According to the American Psychiatric Association, depression is a common and serious medical illness that negatively affects how one feels, the way one thinks, and how one acts.  Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

What are the symptoms of depression?

Symptoms vary from mild to severe and must last at least two weeks.  These include:

• Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite — weight loss or gain unrelated to dieting
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide

Who Can Have It?

Anyone. Even a person who appears to live in relatively ideal circumstances. Depression affects approximately one in 15 adults (6.7%) in any given year. One in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, it first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime.

Risk Factors for Depression

• Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
• Genetics: Depression can run in families. 
• Personality: People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression.
• Environmental factors: Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.

How is it Treated? 

Depression is among the most treatable of mental disorders, with 80-90 percent of people responding well to treatment.

Evaluation

Before starting any treatment have a health professional conduct a thorough diagnostic evaluation, including an interview and possibly a physical examination to make sure the depression is not due to a medical condition. 

Psychotherapy

Psychotherapy, or “talk therapy,” is sometimes used alone for treatment of mild depression, however for moderate to severe depression, psychotherapy is often used along with antidepressant medications. Cognitive-behavioral therapy (CBT) has been found to be effective in treating depression, which helps a person to recognize distorted thinking and then change behaviors and thinking.

Psychotherapy may involve only the individual, or it can include others (i.e. family therapy, or group therapy). Depending on the severity of the depression, treatment can take a few weeks or much longer. In many cases, significant improvement can be made in 10 to 15 sessions.

Medication

Antidepressants might be prescribed to help modify one’s brain chemistry.  Antidepressants may produce some improvement within the first week or two of use, though full benefits may not be seen for two to three months. If a patient feels little or no improvement after several weeks, his or her psychiatrist can alter the dose of the medication or add/change/substitute another antidepressant. It is important to let your doctor know if a medication does not work or if you experience side effects.

Psychiatrists usually recommend that patients continue to take medication for six or more months after symptoms have improved. Longer-term maintenance treatment may be suggested to decrease the risk of future episodes for certain people at high risk.

• Electroconvulsive Therapy (ECT) is a medical treatment used for patients with severe major depression or bipolar disorder who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia. A patient typically receives ECT two to three times a week for a total of six to 12 treatments. It is usually managed by a team of trained medical professionals including a psychiatrist, an anesthesiologist and a nurse or physician assistant.

• Coping Strategies: For many people, regular exercise helps create positive feelings and improves mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression.

For more information on depression and psychotherapy used to treat it, contact me at SHCS.