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DEPRESSION TREATMENT | Learn more about Depression What is depression?Depression is not a weakness is but usually a serious disease or a syndrome (group of symptoms) with biological, psychological, and social aspects, that involves the body, mood, and thoughts that affect the way a person thinks about things, eats and sleeps, often reflecting a sad mood exceeding normal sadness or grief. People with a depressive disorder, also called [blues, discouragement, gloom, sadness, melancholy] cannot simply "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, and even years. The principal types of depression are major depression, dysthymia, and bipolar disease. However, an appropriate treatment can help most people with depression. Most Prescribed Medications [Sorted by Popularity]Celexa, Buspar, Eskalith, Lithobid, Elavil, Endep, Desyrel, Zoloft, Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, Prozac, Pamelor, Buspar, Lexapro, Remeron, Zyprexa, Effexor, Emsam, Paxil, Tegretol, Cymbalta, Geodon, Pamelor, Risperdal, Atarax, Aventyl, Sinequan, Tofranil, Luvox. view all medications » Is depression a major community health problem?Depression is generally ranked in terms of severity [mild, moderate, or severe]. The degree of your depression, which your doctor can determine, influences how you are treated. Depression is usually first identified in a primary-care setting, not in a mental health practitioner's office. Moreover, it often assumes various disguises, which causes depression to be frequently under-diagnosed. Depression symptoms are characterized not only by negative thoughts, moods, and behaviors, but also by specific changes in bodily functions (for example, irregular eating, sleeping, crying spells, and decreased libido). The functional changes of clinical depression are often called neurovegetative signs. This means that the nervous system changes in the brain cause many physical that result in diminished activity and participation. Certain people with depressive disorder, especially bipolar depression (manic depression), seem to have an inherited vulnerability to this condition. Depression costs the United States huge amounts of direct costs, which are the treatment costs, and indirect costs, such as lost productivity and absenteeism. In a major medical study, depression caused significant problems in the functioning of those affected more often than did arthritis, hypertension, chronic lung disease, and diabetes, and in two categories of problems, as often as coronary artery disease. Depression can increase the risks for developing coronary artery disease, HIV, asthma, and some other medical illnesses. Furthermore, it can increase the morbidity (illness) and mortality (death) from these conditions. For full recovery from a mood disorder, regardless of whether there is a precipitating factor or it seems to come out of the blue, treatments with medications and/or electroconvulsive therapy (ECT) and psychotherapy are necessary. What causes depressionDepression often runs in families. This may due to your genes (inherited), learned behavior, or both. Even if your genes make you more likely to develop depression, a stressful or unhappy life event usually triggers the onset of a depressive episode.
Depression may be brought on by any of the following factors: Postpartum psychosisPostpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first three months after childbirth. Women can lose touch with reality, often having auditory hallucinations (hearing things that aren't actually happening, like a person talking) and delusions (seeing things differently from what they are). Visual hallucinations (seeing things that aren't there) are less common. Other symptoms include insomnia (not being able to sleep), feeling agitated (unsettled) and angry, and strange feelings and behaviors. Women who have postpartum psychosis need treatment right away and almost always need medication. Sometimes women are put into the hospital because they are at risk for hurting themselves or someone else. Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms and some many symptoms. The severity of symptoms also varies with individuals. Depression medications reviewsThe earliest developed antidepressants, examples of MAOIs include phenelzine (Nardil) and tranylcypromine (Parnate). MAOIs elevate the levels of neurochemicals in the brain synapses by inhibiting monoamine oxidase. Monoamine oxidase is the main enzyme that breaks down neurochemicals, such as norepinephrine. When monoamine oxidase is inhibited, the norepinephrine is not broken down and, therefore, the amount of norepinephrine in the brain is increased. MAOIs also impair the ability to break down tyramine, a substance found in aged cheese, wines, most nuts, chocolate, and some other foods. Tyramine, like norepinephrine, can elevate blood pressure. Therefore, the consumption of tyramine-containing foods by a patient taking an MAOI drug can cause elevated blood levels of tyramine and dangerously high blood pressure. In addition, MAOIs can interact with over-the-counter cold and cough medications to cause dangerously high blood pressures. The reason for this is that these cold and cough medications often contain drugs that likewise can increase blood pressure. Because of these potentially serious drug and food interactions, MAOIs are usually only prescribed after other treatment options have failed. Electroconvulsive therapy (ECT)In recent years, the technique of ECT has been much improved. The treatment is given in the hospital under anesthesia so that people receiving ECT do not feel pain. Most patients undergo six to 10 treatments. An electrical current is passed through the brain to cause a controlled seizure, which typically lasts for 20 to 90 seconds. The patient is awake in five to 10 minutes. The most common side effect is short-term memory loss, which resolves quickly. After the initial course of treatment, ECT can be safely done as an outpatient procedure. In the ECT procedure, an electric current is passed through the brain to produce controlled convulsions (seizures). ECT is useful for certain patients, particularly for those who cannot take or are not responding to antidepressants, have severe depression, or are at a high risk for suicide. ECT often is effective in cases where antidepressant medications do not provide sufficient relief of symptoms. This procedure probably works, as previously mentioned, by a massive neurochemical release in the brain due to the controlled seizure. Highly effective, ECT relieves depression within one to two weeks after beginning treatments. After ECT, some patients will continue to have maintenance ECT, while others will return to antidepressant medications. PsychotherapiesPsychodynamic therapies are sometimes used to treat depression. They focus on resolving the patient's internal psychological conflicts that are typically thought to be rooted in childhood. Long-term psychodynamic therapies are particularly important if there seems to be a life-long history and pattern of inadequate ways of coping (maladaptive coping mechanisms) in negative or self-injurious behavior. Many forms of psychotherapy are effectively used to help depressed individuals, including some short-term (10 to 20 weeks) therapies. Talking therapies help patients gain insight into their problems and resolve them through verbal give-and-take with the therapist. Behavioral therapists help patients learn how to obtain more satisfaction and rewards through their own actions. These therapists also help patients to unlearn the behavioral patterns that contribute to their depression. Interpersonal and cognitive/behavioral therapies are two of the short-term psychotherapies that research has shown to be helpful for some forms of depression. Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate the depression. Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving that are often associated with depression. What is the common depression treatment?There are many safe and effective medications, particularly the SSRIs, that can be of great help in depression. However, depression treatment often takes time. Sometimes, the doctor will need to try a variety of antidepressants before finding the medication or combination of medications that is most effective for the patient. Sometimes, the dosage must be increased to be effective. In general, the severe depressive disorders, particularly those that are recurrent, will require antidepressant medications (or ECT under special conditions) along with psychotherapy for the best outcome. If a person suffers one major depressive episode, he or she has a 50% chance of a second episode. If the individual suffers two major depressive episodes, the chance of a third episode is 75 to 80%. If the person suffers three episodes, the likelihood of a fourth episode is 90 to 95%. Therefore, after a first depressive episode, it might make sense for the patient to gradually come off medication. However, after a second and certainly after a third episode, most clinicians will have a patient remain on a maintenance dosage of the medication for an extended period of years, if not permanently. In choosing an antidepressant, the doctor will take into account the patient's age, his/her other medical conditions, and medication side effects. Doctors often use one of the SSRIs initially because of their lower severity of side effects compared to the other classes of antidepressants. Side effects of SSRI medications can be further minimized by starting them at low doses and gradually increasing the doses to achieve full therapeutic effects. For those patients who do not respond after taking a SSRI at full doses for six to eight weeks, doctors generally switch to a different SSRI or another class of antidepressants. For patients whose depression failed to respond to full doses of one or two SSRIs, doctors will then try medications from another class of antidepressants. Some doctors believe that antidepressants with dual action (action on both serotonin and norepinephrine) such as duloxetine (Cymbalta), mirtazapine (Remeron), and venlafaxine (Effexor) may be effective in treating patients with severe depression that are treatment resistant. Other options include bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban), which has action on dopamine (another neurotransmitter). Sometimes doctors may use a combination of antidepressants from different classes. Also, new types of antidepressants are being constantly being developed, and one of these may be the best for a particular patient. Patients often are tempted to stop their medication too soon. It is important to keep taking medication until the doctor says to stop, even if the patient feels better beforehand. Doctors often will continue the antidepressant medications for at least six to nine months. Some medications must be stopped gradually to give the body time to adjust (see discontinuation of antidepressants below). For individuals with bipolar disorder or chronic major depression, medication may have to become a part of everyday life for extended period of years in order to avoid disabling symptoms. If the depressed person is taking more than one drug for depression or drugs for any other medical problem, all of the patient's doctors should be made aware of the other prescriptions. Many of these medications are cleared from the body (metabolized) in the liver. This means that the multiple drugs can interact competitively with the liver's biochemical clearing systems. Therefore, the actual blood levels of the drugs may be higher or lower than would be expected from the dosage. This information is especially important if the patient is taking anti-coagulants (blood thinners), anticonvulsants (seizure medications), or heart medications, such as digitalis (Crystodigin). Although multiple medications do not necessarily pose a problem, all of the patient's doctors need to be in close contact to adjust dosages accordingly. How to stop taking antidepressants?Antidepressants should be gradually tapered and should not be abruptly discontinued. Abruptly stopping an antidepressant in some patients can cause discontinuation syndrome. For instance, rapidly stopping a SSRI such as paroxetine can cause dizziness, nausea, flu-like symptoms, body aches, anxiety, irritability, fatigue, and vivid dreams. These symptoms typically occur within days of abrupt cessation, and can last one to two weeks (up to 21 days). Among the SSRIs, paroxetine and fluvoxamine cause more pronounced discontinuation symptoms than fluoxetine, sertraline, and citalopram. Some patients experience discontinuation symptoms despite gradual tapering of the SSRI. Abrupt cessation of venlafaxine can cause discontinuation symptoms similar to those of SSRIs. Abruptly stopping MAOIs can lead to irritability, agitation, and delirium. Similarly abruptly stopping a TCA can cause agitation, irritability, and abnormal heart rhythms. How can I help a person who is depressed?Seeing as depression can make the affected person feel exhausted and helpless, he or she will want and probably need help from others. Family and friends can be ideal helpers! However, people who have never had a depressive disorder may not fully understand its effect. Although unintentional, friends and loved ones may unknowingly say and do things that may be hurtful to the depressed person. It may help to share the information in this article with those you most care about so they can better understand and help you. The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. This help may involve encouraging the individual to stay with treatment until symptoms begin to go away (usually several weeks) or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication. Always report a worsening depression to the patient's physician or therapist. The second most important way to help is to offer emotional support. This support involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Always report them to the depressed person's therapist. Do not accuse the depressed person of faking illness or of laziness. Do not expect him or her "to snap out of it." Eventually, with treatment, most depressed people do get better. Keep that in mind. Moreover, keep reassuring the depressed person that, with time and help, he or she will feel better. Invite the depressed person for walks, outings, and to the movies and other activities. Be gently insistent if your invitation is refused. Encourage participation in activities that once gave pleasure, such as hobbies, sports, or religious or cultural activities. However, do not push the depressed person to undertake too much too soon. The depressed person needs company and diversion, but too many demands can increase feelings of failure. Depression home remediesIf you are depressed for 2 weeks or longer, you should contact your doctor, who can offer treatment options. Regardless of whether you have mild or major depression, the following self-care steps can help: ExpectationsA complete history, a psychiatric interview, and a physical examination will be performed to try to classify your depression as mild, moderate, or severe and to see if there is an underlying, treatable cause (such as alcohol abuse or an underactive thyroid). Hospitalization is usually recommended if suicide seems possible.
Expect some exploration of the issues and events associated with your feelings of depression. PreventionHealthy lifestyle habits can help prevent depression, or lessen the chances of it happening again. These habits include eating properly, sleeping adequately, exercising regularly, learning to relax, and not drinking alcohol or using drugs. Counseling may help you through times of grief, stress, or low mood. Family therapy may be particularly important for teens who feel blue. If you feel socially isolated or lonely, try volunteering or getting involved in group activities. Depression related topicsDepression, Bipolar Disorder (Mania), Depression in Children, Depression in the Elderly, Holiday Depression and Stress, Postpartum Depression, Posttraumatic Stress Disorder (PTSD), Seasonal Affective Disorder (SAD), Symptoms of Depression, Teenagers Depression, Women and Depression, Depression while Pregnancy. Depression contents
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