Depression is a common but serious mood disorder. It causes severe symptoms that can affect you daily activities, such as sleeping, eating, or working.
Clinical depression is diagnosed when you have symptoms intense enough to interfere with your routing functions for at least two weeks. Symptoms of depression include:
Persistent sad, anxious, or “empty” mood
Feelings of hopelessness, or pessimism
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Decreased energy or fatigue
Moving or talking more slowly
Feeling restless or having trouble sitting still
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, early-morning awakening, or oversleeping
Appetite and/or weight changes
Thoughts of death or suicide, or suicide attempts
There are many types/forms of depression that may develop under unique circumstances, such as:
Seasonal affective disorder
characterized by the onset of depression during the winter months, usually starts when the days are shorter, and sunlight is less and generally lifts during spring and summer. Winter depression is typically accompanied by isolation, increased sleep, and weight gain. It predictably returns around the same time of the year every year.
Persistent depressive disorder (also called dysthymia)
is a state of low/depressed mood, for most of the days, that lasts for at least two years. There may be episodes of major depression along with periods of less severe symptoms.
Women with postpartum depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany postpartum depression may make it difficult for these mothers to complete daily care activities for themselves and/or for their babies. It is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth.
Premenstrual dysphoric disorder (PMDD)
Women with PMDD have cyclical depressive symptoms, starting 1-10 days prior to the start of their menstrual cycle, and usually resolves with the start of the menstruation.
occurs when a person has severe depression plus some form of psychosis, such as having disturbed false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.
Anxiety disorders, trauma, stress, medical conditions
Personal or family history of depression
Major life changes, trauma, or stress
Certain physical illnesses such as diabetes, cancer, heart disease, Seizure disorder, Parkinson’s disease
Certain medications such as Beta blockers
Treatment and Therapies
Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.
Antidepressants are medicines that treat depression. Antidepressants usually take 2 to 4 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before reaching a conclusion about its effectiveness. Once you start feeling better, usually after a course of 6 to 12 months, you may be able to gradually taper off the antidepressants. Stopping them abruptly can cause withdrawal symptoms.
Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.
If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding please let us know prior to starting the medicines.
In addition to prescription antidepressants, there are some herbal medicines that can potentially help like St. John’s wort, omega-3 fatty acids and S-adenosylmethionine (SAMe). However, they remain under study but have not yet been FDA approved for safety and effectiveness.
Ketamine has been shown to provide rapid-acting antidepressant effect. If it works it can rapidly reduce the suicidal thoughts and behaviors. Ketamine can be effective for treating depression combined with anxiety.
Several types of psychotherapy (also called “talk therapy” or, in a less specific form, counseling) can help people with depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy.
Brain Stimulation Therapies
Electroconvulsive Therapy (ECT): ECT is a brain stimulation procedure that can help people get relief from severe symptoms of depressive disorder.
Transcranial magnetic stimulation (TMS): TMS is a newer approach to brain stimulation that uses magnetic waves.
Getting regular exercise such as brisk walk, swimming, jogging etc. helps with anxiety and depression and promote sleep in addition to the physical benefits of work out
Yoga and anaerobic exercise have also shown beneficial effects on mental health
Keep a mood log
Be mindful of your triggers and warning signs
Eat healthy and nutritious diet
Maintain regular follow ups with your care providers
Take all medicines as prescribed, consult your doctor before making any medicine changes