Most people, at some point in their lives, experience periods of sadness and feeling down. However, when these feelings persist for a significant period and begin to substantially affect a person’s life, they may be dealing with depression.
Experiences of grief or trauma are not in and of themselves considered to be depression, although many of the symptoms are the same; however, they may lead to depression if the feelings continue. Depression is ongoing and may last for several weeks, months, or years.
Symptoms of depression
Depression is a mood disorder, characterized by feelings of sadness, loss of pleasure or interest in activities that previously would have been pleasurable, loss of sexual desire, unintentional weight changes, sleeping too much or experiencing insomnia, agitation, and restlessness, or fatigue and loss of energy.
A depressed person may experience feelings of worthlessness or guilt, anxiety, mood swings, difficulty concentrating or making decisions, or recurrent thoughts of death or suicide, perhaps even may attempt suicide.
Treatment for depression
For very mild to moderate depression, one may want to just wait and see if it improves on its own in a couple of weeks. Doing things like exercising and eating certain healthy foods, like fruit, vegetables, and fish may bring some improvement.
One could also try talking to a friend or trusted relative, joining a self-help group, reading self-help books, or using a mental health app. However, if the depression is serious, no mental health app can be a substitute for a qualified medical professional.
If there is no improvement after two weeks, one may find counseling or psychotherapy (also known as talk therapy) to be helpful. If talk therapy on its own isn’t helping, antidepressants may be recommended, particularly for moderate to severe depression.
The backbone of treatment for depression is typically talk therapy, medication, or a combination of the two. Most people benefit from the use of antidepressants and psychotherapy. Your primary care physician can prescribe medication to relieve your symptoms, but you may also receive help from seeing a psychologist, psychiatrist, or other mental health professional.
Severe depression, where one is unable to properly care for themselves, or is at risk of hurting themselves or others, may require a hospital stay or joining an outpatient treatment program, until the symptoms improve.
Medications for depression
There are several classes of antidepressants available. Each class acts on a different neurotransmitter or combination of neurotransmitters. Some take a while to make an impact, so they should be taken only as the doctor prescribes, and any concerns about major side effects should be raised with your doctor.
Selective Serotonin Reuptake Inhibitors (SSRIs) are often the first to be prescribed. They are safer and have fewer troublesome side effects than other types of antidepressants. One may also be prescribed Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), which list possible side effects such as nausea, constipation, diarrhea, low blood sugar, weight loss, and sexual dysfunction. There are also some atypical antidepressants, which don’t fit neatly into any other categories.
When other medications haven’t yielded any improvement, one may be prescribed tricyclic antidepressants. These can be highly effective but won’t generally be prescribed until SSRIs have been tried because they tend to cause more serious side effects.
Monoamine Oxidase Inhibitors (MAOIs) may be prescribed after other antidepressants haven’t worked, as they may have much more severe side effects. These require one to follow a strict diet, because of dangerous and possibly deadly interactions that may happen with certain foods, medications, and herbal supplements. These cannot be combined with SSRIs.
Certain other medications may be added to enhance the effects of some antidepressants. Two antidepressants may be combined, or mood stabilizers, antipsychotics, anti-anxiety, or stimulant medications may be added as needed by a medical professional.
Finding the right medication
You may find that a medication that worked for a relative works well for you too, but as there are other variables besides genetics that affect how you respond to an antidepressant, you may find yourself needing to try several, or a combination of medications, to find what works best for you. Finding the right antidepressant will require patience, as some take several weeks to reach their full effect, and for side effects to ease up, as your body adjusts to it.
Most antidepressants are generally considered to be safe. However, the Food and Drug Administration (FDA) requires that they all carry the strictest warning for prescriptions, because in some cases, among children, teens, and young adults, there may be an increased risk of suicidal thoughts or behavior, particularly in the first few weeks after starting on antidepressants or when the dosage is changed.
When trying a new medication or changing the dosage, a person should be closely watched for any unusual behavior or worsening depression. This initial risk is weighed against the fact that in the long term, improving a person’s mood is more likely to reduce the risk of suicide.
While antidepressants are not considered addictive, sometimes a physical dependence can occur, causing withdrawal-like symptoms if one misses doses or suddenly stops taking them. This may cause a sudden worsening of depression, so you should talk with your doctor before stopping so that your doctor can help you to first decrease your dose safely.
Also known as counseling, talk therapy, or psychological therapy, psychotherapy is often the first line of treatment for some forms of depression, although others respond better to a combination of talk therapy and medication. “Psychotherapy” is the general term used for treating depression by talking about your condition and related issues with a mental health professional.
There are several types of psychotherapy, such as Cognitive Behavioral Therapy (CBT) or interpersonal therapy. While recognizing the influence of past events, the focus of CBT is on changing the way you think, feel, and behave in the present. Interpersonal therapy focuses on your relationships with others.
Psychotherapy helps you to think through the problems that you experience in your life so that you can find new and better ways of dealing with them. It can help you to adjust to a current crisis or difficult situation by helping you find better ways to cope and solve problems. It can help you overcome negative thoughts, like feelings of hopelessness, by helping you identify negative beliefs and behaviors and replace them with healthy, positive ones.
It can help you explore your relationships and experiences and aid you in positively interacting with others. It can help you in growing your ability to deal with and accept stressful situations and can teach you how to set realistic goals and regain a sense of satisfaction and control over your life.
This can help to ease symptoms of depression like hopelessness and anger. By identifying issues and behaviors that contribute to your depression, psychotherapy can equip you to change the behaviors that make it worse and move forward with more positive behaviors and ways of thinking.
Alternative treatment for depression
In addition to the traditional face-to-face sessions in a counseling office, certain people may receive help from online sessions or working through self-help videos or a workbook. This can be done independently or be guided by a therapist.
Before choosing a different type of therapy, it would be helpful to discuss it with a therapist to decide if a particular format would be most effective for you specifically. Be aware that not all program developers or online therapists have the proper training or credentials, so be sure to ask for recommendations from a mental health professional about a trusted source or program.
The important thing is that you get the help and support that you need to help you out of your depression. And while the alternative formats of therapy are available, be sure that you are getting the benefit of qualified healthcare professionals.
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