Depression, also known as clinical depression and major depressive disorder, is a mood disorder that is characterized by a prolonged sense of sadness and loss of interest. This disorder affects people’s feelings, thoughts, and behaviors and can cause several mental and physical issues.
It produces symptoms that disrupt people’s ability to function on a daily basis, including sleeping, eating, and working. For a diagnosis of depression, symptoms must last at least two weeks. Most people who are depressed can recover with the proper diagnosis and care.
What are the types of depression?
Different types of depression include:
- Major depression is characterized by depressive symptoms that have persisted for at least two weeks and are disruptive to one’s ability to work, sleep, study, and eat.
- Dysthymia (also called persistent depressive disorder) involves less severe depressive symptoms that persist for at least two years on average.
- Perinatal depression (also called postpartum depression) is when a woman develops severe depression during her pregnancy or right after giving birth.
- Seasonal affective disorder comes and goes with the changing of the seasons, usually beginning in the late fall or early winter and ending in the spring or summer.
- Depression with psychotic symptoms is a severe form of depression in which a person has delusions (upsetting, false fixed beliefs) or hallucinations, among other psychotic symptoms.
- Manic depression is when people who have bipolar disorder also go through depressive episodes during which they feel down and out and have very little energy.
What are the symptoms of depression?
You may have depression if you have been exhibiting some of the following symptoms for at least two weeks:
- Sadness, anxiety, or emptiness
- Energy loss or increased fatigue
- Feelings of unease, agitation, or irritability
- Feelings of guilt or worthlessness
- Loss of enjoyment or interest in the majority of everyday activities
- Problems with memory, concentration, and decision-making
- Inability to sleep or excessive sleeping
- Appetite changes or unintended weight changes
- Undiagnosed physical issues like headaches or back pain
- Suicide attempts and/or suicidal thoughts
What are the causes of depression?
Depression may have various causes, including:
- Brain structure differences: There are visible physical changes in the brains of people who are depressed.
- Brain chemistry: If you are depressed, you may have a chemical imbalance in the areas of your brain that control your mood, thoughts, and behavior.
- Hormones: Depression may be brought on by changes in the hormone balance in the body. Your hormone levels can change as a result of menopause, thyroid disorders, pregnancy, or other conditions.
- Genetics: People with biological relatives who also have this condition are more likely to experience depression.
How is depression diagnosed?
Your healthcare provider will review your medical and family history, ask about your symptoms, and perform a physical examination to provide a diagnosis and determine a course of action. They may request a blood test to ensure that a medical condition like a thyroid issue is not the cause of the depression because reversing the medical cause would alleviate the depression-like symptoms.
Your treating physician may ask you to fill a simple questionnaire which can frequently accurately reveal the depression and its severity and the need for intervention. One of the most common ones is the Beck’s depression inventory.
How is depression treated?
Antidepressants are medications that are frequently prescribed to treat depression. They might enhance how your brain employs specific hormones that regulate stress or mood. Before you find an antidepressant that reduces your symptoms and has tolerable side effects, you may need to try a few different ones.
The chances of succeeding in getting an antidepressant that work for you with minimum side effects is only 35%, so the doctor has on average to spend a year to get the right medicine and the right dose for you. There are more than 30 antidepressants on the market. We can improve the odds of selecting the right medicine and right dose to 85% by using first a genetic test through a swab of your cheek using a cotton ball that help us determine what best suit your liver. (personalized or targeted medicine). The test is sent outside the country and our expert psychiatrist are used to interpreting the data to arrive to the right medicine and right dose.
Frequently, a medication that has previously helped you or a close relative will be considered. Combining the information gained from the pharmacogenomic saliva test described above with the clinical history allows for best decisions. Giving medication a chance before deciding whether it works is vital because antidepressants typically take 4 to 8 weeks to start working. Do not discontinue taking antidepressants after starting them without consulting your doctor.
The beauty of the pharmacogenomic test is that it gives other specialist at Novomed an insight into what work for you if you need a blood pressure pill (there are more than 60 of them) or what blood thinner work for you. Keep in mind that this test is done once in your lifetime since your DNA does not change.
Psychotherapy, also known as counseling, can help people who are depressed by educating them on new ways of thinking as well as how to break patterns that fuel sadness.
Cognitive-behavioral therapy (CBT) is an example of an evidence-based strategy specifically designed to treat depression. CBT helps you identify distorted or negative thinking to alter beliefs and actions to react to difficulties more positively. It is essential in treating anger management, psychopathic behavior, and schizophrenia type disorders (schizoid).
Brain stimulation therapies
Brain stimulation therapies may be recommended for patients who have not responded to medication and psychotherapy.
- Electroconvulsive Therapy (ECT): In ECT, electrical currents are sent into the brain to affect the way neurotransmitters work and have an impact on your mood. It is like resetting your computer or your mobile when everything else fails. It requires several sessions and is done under very short general anesthesia (five minutes). It can be effective when all medications failed but can result in a flat mood after the treatments.
- Transcranial Magnetic Stimulation (TMS): In TMS, brief magnetic pulses are sent through a treatment coil across your scalp to stimulate the brain’s mood-regulating and depressive nerve cells. There is no radiation involved and no anesthesia required. The technology is 20 years old but the new generation of TMS has much better protocols and software and his much more effective than the older models. We have the newest model at Novomed operated by our Italian neuroscientist under the supervision of our superb neurologist, Dr Anne Vehmas.
Insurance may pay for the sessions. The treatment is effective in 60% of cases, may or may not be combined with medications but requires 20-30 sessions (2-3 times per week), one hour each time.
How can I reduce the symptoms of depression?
You can take various actions to help reduce the symptoms of depression, including eating a good diet, exercising frequently, and getting regular and quality sleep. Getting exposed to sunlight on a regular basis every morning is essential.
How do you select the right medication for depression?
You might need to try several medications or a mix of medications until you find one that works. This calls for patience because it might take a few weeks or more for some medications to fully act and for side effects to subside as your body becomes used to them. See above section on medications and pharmacogenomic testing.
What are the risks of discontinuing medications suddenly?
Avoid stopping an antidepressant without first consulting your doctor. Abruptly stopping medication or skipping several doses might result in withdrawal-like symptoms, and discontinuing too soon can exacerbate depression. To safely and gradually reduce your dosage, consult your doctor.
Does depression require a hospital stay?
Depression can be so severe in some people that a hospital stay is required. If you can’t take care of yourself properly or if you’re in immediate danger of hurting yourself, a hospital stay may be necessary.