Comparing Five Different Treatment Modalities for Major Depressive Disorder (MDD)

Finding a Best-Fit Treatment for Major Depressive Disorder: A Review of Five Context-Dependent Modalities
Finding a Best-Fit Treatment for Major Depressive Disorder: A Review of Five Context-Dependent Modalities
This paper will attempt to survey five different treatment modalities for Major Depressive Disorder (MDD). Each of these treatments is associated with a body of evidence described in peer-reviewed psychological literature. The final section of the paper will compare and contrast the surveyed modalities, in an effort to develop context-appropriate recommendations for MDD treatment.
Light Therapy
Tao et al. (2020) investigated whether light therapy can offer relief from key symptoms of MDD. Light therapy is a non-pharmacologic treatment that involves daily exposure to a bright light, typically in the form of a fluorescent light box or ceiling unit. While the exact mechanism of the therapy is unknown, it is thought to involve the stimulation of retinal ganglion cells, which in turn trigger a release of glutamate, a substance involved in regulating the sleep/wake cycle in the brain. In this way, light therapy has been demonstrated to be an effective therapeutic option for sufferers of seasonal affective disorder, especially those who report problems with sleep/wake patterns.
Tao et al. reasoned that, since a number of these symptoms also appear in MDD sufferers, light therapy may offer relief from aspects of MDD as well. If so, the therapy could be particularly helpful for those who cannot easily access psychotherapy or psychiatric assistance.
Tao et al. conducted a meta-analysis of 23 studies of the relationship between light therapy and MDD symptoms, particularly sleep problems. They concluded that light therapy has “a mild to moderate effect in improving depressive symptoms compared to placebo/control” (9). In addition, they found that efficacy was strongest when light therapy was applied daily, in a single 60-minute session, using a bright white light.
Electroconvulsive Therapy
Ferrier et al. (2021) conducted a non-systematic analysis of recent literature on the efficacy (and safety) of electroconvulsive therapy (ECT) in treating symptoms of MDD. Electroconvulsive therapy is a procedure given under general anesthesia in which low-level electric currents are sent through the brain. The goal is to trigger immediate changes in brain chemistry that are capable of ameliorating symptoms of depression, as well as a number of other mental health disorders.
Ferrier et al. draw on two large meta-analyses from 2003 and 2004 to contend that “ECT is the most effective short-term treatment for major depression,” with “remission rates around 60-80%” (295). They claim that these rates are particularly applicable to those with severe depressive symptoms, as well as those who meet the criteria for psychotic depression and depression with suicidal features. The contention that ECT is particularly useful as a short-term treatment appears to be related to its relatively high degree of effectiveness when compared to the short-term effectiveness of psychotherapy and antidepressant medication.
Not surprisingly, the safety of this procedure is commented on by Ferrier et al., as this treat...