What is Depression?

Depression is a mental health disorder that includes chronic illness or loss of interest in activities that bring pleasure and satisfaction. It can affect your relationships with family, friends, or work.

The most common types of depression are major depression or dysthymia (“severe depression”). These kinds of disorders are more severe than minor depression or mild depression.

Depression is relatively common throughout the world, affecting about 2 out of 100 people. According to the World Health Organization, some 10% of the global population suffer from depression. About one-fifth of these people develop serious depression, and some 3/4 of these become severely depressed.

Although there is no known cure for depression, several treatments are available. Depending on the severity or type of depression you have, treatment may involve physical, psychological, social, financial, and occupational therapies.

Symptoms

Depression symptoms generally include feelings of sadness or grief that do not improve and feeling empty, helpless, worthless, or guilty. You may also feel irritable, angry, restless or irritability, appetite changes, weight gain, or any other change in food or diet.

The Diagnosis

Diagnosing depression is difficult because it usually appears before a person realizes they have it. However, people who experience depression may show signs of it beginning at the very least ten years before they were diagnosed.

In addition to being diagnosed with depression, a patient may show symptoms after more than five years of having depression. The most common symptoms are insomnia or anxiety. Other symptoms may be:

A lack of energy that makes it difficult to get up and moving around daily

A persistent feeling of guilt or shame over something you have done or have not done

Negative thoughts about yourself (this might be linked to depression) or someone else (this could have nothing to do with depression but could be a symptom of another problem)

Negative or dangerous changes in behavior

A sense of apathy or boredom

Impaired memory or concentration (even when you are paying attention)

Walking into the office on time or keeping track of appointments

A feeling of detachment or disconnection

The Diagnostic Criteria for Depression

There are two main criteria used by physicians and healthcare professionals when diagnosing depression. One is called the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) and the other is called the International Classification of Diseases, IVYG (International Diagnostic Interview Schedule).

The DSM-IV-TR is used to diagnose depression in adults who do not require intensive care. The ICD-9 is used to diagnose major depression in adults who also need to be treated in an inpatient facility. In practice, both are used in combination to make up the full range of diagnoses available. It is important to note, however, that neither ICD-9 nor the DSM-IV-TR is considered “magic bullet” diagnoses. A diagnosis of one is only as good as the clinician’s judgment based on observation and clinical observation of each individual patient.

Treatment Options

There are many different treatment options available for depression. Some patients can benefit from medication while others may benefit more from talking therapy. Medications such as selective serotonin reuptake inhibitors (SSRIs) are commonly used for treating depression. SSRIs are effective and safe for treating depression. Many researchers believe that SSRIs are better options than traditional medicine in managing depression.

Medication options for depression have ranged among pharmacological options. There are three main categories of antidepressants: class I (steroids), class II (Selective Serotonin Reuptake Inhibitors), and class III (tricyclic pyrimidines). Antidepressants called tricyclic compounds bind to receptors on the brain’s central nervous system and cause the neurotransmitters dopamine and norepinephrine in the brain to shut down instead of increasing them, which in turn causes symptoms of depression. Tricyclics were originally designed as treatments for migraines, menstrual cramps and seizures. Today, SSRIs are increasingly being prescribed for depression. Research shows that the SSRI fluoxetine reduces the levels of cortisol and dopamine in the amygdala, hippocampus and cortical cortex in animal studies and in humans.

A review published in 2004 reviewed studies and found that antidepressant drugs are highly successful for managing depression. Three different types of antidepressants have been identified as effective: SSRIs, clomipramides, selective non-adrenergic reuptake inhibitors (SNRIs), and monoamine oxidase blockers.

There is an emerging role of alternative medicines for depression. Medications such as psychedelics, kava, ayurveda, meditation and other herbal medicines, all of which are used in Ayurveda, are being studied in scientific research. Alternative medicines present new opportunities for treating mood disorders like depression. They also offer a variety of benefits beyond their conventional use in traditional medicine and traditional ways of life as well as in scientific research and in clinical trials. These alternatives have the potential to be helpful not just for those with depression, but for anyone with a mental health illness and depression in particular.

How Does Depression Treatments Work?

There are different ways in which depression treatments work. Most patients can stop the depression symptoms without any treatment but treatment usually begins after an initial assessment. Patients who continue therapy face treatment that involves a number of different elements. Doctors and psychiatrists will assess the patient’s progress throughout treatment. To help make sure that your symptoms go away after you stop treatment, doctors may start your recovery on a partial basis. This means not only stopping your symptoms, but also continuing your therapy. If you are thinking of stopping your medication, you should think critically about how long, how often, and how hard you want to do that in order to prevent further withdrawal. Your doctor can help you decide. For some patients who are already committed to living, driving, working and eating independently and making decisions on a daily basis, the effects of untreated depression symptoms can appear to persist longer, so treatment needs to be ongoing.

Medication Therapy

Medication therapy for depression involves changing the way your body functions. Medication therapy involves a total abstinence from taking any medication or substance that has the potential to negatively impact your symptoms. Medicated therapy is not as short and fast as some other forms of therapy. Medication may be taken daily, every day, but many patients find that medication therapy works best if you take medication on a regular routine.

Antiepileptic medications were originally created to control epileptic seizures but today they have been put to better use in helping treat depression. Antiepilectic medications come in different types depending on what side effects you have. Valproate is used to relieve nausea and vomiting caused by chemotherapy and other treatments that require it. Another antiepiletic drug is levetir. These medications help reduce nerve cell deaths and thus help in reducing stress in your brain. Antiepileptics have had mixed results on the effectiveness of antidepressants. Some studies show that antiepileptics have reduced the number of suicidal ideations reported by their subjects. Several studies have shown that valproates block the production of procalcitonin, a protein related to sleep and memory loss in Alzheimer’s disease patients.

Antipsychotic medication targets psychotic symptoms in patients with borderline personality disorder. Antipsychotics have an effect on the frontal lobes of the brain as well as on the cerebellum, amygdala and hypothalamus and, especially the amygdala and hippocampus. Antipsychotics have less effect on the prefrontal parts of the brain. This treatment is much safer and less common than medication. With antipsychotic treatment, psychosis symptoms typically last one to five months and the treatment can last for up to five years. It can cause problems with family members in case the treatment does not go well.

Psychotherapy

Psychotherapy is a form of treatment for depression. Psychotherapy helps you learn how to cope with your depression and to develop healthy coping skills. When depression first strikes, it usually takes seven to 15 days or more for someone experiencing depression to realize that it is actually happening. Someone may feel sad, alone, isolated and lonely. Family members and friends may notice your depression symptoms but they will likely not know why the symptoms came on or why they started. Before you begin treatment, your personal family and other close relatives will always be consulted. You also choose what kind of support you want. You will not get rid of that depression overnight and it will not end there. Many people who have depression go through depression without ever reaching the point of severe depression. During your depression treatment, you will learn and accept the value of life. Your mood will shift from crying all the time, to taking pleasure in everyday things, to being happy every morning. The changes in your mood often take time to occur, so treatment for depression must start early enough as possible.

Psychotherapy includes a wide range of techniques such as group therapy, which gives victims a chance to talk with multiple people in a small space. Individual therapy is similar but more structured. Social skills training involves teaching others how to recognize warning signals in your environment, how to avoid becoming trapped and why you act the way you act and how to communicate effectively with those around you and why you do these things. Group work teaches people how to build a positive relationship with others in their lives. Counseling involves educating individuals on coping strategies for themselves and with others. Asking questions in interviews allows the interviewer to discover what the person really wants to know. Interpersonal communication includes making friends with others in your life and finding solutions to problems. Learning skills comes later in the treatment process, but during it you will be taught the importance of learning about coping and managing your condition.