Interpersonal Therapy for Depression

Interpersonal therapy (IPT) is a type of treatment for patients with depression which focuses on the past and present social roles and interpersonal interactions. During treatment, the therapist generally chooses one or two problem areas in the patient's current life to focus on. Examples of areas covered are disputes with friends, family or co-workers, grief and loss and role transitions, such as retirement or divorce.

IPT does not attempt to delve into inner conflicts resulting from past experiences. Rather it attempts to help the patient find better ways to deal with current problems.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychological counseling or both.

There are two subtypes of IPT. The first type is used for the short-term treatment of a depressive episode. The patient and therapist typically meet weekly for two to four months and treatment ends once the symptoms subside. The second type is maintenance treatment (IPT-M), which is long-term treatment with the goal of preventing or reducing the number of future episodes of depression. IPT-M may consist of monthly sessions over a period of two to three years.

IPT identifies four basic problem areas which contribute to depression. The therapist helps the patient determine which area is the most responsible for his depression and therapy is then directed at helping the patient deal with this problem area.

The four basic problem areas recognized by interpersonal therapy are:

• Unresolved grief: In normal bereavement, the person usually begins to return to normal functioning within a few months. Unresolved grief is generally grief which is either delayed and experienced long after the loss or distorted grief, in which the person may not feel emotions, but instead experiences other symptoms.
• Role disputes: Role disputes occur when the patient and significant people in his life have different expectations about their relationship.
• Role transitions: Depression may occur during life transitions when a person's role changes and he doesn't know how to cope with the change.
• Interpersonal deficits: This may be an area of focus if the patient has had problems with forming and maintaining good quality relationships.

IPT was developed for the treatment of depression and its efficacy for this application is backed up by several large-scale randomized control trials. It may also be used as couple's therapy for those whose marital troubles contribute to their depression. The data regarding its efficacy in treating bulimia nervosa is "modest but promising," according to the International Society for Interpersonal Psychotherapy. In addition, preliminary data show it to be of potential use in treating adolescent depression, dysthymic disorder, bipolar disorder and postpartum depression.