The purpose of this article is to provide a brief overview of the diagnosis and treatment of depression.
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If while reading this article you can relate to some of the information about yourself, and think that you may be experiencing some depression, it’s important to speak with your doctor or other healthcare professional as soon as possible. I will provide some resources at the end of this article.
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Depression
According to the Mayo Clinic, “Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depression, major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn't worth living.”
Diagnosis and Treatment
It’s unfortunate. but due to the stigma of depression, many people still fail to seek help. As I had shared in “Understanding Depression – Part 1”, a person who is experiencing depression may look to self-medicate by using alcohol, over the counter medication, or illegal drugs (street drugs or prescription drugs without a prescription). This can only makes things worse.
Through a combination of medication and psychotherapy, 60% to 80% of those suffering from depression can find relief with proper treatment.
Diagnosing Depression
Even though depression is very common, it is frequently missed or misdiagnosed, and as a result goes untreated.
To diagnose depression, your health care provider will ask you questions about your symptoms and family history. You may be asked to fill out a questionnaire about your symptoms. You may be given medical tests to rule out other conditions that may be causing your symptoms, such as nutrient deficiencies, underactive thyroid, dementia, hormone levels, or reactions to drugs (either prescription or recreational) and/or alcohol.
Areas to Explore
Making a diagnosis of any kind is like putting a jigsaw puzzle together. The more pieces of the puzzle a healthcare professional has to work with, the clear the picture, and the more accurate the diagnosis.
To follow are a few areas that a medical professional will explore.
• A doctor notes symptoms and signs of depression during the history and physical examination.
• A psychological assessment is conducted, in which a patient is asked a series of questions about moods, thoughts, sleeping patterns and personal relationships.
• Symptoms of depression in the elderly are often confused with symptoms of other ailments (e.g. UTI). An assessment for an elderly person may also need to focus on memory issues, chronic pain and medical problems.
• Complicating a diagnosis of depression is the fact that depression itself is a common symptom of many chronic conditions, as well as a side effect of many drugs commonly prescribed for the elderly and for those with chronic conditions.
How Depression Is Treated
Through a combination of medication and psychotherapy, 60% to 80% of those with depression may find relief with proper treatment.
Antidepressant Drugs
Medication or drug therapy focuses on a person’s symptoms, which are thought to be caused by brain circuit abnormalities that are tasked with regulating our thinking, behavior, and mood. Keep in mind that it will take between 4 and 6 weeks for the drug therapy to begin to produce changes, although often people report some improvement of symptoms in as little as two weeks of being on the medication.
There are several types of antidepressant medications in use. Depending on the particular medication, it can take 4 to 12 weeks to achieve the desired effects.
• Tricyclic antidepressants are among the oldest antidepressants, with their effectiveness well documented. However, they have numerous side effects, including dry mouth, blurred vision, weight gain, constipation, drowsiness and dizziness.
• Selective serotonin-reuptake inhibitors (SSRIs), such as Prozac, help to raise the level of serotonin in the brain. They have fewer side effects than other antidepressants.
• Monoamine oxidase inhibitors (MAOIs) may work when other antidepressants are ineffective. They have numerous side effects and can react dangerously with certain foods to cause severe high blood pressure.
• Lithium is normally used in the treatment of bipolar disorder (formerly called manic-depression), but may be effective in combination with other antidepressants for those who don’t respond to antidepressants alone.
• Other medications can have antidepressant effects as well, depending on the medical situation.
Psychotherapy
Psychotherapy is a generic term used to describe a process of helping a person who is struggling with stress, loss, change, or a psychological disorder. A wide variety of techniques and strategies may be used in psychotherapy, depending on the client’s unique needs. In most cases however, the process focuses on developing a therapeutic relationship, exploring problem areas, introducing healthy skills and strategies, and working to address problematic thoughts, patterns, or behaviors.
A number of forms of therapy are available, some of them specifically designed for working with depression. Treatment of depression is known to be more effective when antidepressants and psychotherapy are combined.
Electroconvulsive Therapy (ECT)
Commonly called shock therapy, this treatment is sometimes used when other methods have failed.
While the patient is under anesthesia, a small amount of electric current is sent to the brain, causing a generalized seizure that lasts for about 40 seconds.
Eight to 12 treatments may be given over a three week period.
Although this method was at one time abused, ECT is now done only with the patient’s consent and only when other methods have been ineffective.
Personal Behavior Changes
If you’ve been diagnosed with depression, there’s much that you can do to contribute to your own recovery and help prevent relapses. Most of the behavior changes that help ease depression are also good for your general health:
• Take your medication and attend therapy as prescribed
• Get regular exercise. Exercise has been shown to decrease depression
• Join a support group. Isolation is an aggravating factor, or even the source of much depression
• Eat nutritious, well-balanced meals
• Participate in activities even when you have to push yourself to do so
• Express yourself and your feelings
• Pay attention to personal hygiene and good grooming, even if you don’t feel you deserve it
• Keep a regular schedule and get a good night’s sleep
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• Light therapy can be used for SAD (seasonal Affective Disorder)
• Learn to be assertive about your needs
• Quit smoking
• Cut back on caffeine and alcohol
• Schedule activities that you enjoy
• Seek help if you are feeling suicidal
Source: Parlay International
Mental Health and Substance Abuse Resources
Remember that help is just a phone call away!
CT Department of Mental Health and Addictions Services
410 Capitol Avenue
Hartford, CT 06106
F.S. DuBois Center
(Operated by the State of CT)
780 Summer Street
Stamford, CT 06905
For general information: 203-388-1600
Crisis services: 203-358-8500
Connecticut Suicide Hotline
Serving Southwestern CT
Greater Bridgeport Community Mental Health Center
8am - 8pm
(203) 551-7507
CT Info-line
Dial 211
The Caregiver Resource Center
The Caregiver Resource Center assists seniors, people with special needs and their families in planning for and implementing ways to allow for the greatest degree of independence, safety and quality of life.
We are available 7 days a week by appointment, and 24/7 for emergencies. All of our services are individually designed to meet the unique needs of the client and their family.
For more information, or to request an initial consultation, please contact:
Linda Ziac, LPC, LADC, BCPC, CEAP, CCM, CDP
The Caregiver Resource Center
Greenwich, CT
203-861-9833
www.CaregiverResourceCenter.com
Disclaimer
The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.
Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.
To learn more about health and mental topics and to become a more educated self advocate, please subscribe to this blog or visit us at www.CaregiverResourceCenter.com
