Depression, Not otherwise specified

The treatment plan remains the same as for other depressive disorders. Cognitive psychotherapy is effective in reducing depressive symptoms, and the cognitive distortions that appear to cause the mood problem. Interpersonal psychotherapy is used to help the individual resolve relationship problems that are causing the depression. If the symptoms are severe, the individual may be referred for a medical evaluation to assess the need for medication, but in most cases medication is not necessary.

The different diagnostic categories of depression are sometimes more useful for research purposes than for treatment purposes. When making distinctions between different categories within a particular class of disorders, such as depression, psychologists are looking for differences that may indicate different causes, or that require different treatment.

Also, in completing research on treatment for a specific category of depression, the differences become important in measuring the results of treatment. For example, if a study is comparing different treatments, it is important that the treatment groups are similar. We would not want one treatment group to include mostly people with a major depression and another group to include mostly people with an adjustment disorder. If that happened, the research results would be tainted. Generally, moderate depression requires less treatment, and responds better to treatment, than severe depression. If we are comparing different types of treatment, the different treatments must be applied to similar problems. 

To some extent then, the use of a diagnosis helps the psychologist predict the expected duration of treatment, or to anticipate possible issues that might arise in treatment. The history of symptoms, especially the duration of the depression, can help a psychologist understand the overall impact of the depression on a person's life. Someone who has been depressed for many years, either with dysthymic disorder or recurrent major depression, will have a multitude of issues related to how the disorder has taken over his/her life. This is very different than the clinical picture presented when a person becomes depressed initially after a specific trauma, and recovers.