Persistent depressive disorder is a debilitating depressive illness that is usually evidenced by having a depressed mood that lasts for 2 years or more. The symptoms of persistent depressive disorder were found to impact one’s ability to function effectively. Individuals with persistent depressive disorder could have a prolonged low mood which interferes with their relationships, daily activities, school, and work. This makes it important to identify a treatment that can be used to alleviate the symptoms. The treatment of persistent depressive disorder should focus on medication through the use of duloxetine and psychotherapy through cognitive behavioral therapy.
Treatment for persistent depressive disorder can be possible through the use of duloxetine. Duloxetine is a type of medicine that is categorized as a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). The theoretical basis for the functioning of the drug is that it affects chemicals in the brain that are usually unbalanced for people that have depressive symptoms. The drug thus works by increasing the levels of norepinephrine and neurotransmitters serotonin and this can realize several advantages such as blocking pain signals from traveling through the brain and thus helps in the regulation of mood. People that have persistent depressive symptoms may experience a prolonged imbalance of chemicals in their brain hence the need to use a pharmacological approach. The use of duloxetine will thus function as a treatment that balances these chemicals to normal levels.
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The medication of duloxetine has been identified for persistent depressive disorder as it can balance the abnormal levels of N-acetyl-aspartate (NAA) which is a marker for depression. Bansal et al. (2019) studied the effects of using duloxetine to balance the levels of NAA to normal levels. The study involved patients that had been previously diagnosed with persistent depressive disorder. Magnetic Resonance Imaging (MRI) showed high levels of NAA for the patients. The patients went active medication and were tested for NAA levels after 10 weeks. The study found that NAA concentrations of duloxetine decreased after the patients had experienced duloxetine treatment. The study thus showed how the use of duloxetine works by reducing balancing chemicals in the brain and this resultantly reduces depressive symptoms.
The effectiveness of duloxetine was also identified among patients that experienced an improvement in their symptoms after going through treatment. Hellerstein et al. (2017) studied the effectiveness of duloxetine on the reduction of depressive symptoms and improvement in social functioning. The study involved 50 patients that had been diagnosed with dysthymia and thus went through treatment and their symptoms were observed at week 10 and week 22. The study found that patients that had continued duloxetine intake continued improvements in their symptoms where they experienced 84% response rate and 63% remission. Additionally, there were notable positive effects on social functioning as a result of continued treatment. Treatment through the use of duloxetine should thus be continued to realize positive effects such as symptoms response and positive effects on one’s social functioning.
The second type of treatment is through psychotherapy through the use of cognitive-behavioral therapy (CBT). The treatment is based on the theory that patients usually experience the cognitive bias of depression which involves a negative view of the future, the world, and themselves. These negative distortions and automatic thoughts usually arise from cognitive structures that usually influence how information is usually retrieved and interpreted. The use of CBT through talk therapy can be used to retrain one’s mind against biased thoughts.
Such treatment usually involves several treatments talks that vary between 10 and 20 sessions. The treatment will involve the therapist assisting the patient to identify the false and negative thoughts and later replacing those thoughts with realistic and healthier thoughts. Patients with persistent depressive disorder usually have mild depressive symptoms that last for several years and this could be caused by the inherent habits of having a negative thought process. CBT thus assists the patient to become aware that they have those negative thoughts. One is then taught how to swap those thoughts for the more positive ones. Such a change in thoughts results in a change in one’s attitude and a resultant change in behavior.
Cognitive-behavioral therapy has been analyzed and found to be effective for the treatment of persistent depressive disorder. Furukawa et al. (2018) analyzed the effectiveness of CBT among 1,036 participants that had experienced more than 2 therapy sessions. The findings of the study showed that the use of CBT alone could be a recommended treatment option. The treatment was also found to have several advantages such as being a less costly treatment, having fewer side effects, and it could be created to match the individual preferences of the patients. However, the authors observed that the use of a combination therapy where CBT was used with medication resulted in a superior treatment. The use of CBT was thus identified to be an effective treatment for persistent depressive disorder as it can lead to a restructure in one’s thought process.
In conclusion, persistent depressive disorder was found that it could be treated through the use of duloxetine medication and psychotherapy. Duloxetine is a medication that balances the chemicals in the brain that are usually associated with depressive episodes. Balancing chemicals this way can thus reduce the symptoms of depression and thus reduce the symptoms of depression. Psychotherapy through CBT was identified as a way to restructure one’s thought process and focus less on negative thoughts but to focus on positive thoughts and a positive attitude.
References
Bansal, R., Hellerstein, D. J., Sawardekar, S., O’Neill, J., & Peterson, B. S. (2019). Effects of the antidepressant medication duloxetine on brain metabolites in persistent depressive disorder: A randomized, controlled trial. PloS one , 14 (7).
Furukawa, T. A., Efthimiou, O., Weitz, E. S., Cipriani, A., Keller, M. B., Kocsis, J. H., ... & Schramm, E. (2018). Cognitive-behavioral analysis system of psychotherapy, drug, or their combination for persistent depressive disorder: personalizing the treatment choice using individual participant data network metaregression. Psychotherapy and psychosomatics , 87 (3), 140-153.
Hellerstein, D. J., Hunnicutt-Ferguson, K., Stewart, J. W., McGrath, P. J., Keller, S., Peterson, B. S., & Chen, Y. (2017). Do social functioning and symptoms improve with continuation antidepressant treatment of persistent depressive disorder? An observational study. Journal of affective disorders , 210 , 258-264.
