There are actually several different types of depression. No individual fits any one category exactly, since depression is as variable as the persons who have it. These classifications do serve, however, as a convenient shorthand, describing symptoms, prognosis, and treatments.

Those of us who practice natural medicine have found that depression can be treated with appropriate nutritional supplements and, in some cases, without any medication at all. In the absence of treatment, on the other hand, clinically depressed individuals can become immersed in a self-perpetuating negative spiral. Let's look at both the conventional approach to depression and an approach that emphasizes the use of St. John's wort.

Standard Medical Treatments
The mainstays of traditional psychiatric treatment have been psychotherapy and medication. Beginning with the psychological approach, to people who have experienced depression for their entire lives, "reality" feels depressing. Their mistaken beliefs and resulting behaviors tend only to reinforce their misperceptions. The goal of psychotherapy is to help patients come to terms with the world around them. It helps them to break dysfunctional patterns, and eventually to see things in a more positive light in order to achieve happier and more productive lives. More than simply a form of re-educating the patient, psychotherapy also involves "re-parenting" the patient, with the therapist providing a safe and nurturing context in which the patient can grow as an individual.

While psychotherapy was once the traditional domain of psychiatrists, times have changed. The availability of many well-trained non-medical psychotherapists, combined with the economic realities of reductions in insurance reimbursement and the higher fees of psychiatrists as compared with those of psychotherapists, often dictates a split in patient care. Therapists, including psychologists, marriage and family counselors, and social workers, are trained to know when a problem is beyond their field of expertise, and will refer the patient for psychiatric consultation when appropriate. Thus, psychiatrists often treat only the more seriously ill individuals, or act as medication consultants rather than as primary therapists. In many of these cases, psychiatrists treat depression with antidepressant medications in an attempt to counteract the chemical imbalances in the brain.

Over years of laboratory research, the existing antidepressant drugs have been developed to have a very specific effect. Some of them have been in use since the 1950s, and drug therapy remains a useful tool in the treatment of psychiatric illness. We will explore the characteristics of these medications in Prozac and Beyond-The Synthetic Antidepressants.

However, the antidepressants have their drawbacks. While they may be effective 60 to 80 percent of the time in treating depression, they can exact a stiff price. Many patients stop taking them because of side effects. Common side effects of Prozac include nausea, headaches, anxiety, insomnia, drowsiness, diarrhea, dry mouth, loss of appetite, sweating, tremors, short-term memory loss, and rashes. As if all of this weren't bad enough, most antidepressants also reduce your sex drive. Studies that looked specifically at sexual dysfunction found that 30 to 40 percent of all men and women taking antidepressants suffered a drop in libido.