examine the relationship of their feelings of depression to thoughts, behavior, environmental events, and interpersonal styles. Patients are encouraged to actively change conditions associated with their negative mood.

But how can we account for the equivalent effectiveness of medications and psychotherapy? The possibility exists that both medications and psychotherapy function by altering specific neurochemical systems in the brain. Although a common biological pathway for clinical improvement among depressed patients has not been identified. this possibility is consistent with recent research on the treatment of anxiety.

Studies of patients with obsessive-compulsive disorder, for example, indicate that both medications and cognitive—behavioraI psychotherapy are associated with normalization of brain metabolism in regions implicated in the maintenance of compulsive behaviors (Baxter et al., 1992;Schwartz, Stoessel, Baxter, Martin, & Phelps, l996), ln a similar manner, it has been observed that psychodynamic psychotherapy may be associated with changes in serotonin metabolism (Viinamaki. Kuikka, Tiihonen, & Lehtonen, 1998}. lt is possible, as such. that both psychosocial and pharmacological interventions exert their eflect by normalizing the Function of specific neurochemical systems that regulate mood.

Although the specific mechanisms by which this occurs are not well understood, the possibility exists that it may involve functioning of the prefrontal cortex—an area of the brain implicated in planning, problem-solving, and executive regulation of mood and behavior (Baxter, l99l: Baxter et al., 1989; Maeda, Keenan. & Pascual—Leone, 2000). It appears that interactions between the brain and the environment are dynamic, and that the brain responds to environmental influence through the regulation of gene expression (Gottlieb,21.100). lf psychotherapy is viewed as a learning experience—alneit one accompanied by strong affect—then it is reasonable to assume that these experiences affect cerebral function, most likely through the modulation of gene transcription [Kandel, 1998). The possibility that psychotherapy and medications may function through shared mechanisms may not, then, be so very far-fetched. It is a possibility with important implications for our understanding of both human adaptation and clinical practice. and is worthy of careful consideration.

CONCEPTUAL ADEQUACY OF ALTERNATIVE MODELS OF DEPRESSION TREATMENT
A difficulty with synthetic, "big picture” scholarship is that it often attempts to impose a pattern on too much information. This is true in both the humanities and the social sciences. In comparing and contrasting alternative theories of depression, it is important to keep the specific goals and objectives of each model in mind. Put another way, what is the range or scope of each model? Were they, for example, developed as models of clinical depression, of psychopathology more generally of psychotherapy, or of normative human development? Can the models successfully account for the phenomena they were designed to describe and predict? What are the limits or bounds of what they attempt to describe and predict?

As Elster (1990) observed, there are two ways in which conceptual models can fail—through indeterminacy and through inadequacy. As he noted, a theory is indeterminate to the extent. that it fails to yield specific predictions, and is inadequate to the extent that its predictions are disconfirmed. Of these, the latter is the more serious concern. A theory may have a relatively narrow range of convenience, and yet have some explanatory power and clinical utility if it excludes at least some possible alternatives and serves as an effective guide for intervention.

A model can be weak, but not useless. It is a more serious problem if the model makes predictions that are falsified by research—that is, if it makes predictions that are not supported by observation. It is worse, in short, for a theory to predict wrongly, than to predict weakly but truthfully, As regards our models of depression, it is worth asking, what specifically does each model predict? Are its predictions supported by empirical research and by clinical observation? Are its concepts and predictions made in such a way that we can distinguish it from other, alternative models? Do the clinical strategies and interventions logically follow from the proposed model of psychopathology? Are there ways in which the concepts employed by the model should be modified, clarified. or supplemented? It is a sign of intellectual honesty when we are able to modify or discard concepts and “interpretive keys" when they are not supported by observation or evidence, and when they no longer serve our purposes as guides for effective treatment. Our first challenge, then, is to determine the conceptual adequacy of each model in the light of evidence and observation.

This is particularly important given the heterogeneity of clinical depression. It is possible that some models may be more effective for understanding specific subtypes of depression or for guiding the treatment f`specific groups of patients than are others. Abramson, Metalsky,and Alloy (1989), for example, proposed that feelings of hopelessness may serve as a proximal, sufficient cause of depression in a subset of patients. Theirs is not, then, a general model of depression. Rather, it is a descriptive and predictive model for a subset of depressed patients. Read Completely : Comparative Treatments of Depression

The conceptual of depression treatment need to be review and re-analysis to find best structure of therapy for treating depression. With comparative treatments of depression we can find big picture of what causes of depression ,is the depression hereditary? , the "How to deal with depression" and right healing. The causes of depression are unique and vary so the treatment for depression. This book tell us completely about the comparison of depression so this will be good choice to buy and learn.


Note : This article is copyrighted material and use only for promotion purpose of this book.