Treatment for Depression at Mount Sinai
Because depressive disorders come in many forms, Mount Sinai offers a wide range of treatment options—from Cognitive Behavioral Therapy to device-based treatments and new antidepressant medications. Whether a patient is struggling with mild symptoms and looking for basic care, or a treatment-resistant depression that requires advanced therapies, our psychiatrists, psychologists, and social workers are skilled in providing the right help in the form of medications, psychotherapy, and the growing field of device-based therapies. Due to our role as a leading research center, our patients also have access to the state-of-the-art treatments still undergoing evaluation by joining clinical trials, making Mount Sinai a destination for challenging depressions that haven’t responded to therapies elsewhere.
With the goals of alleviating the immediate pain of depression and ultimately returning patients to their fullest lives, Mount Sinai provides the following treatments for patients of all ages who come to us for both outpatient and inpatient care.
Medications to Treat Depression
Medications (also called psychotropics) are intended to treat depression by balancing levels of neurochemicals in the brain. They include the following proven drugs as well as new medications being studied in clinical trials.
- Proven Antidepressant Medications
The current classes of antidepressant medications work to balance levels of neurotransmitters (such as serotonin and dopamine), which are chemicals that facilitate communication between brain cells. Selective Serotonin Reuptake Inhibitors (SSRIs) are the most common class of medications, and include the brands Prozac®, Zoloft®, and Paxil®. Other medications currently available include Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs), such as Effexor or Cymbalta, and atypical antidepressants such as Wellbutrin and Remeron. Older classes of antidepressants include Monoamine Oxidase Inhibitors (MAOIs) and Tricyclic Antidepressants, and remain very effective while generally carrying more side effects.
- Antidepressant Clinical Trials
Mount Sinai is conducting a number of clinical trials to develop medications that treat depression in new ways. Some trials explore existing medications used for other disorders that are not approved as psychiatric treatments but have shown promising antidepressant effects; these include ketamine (an anesthetic) and minocycline (an antibiotic). Mount Sinai is also working with the pharmaceutical industry to develop and test the efficacy of entirely new medications for depression.
Psychotherapy to Treat Depression
Also known as “talk therapy,” psychotherapy involves discussing thoughts, feelings, and behaviors with a trained professional in order to alleviate a range of mental health disorders. There are many forms of psychotherapy used for depression, such as the following:
- Cognitive Behavioral Therapy (CBT)
A “problem-solving” form of therapy, CBT involves a therapist helping the patient identify and evaluate negatively skewed thought patterns, then providing methods for replacing those unhealthy patterns with new, helpful ones.
- Psychodynamic Therapy
This form of therapy involves exploring unconscious thoughts and motivations, using self-examination to achieve insights hoped to resolve the sources of depression.
- Interpersonal Therapy
This is a form of short-term therapy that focuses on the patient’s relationships with others to alleviate depression.
- Psychotherapy Clinical Trials
Mount Sinai researchers are currently testing a computer program that guides the user through psychotherapy exercises. Based on the fact that many depressions involve a tendency to perceive things negatively, this program helps patients correct their thought patterns.
Devices to Treat Depression
The procedures in this growing field of therapy use various means of delivering energy directly to the brain—such as electric currents and magnetic fields—to treat depression. They are largely intended for severe, treatment-resistant depressive disorders, and include the following:
- Electroconvulsive Therapy (ECT)
ECT applies an electrical stimulus to the brain in order to alleviate depression symptoms. The most established of the device-based treatments, ECT has undergone numerous improvements, such as the use of anesthesia and muscle relaxants and the use of novel electrical stimuli associated with improved side effects.
- Transcranial Magnetic Stimulation (TMS)
In Transcranial Magnetic Stimulation, a magnetic coil is positioned against the patient’s forehead, producing a change in the electrical field that stimulates nerves in the brain, improving symptoms of depression.
- Device-Based Clinical Trials
Mount Sinai is at the forefront of the development of new device-based therapies. We are studying an emerging treatment called Deep Brain Stimulation, which involves implanting a device that sends electrical signals to targeted areas of the brain in order to alleviate a number of disorders, including depression. Mount Sinai is also studying new forms of Transcranial Magnetic Stimulation (which are more adapted to the individual subject or better able to stimulate brain structures located deep in the brain) in order to increase the efficacy of TMS treatments.
Our Programs for Treating Depression
The following Mount Sinai programs provide care for a range of depressive disorders, with the goals of alleviating depression symptoms among patients as well as providing support for their loved ones.
- Faculty Practice Associates
The psychiatrists and psychologists of Mount Sinai’s Faculty Practice Associates offer a range of treatments, from psychotherapy to psychopharmacology.
- Outpatient Psychiatric Department Clinic
Open to adult, geriatric, and child and adolescent patients, our outpatient clinic provides a range of treatment options, from weekly talk therapy sessions to antidepressant medications.
- Mood and Anxiety Disorders Program
While the Mood and Anxiety Disorders Program (MAP) is primarily a research group, it also provides tertiary care for patients with severe, treatment-resistant depressions.
- Inpatient Services
The Inpatient Psychiatric Service provides acute care for patients with a range of mental illnesses, from psychotic disorders to substance abuse disorders. Our multidisciplinary team cares for patients in specialized units, including Geriatrics, Child and Adolescent, and Co-Occurring Disorders.
- Emergency Services
If someone is in crisis (for example if the person is suicidal) our dedicated Psychiatric Emergency Room provides immediate evaluation and stabilization. Our emergency patients are either admitted to one of our inpatient psychiatry units or released with specific care plan arrangements.