When looking at the treatment needed to be given there is a wide variety of options ranging from cognitive behavioural therapy to drug therapy to electro-convulsive therapy. The national institute of mental health looked at the treatment given to major depressed patients and discovered that a basic sixteen week drug and psychotherapy course of treatment was not sufficient as it resulted in many relapses.The institute then studied patients and discovered that a twelve month course of antidepressants was the most effective way of curing depression; they also stated that it would be morally wrong to offer a long course of drug treatment without any kind of counseling.

It can take a few weeks before the drugs will take affect and so to offer appropriate counseling is essential. These findings are contrary to most others such as Landreville et al (2001).The counseling that can be offered to Susan is interpersonal therapy which focuses on the here and now; it is a short term therapy that was specifically designed to deal with patients with major depression. This kind of therapy is designed to deal with any social dysfunction, unlike the psychoanalytic approach it does not deal with coping mechanisms, defense mechanisms or internal conflicts. Cognitive behavioural therapy was first founded by Aaron Beck’s (1921).Beck’s first started out from a psychoanalytic background which enabled him to outline the problem with cognitive distortions within the illness of depression. Cognitive behavioural therapy works on the bases that it is the negative thoughts that cause depression. This therapy aims to change negative unrealistic thoughts into positive realistic ones.

It focuses on the here and now instead of focusing on problems from the past it looks at ways that can improve state of mind.The therapy takes one problem and breaks it down into smaller categories this in turn makes it easier to see how the problems are connected and how they affect you. Some critics of this therapy suggest that the negative thoughts are a result of the depression instead of them being the cause. Psychoanalytic therapies focus on unconscious mechanisms such as the defense mechanism these therapies focus on the historical reasons as to why the patient became depressed. This kind of therapy may take several years to go through at a couple of times a week this therapy is known as the most expensive and time consuming of them all.

There is also family therapy which is not widely known to cure depression, but is advised if the patient is jeopardizing a marriage or family life. In this case Susan may be referred to family therapy as this may build confidence between there relationship and boost her in some of her pessimism towards her home life. Susan would also be advised to seek one of the other forms of counseling also.

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The counseling is provided along with drug therapy as it is the chemicals within the brain that are unbalanced such as serotonin, there are two major types of antidepressants that aid the chemicals; the selective serotonin reuptake inhibitors (SSRI) and tricyclic antidepressants.Trycyclic anti-depressants are used in conditions such as depression, obsessive compulsive disorder and panic disorder they alter the balance of chemicals within the brain, such as serotonin and another neurotransmitter norepinephrine these anti-depressants have been used for a long time for treating depression. There are side effects like there are in most drugs these include; dry mouth, blurred vision, constipation and tiredness. Selective serotonin reuptake inhibitors work only on serotonin levels where as tricyclic work on both.There seem to be fewer side effects with this drug this may be due to the fact that it only affects one chemical instead of two or several within the body. These side effects include dry mouth, nervousness, insomnia, sexual problems and nausea. When looking at this evidence it is clear that Susan has depression it is also clear that she needs family therapy to reconcile her relationship with her husband it is also clear that some kind of drug therapy is needed coincided with the appropriate counseling. There are but a few mentioned above and are many more possibilities, Susan would need referral to a proper doctor.