Depression
Depression is one of the most common mental illnesses. Depression affects all ages, ethnic and socioeconomic groups as no one is immune to the effects of this disorder. Although we all feels down or sad at times, depression is more than just having a case of the blues.
Depression is characterized by a relentless sense of despair and sadness. With depression, these feelings persist and become a chronic condition which requires treatment. An individual with depression cannot “just snap out of it” on their own and will require the help of a mental health provider to treat their depression. There are many effective clinical treatments for depression and researchers are developing new therapies all the time.
Despite the fact that depression is so prevalent and there are so many effective treatments for the disorder, many don’t seek help. Research indicates that less than 30 percent of individuals with depression seek treatment. Many reasons surround why individuals don’t seek treatment for depression including the stigma associated with the disorder. According to the National Alliance on Mental Illness (NAMI), many individuals with depression are still discriminated against when it comes to housing, employment and more.
Another reason why individuals don’t seek treatment is that they don’t recognize the symptoms of depression. Sadness isn’t the only sign that one could be struggling with depression and many of the signs of depression are quite surprising or subtle.
Common symptoms of depression include:
Types of Depression
There are different types of depression, each with unique causes, effects, and symptoms. Treatment for depression will depend on the type of depression and knowing the type of depression one has is the first step in helping to manage symptoms. A therapist will conduct an assessment to determine which kind of depression a patient has and then develop an individualized treatment plan to address it. Clinical disorders of depression include:
Major Depressive Disorder
Most who use the term depression are typically referring to major depressive disorder. To be diagnosed with major depressive disorder, an individual must have 5 or more of the following symptoms for a period of at least two weeks.
These symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning. Furthermore, these symptoms are not attributable to the physiological effects of a substance such as drug or alcohol abuse, a medication, or is not part of a medical condition.
Additionally, there are several different subtypes of major depression including:
Persistent Depressive Disorder
Persistent Depressive Disorder used to be known as Dysthymia. It is referred to as a less severe but still chronic form of depression. Individuals with Persistent Depressive Disorder may experience low-grade symptoms of depression over a period of years. These symptoms are identified as mild but remain persistent.
Premenstrual Dysphoric Disorder (PMDD)
In Premenstrual Syndrome (PMS), a woman may experience depression approximately a week before the beginning of a menstrual period. Symptoms of PMS may include frequent crying or moodiness, agitation, irritability, lack of interest in enjoyable activities, physical symptoms, problems sleeping and appetite changes. However, with Premenstrual Dysphoric Disorder (PMDD), these PMS symptoms present in greater severity and have a much larger impact daily functioning. In PMDD these symptoms may also occur between one and two weeks before every monthly period.
Depression Treatment
According to research, 80 to 90 percent of patients with depression will experience significant improvements with therapeutic treatment. Most treatment for depression will consist of a combination of treatments including medication and psychotherapy. Thousands of clinical studies have researched the effectiveness of treatments for depression. The following treatments are evidenced-based which means they have been found to be clinically effective in treating individuals suffering from depression.
Medication
Several types of medications are currently used to treat depression including:
These medications are just a few of the antidepressants available for depression and new medications are becoming available on the market all the time. If you decide to seek medication to treat your depression, a doctor will be able to find the right medication for you.
Psychotherapy
Psychotherapy is a proven effective treatment for depression. Clinical research has shown psychotherapy as being more effective than medication in the long term and also more cost effective.
There are several different types of psychotherapy known to be effective in treating depression. While each of these therapeutic approaches may be different, they all have the same goals in mind. That is, to help you explore and understand your depression, teach you ways to manage and cope with your depression, and give you a much better control over your life.
Most common types of psychotherapy for depression include:
Depression is characterized by a relentless sense of despair and sadness. With depression, these feelings persist and become a chronic condition which requires treatment. An individual with depression cannot “just snap out of it” on their own and will require the help of a mental health provider to treat their depression. There are many effective clinical treatments for depression and researchers are developing new therapies all the time.
Despite the fact that depression is so prevalent and there are so many effective treatments for the disorder, many don’t seek help. Research indicates that less than 30 percent of individuals with depression seek treatment. Many reasons surround why individuals don’t seek treatment for depression including the stigma associated with the disorder. According to the National Alliance on Mental Illness (NAMI), many individuals with depression are still discriminated against when it comes to housing, employment and more.
Another reason why individuals don’t seek treatment is that they don’t recognize the symptoms of depression. Sadness isn’t the only sign that one could be struggling with depression and many of the signs of depression are quite surprising or subtle.
Common symptoms of depression include:
- Persistent feelings of sadness: Having a crushing feeling of sadness which doesn’t go away after a couple of weeks could be a sign of depression. We all feel sad from time-to-time but with depression, this feeling of sadness prevents you from doing the things that you normally do, like going to work or school. You may engage in unhealthy behaviors such as binging on junk food to bring up your mood or drinking alcohol to numb the persistent feeling of sadness.
- Difficulty making decisions: When depressed, it can be very hard to make even simple decisions. Small things you don’t normally think about become hard — like deciding whether to have cereal or oatmeal for breakfast.
- Social isolation: Depression can cause you to become isolated from friends and family. Many individuals with depression may seem distant and isolated.
- No interest in enjoyable activities: In depression, you may no longer care about doing the activities you used to enjoy. If going to working out used to be the highlight of your day and you haven’t been in weeks or you no longer care about your favorite television show, depression may be the cause of your disinterest in these things you used to love.
- A crippled sense of self-worth: Depression causes ones self-esteem and feelings of self-worth to plummet.
- Unexplained physical problems: Chronic pain and constant head or stomach aches with no physical cause can be a sign of depression.
- Significant weight gain or loss: Have you recently lost a significant amount of weight? You may have lost your appetite and/or no longer enjoy eating. A lack of appetite is common in depression causing weight loss. Conversely, depression can cause some individuals to overeat which may lead to weight gain.
- Irritability: Agitation and irritable mood is a common sign of depression, especially in children, adolescents and teenagers.
- Restlessness or agitation: Depression may result in increased agitation and restlessness. If you are depressed, you might feel wound up or fidgety. These sensations can make it hard to relax and may result in the interruption of sleep.
- Exhaustion: When one is depressed, even minor exertion can result in extreme fatigue. Depression may make it hard to even get out of bed in the morning.
- Sluggishness: Psychomotor retardation is another sign of depression. Psychomotor retardation may cause a person to move slower than normal. It may take longer to perform tasks. Psychomotor retardation may also affect speech by causing a person to speak softer or slower.
Types of Depression
There are different types of depression, each with unique causes, effects, and symptoms. Treatment for depression will depend on the type of depression and knowing the type of depression one has is the first step in helping to manage symptoms. A therapist will conduct an assessment to determine which kind of depression a patient has and then develop an individualized treatment plan to address it. Clinical disorders of depression include:
Major Depressive Disorder
Most who use the term depression are typically referring to major depressive disorder. To be diagnosed with major depressive disorder, an individual must have 5 or more of the following symptoms for a period of at least two weeks.
- Depressed mood: For children and adolescents this may manifest as an irritable mood
- Diminished interest or loss of pleasure in almost all activities which is referred to as anhedonia
- Significant weight change or appetite disturbance: in children this may be a failure to achieve expected weight gain
- Sleep disturbances such as insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness
- Diminished ability to think or concentrate; indecisiveness
- Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, having a specific plan for committing suicide, or attempting suicide
These symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning. Furthermore, these symptoms are not attributable to the physiological effects of a substance such as drug or alcohol abuse, a medication, or is not part of a medical condition.
Additionally, there are several different subtypes of major depression including:
- With seasonal pattern.: This subtype of major depression is often referred to as (SAD) seasonal affective disorder. Individuals with this type of depression only experience symptoms during one part of the year, typically during fall or winter. These symptoms then go away during the rest of the year.
- With peripartum onset: Depression with peripartum onset refers to depression which begins sometime during pregnancy and may last up to four weeks after delivery. This type of depression is also known as Postpartum Depression.
- With psychotic features: Depression with psychotic features is a type of depression which also includes symptoms of psychosis, such as extreme paranoia, delusional thinking (or false beliefs) and/or hallucinations, which refers to seeing or hearing things that are not real.
- With anxious distress: This type of depression also features symptoms of anxiety. An individual must have at least two of the following symptoms of anxiety to be diagnosed with this type of depression: feeling on edge or keyed up, difficulty concentrating because of worry, feelings of restlessness, and fear of losing control.
- With atypical features: This is also at times called atypical depression and this subtype includes specific symptoms such as: increased appetite or weight gain, sleeping too much, feeling weighed down, and being really sensitive to criticism or rejection.
Persistent Depressive Disorder
Persistent Depressive Disorder used to be known as Dysthymia. It is referred to as a less severe but still chronic form of depression. Individuals with Persistent Depressive Disorder may experience low-grade symptoms of depression over a period of years. These symptoms are identified as mild but remain persistent.
Premenstrual Dysphoric Disorder (PMDD)
In Premenstrual Syndrome (PMS), a woman may experience depression approximately a week before the beginning of a menstrual period. Symptoms of PMS may include frequent crying or moodiness, agitation, irritability, lack of interest in enjoyable activities, physical symptoms, problems sleeping and appetite changes. However, with Premenstrual Dysphoric Disorder (PMDD), these PMS symptoms present in greater severity and have a much larger impact daily functioning. In PMDD these symptoms may also occur between one and two weeks before every monthly period.
Depression Treatment
According to research, 80 to 90 percent of patients with depression will experience significant improvements with therapeutic treatment. Most treatment for depression will consist of a combination of treatments including medication and psychotherapy. Thousands of clinical studies have researched the effectiveness of treatments for depression. The following treatments are evidenced-based which means they have been found to be clinically effective in treating individuals suffering from depression.
Medication
Several types of medications are currently used to treat depression including:
- Tricyclic antidepressants: These medications were among the earliest drugs used to treat depression. Tricyclic antidepressants can be very effective for some people but tend to have more severe side effects than some of the newer antidepressants. These are typically used for individuals who do not experience an improvement of symptoms with the newer antidepressants.
- Selective serotonin reuptake inhibitors (SSRIs): These are the most often prescribed medications for depression. SSRIs are considered safer and cause fewer side effects than tricyclic antidepressants. SSRIs include sertraline (Zoloft), fluoxetine (Prozac), and citalopram (Celexa).
- Monoamine oxidase inhibitors (MAOIs): These medications are usually prescred for those who do not get better with other types of treatment. These medications can have serious side effects and can cause deadly interactions with certain supplements and foods, such as wines and pickles. As a result, they require a strict diet.
- Zulresso (brexanolone). The United States Food and Drug Administration (FDA) recently approved a new medication for postpartum depression (PPD). This medication, Zulresso (brexanolone) must be injected intravenously at a certified health care facility. It is specifically approved for the treatment of peripartum depression (PPD) in adult women. Zulresso is the very first drug specifically approved by the FDA for PPD. 9
- Spravato (esketamine). Spravato is a nasal spray that was also recently approved by the FDA for depression. It is used to treat resistant depression that has not responded to other treatments. This medication is related to ketamine, a drug that is sometimes abused recreationally, so it is prescribed only from a certified medical office.
These medications are just a few of the antidepressants available for depression and new medications are becoming available on the market all the time. If you decide to seek medication to treat your depression, a doctor will be able to find the right medication for you.
Psychotherapy
Psychotherapy is a proven effective treatment for depression. Clinical research has shown psychotherapy as being more effective than medication in the long term and also more cost effective.
There are several different types of psychotherapy known to be effective in treating depression. While each of these therapeutic approaches may be different, they all have the same goals in mind. That is, to help you explore and understand your depression, teach you ways to manage and cope with your depression, and give you a much better control over your life.
Most common types of psychotherapy for depression include:
- Individual therapy: One of the most common types of individual therapy is Cognitive Behavioral Therapy or CBT. CBT therapy involves identifying and changing thought patterns and behaviors that contribute to depression. Treatment includes learning healthier ways of coping with your symptoms.
- Couples therapy: Depression can affect relationships. Couples or Relationship Therapy addresses the impact that depression has on a person’s relationships.
- Family therapy: Family Therapy helps examine the family dynamics contributing to depression and assists family members in identifying ways to provide support to their loved one with depression.
- Group therapy: Group therapy can help you gain insight into your depression through the experience and perspective of others who are also suffering from depression.