What Triggers Major Depression
Some common triggers or causes of major depression include:
- Loss of a loved one through death, divorce, or separation
- Social isolation or feelings of being deprived
- Major life changes — moving, graduation, job change, retirement
- Personal conflicts in relationships, either with a significant other or a superior
- Physical, sexual, or emotional abuse
When To Seek Emergency Help
If you think you may be in a position to harm yourself or someone else, call 911 or your local emergency number ASAP. There are also several treatment resources and support groups that can be sought through the Substance Abuse and Mental Health Service Administration National Hotline at 1-800-662-HELP .
If you are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one are in immediate danger, call 911.
How Is Major Depression Diagnosed
A health professional — such as your primary care doctor or a psychiatrist — will perform a thorough medical evaluation. You might receive a screening for depression at a regular doctorÃ¢â¬â¢s visit. The professional will ask about your personal and family psychiatric history and ask you questions that screen for the symptoms of major depression.
There is no blood test, X-ray, or other laboratory test that can be used to diagnose major depression. However, your doctor may run blood tests to help detect any other medical problems that have symptoms similar to those of depression. For example, hypothyroidism can cause some of the same symptoms as depression, as can alcohol or drug use and abuse, some medications, and stroke.
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Treating Major Depressive Disorder
While depression is a serious condition, it can be treated. In fact, between 80% to 90% of people with depression respond well to treatment, and almost all patients get some relief from their symptoms.
Its important to seek treatment for depression as soon as possible, because the earlier it is treated, the more effective the treatment can be. Ignoring the symptoms of depression and leaving it untreated can lead to self-harm or death.
Treatment for depression may involve medication, therapy, or brain stimulation. The treatment modalities chosen can depend on the severity of the depression and your individual needs.
Treatment: There Are A Variety Of Options
As with many illnesses, the earlier treatment for depression begins, the more effective it is likely to be at alleviating symptoms and reducing the odds of a recurrence. The sooner you can internalize some of what you learn, the longer you can carry that knowledge with you to help you stay healthy, says Carol Landau, PhD, a clinical professor of psychiatry and medicine at the Alpert Medical School of Brown University in Providence, Rhode Island.
After having a good medical workup to rule out any underlying causes, a person diagnosed with major depression can be treated a number of ways. The most frequently used approaches are medication, thought to relieve symptoms by reversing imbalances in brain chemistry psychotherapy aimed at altering patterns that negatively affect mood or a combination of the two.
Studies suggest that typically a combination of psychotherapy and medication is more effective than either method alone. The reason isnt clear. Perhaps medication eases symptoms so that patients are more open to psychotherapy. Or maybe psychotherapy increases the odds that patients will stick to their medication schedule. It could even be that having two clinicians, one who prescribes medication and one who provides talk therapy, enhances the treatment of both.
The approach chosen may be dictated by the severity of symptoms. Mild to moderate depression, for instance, is often treated first with psychotherapy. More severe symptoms may require medication from the start.
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What Does Major Depressive Disorder Treatment Look Like
There are numerous things to consider when figuring out what depression treatment looks like for you, including your medical history, your personal symptoms,and whether or not youve been depressed before, according to Dr. Combs.
In general, though, your path forward will likely include some form of therapy, medication, or both. In one 2014 meta-analysis of 92 studies on psychotherapy published in the Journal of Affective Disorders3, 62% of 6,937 people with clinical depression found that just going to therapy helped reduce their symptoms to the point where they no longer met the criteria for a clinical depression diagnosis.
Feeling comfortable with your treatment is crucial , so its important to speak up if you feel hesitant about anything. For example, some people may prefer to try talk therapy alone before committing to a medication. If thats the case for you, make sure you make any concerns clear to your doctor or therapist, as they can answer questions to make you feel more at ease or recommend a different approach first.
Core And Associated Symptoms Within The Diagnosis Of Major Depressive Disorder
The current polythetic approach to diagnostic classification of Major Depressive Disorder in the Diagnostic and Statistical Manual of Mental Disorders. 4th ed. 2 is devoid of implications about etiopathology or treatment response. Only depressed mood or loss of interest or pleasure in nearly all activities are considered to be essential requirements for the diagnosis of a .Major Depressive Episode in DSM-IV. When these two core symptoms were used to screen for MDD using a 2-item version of the Patient Health Questionnaire , they displayed a sensitivity of 83% and a specificity of 92% for caseness based on a Structured Clinical Interview for DSM-IV 3 and comparable results were obtained in a subsequent. .European replication.4
Confirmatory diagnosis of an MDE, according to DSM-IV, requires a minimum of five symptoms for a minimum of 2 weeks . It is easy to see how the multiple permutations and combinations of these symptoms contribute to substantial intraclass heterogeneity.
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Other Types Of Depression
There are different types of depression, and some conditions where depression may be one of the symptoms. These include:
- postnatal depression sometimes new mothers, fathers or partners develop depression after they have a baby this is known as postnatal depression and it’s treated in a similar way to other types of depression, with talking therapies and antidepressant medicines
- bipolar disorder also known as “manic depression”, in bipolar disorder there are spells of both depression and excessively high mood the depression symptoms are similar to clinical depression, but the bouts of mania can include harmful behaviour, such as gambling, going on spending sprees and having unsafe sex
- seasonal affective disorder also known as “winter depression”, SAD is a type of depression with a seasonal pattern usually related to winter
Risk Factors For Depression
Depression can affect anyoneeven a person who appears to live in relatively ideal circumstances.
Several factors can play a role in depression:
- Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
- Genetics: Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of having the illness sometime in life.
- 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.
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Which Types Of Psychotherapy Work Best
Psychotherapy always includes talking with a trained professional focused on helping you make positive changes in your thoughts and behaviors to ease your symptoms. But theres some evidence that certain types may be more effective for depression than others, notes the NIMH. These include:
- Cognitive behavioral therapy , a systematic approach aimed at identifying and altering negative thought patterns
- Dialectical behavioral therapy , which emphasizes psychotherapy and group classes in new skills, such as mindfulness, to help make life feel worth living
- Interpersonal therapy , which focuses on increasing happiness by improving how you interact with others
- Psychodynamic therapy, which aims to reduce the negative influence of past life events and traumas through insight into how they affect your current behavior
- Accelerated experiential dynamic psychotherapy , which teaches patients to view depression as a defense against core emotions, including sadness, fear, anger, sexual excitement, and disgust, so that fully feeling those emotions can help restore hope and optimism
How Is Depression Diagnosed
If you are noticing the symptoms of depression, a healthcare professional can help get you a diagnosis.
This will likely begin with a conversation and a physical examination. Your doctor will likely ask you about your family history to see if depression or other mental health conditions run in your family.
If youre talking with your primary physician, they might also order blood tests to ensure that another medical condition isnt the cause of your symptoms. For example, the fatigue or lethargy you can feel with depression could also be caused by vitamin deficiencies or a thyroid issue.
If your doctor cant find another cause for your symptoms, they will likely refer you to a licensed mental health expert who will evaluate your mood, behavior, and day-to-day activities.
They will also ask you about your familys psychological history. They may use a depression-rating questionnaire, such as the Hamilton Depression Rating Scale or the Patient Health Questionnaire 9 , to diagnose the condition.
According to the DSM-5, you have to display at least five of the main symptoms of depression for over two weeks to get a diagnosis.
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You Find It Hard To Concentrate Get Things Done Or Take Care Of Yourself
Often those suffering from depression describe it as a weight on top of them, suffocating them, making it impossible to get out of bed or take care of their basic needs, says Heinemann. They feel drowned by depression.
This can feel like being really low on energy.
Some people find it difficult to do things like showering or brushing their teeth, she says.
Others struggle with simple chores or concentrating at work. Even making decisions can feel difficult if you have depression.
Depression tends to hijack our brain, so the strategies we usually use or rely on arent helpful because our brains are lying to us, explains Meier. We are seeing the world through poop-covered glasses.
New Treatments For Mdd
Recent research has shown that ketamine, primarily used as a tranquilizer in veterinary medicine and abused as a recreational club drug called Special K, can rapidly lift people out of depression and keep even chronically suicidal patients feeling well for days, if not weeks.
Scientists testing ketamine at the University of Illinois at Chicago College of Medicine reported in a study published June 2018 in the journal Molecular Psychiatry that 66 percent of patients felt better within hours after receiving a single infusion of ketamine through an IV .
In 2019, the U.S. Food and Drug Administration approved Spravato , a nasal spray derived from ketamine, for people who havent responded to other depression treatments. Esketamine can only be administered at certified treatment centers because of the potential for abuse and addiction.
Hallucinogenic mushrooms, LSD, and other psychedelics are emerging as another potential new treatment for depression
Anecdotal accounts and federally approved studies, as reported in Michael Pollans best-selling book on the subject, How to Change Your Mind, suggest that miniscule doses one-twentieth to one-tenth of recreational doses significantly lessen depression, possibly by increasing new connections in the brain.
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What You Can Do On Your Own
Having major depression is not something you can just beat with willpower. But you can tweak your lifestyle to find some relief.
Seek out friends and family. It may not come as a surprise that loneliness increases the risk of depression. The importance of social support is not talked about nearly enough, says Dr. Landau.
Eat healthier, nutrient-rich foods. A growing body of research suggests that what you eat can affect your mental health. For example, a study published in October 2019 in the journal PLoS One found that symptoms of depression dropped from the moderate to normal range among a group of young adults who followed a Mediterranean-style pattern of eating for three weeks, increasing their intake of fruits, vegetables, whole grains, lean protein, unsweetened dairy, fish, nuts, seeds, and olive oil.
Be more physically active. Research indicates that exercise can help prevent and treat depression. For instance, an analysis published in May 2018 in JAMA Psychiatry looked at more than 30 previous studies and concluded that resistance training is associated with a significant reduction in depression symptoms.
Key Points About Depression
Depression is a serious mood disorder that affects your whole body including your mood and thoughts.
Its caused by a chemical imbalance in the brain. Some types of depression seem to run in families.
Depression causes ongoing, extreme feelings of sadness, helplessness, hopeless, and irritability. These feelings are usually a noticeable change from whats normal for you, and they last for more than two weeks.
Depression may be diagnosed after a careful psychiatric exam and medical history done by a mental health professional.
Depression is most often treated with medicine or therapy, or a combination of both.
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Are There Different Kinds Of Depression
Yes. Depression isnt a one-size-fits-all.
Many people with depression dont even know they have it, says Adrienne Meier, a clinical psychologist and telehealth practitioner. Symptoms are often misattributed to fatigue or stress or even just getting older.’
These are different kinds of depression:
The Prominence Of Anxiety Symptoms And Syndromes
Surprisingly, anxiety is not considered as a core or associated symptom of depression according to either DSM-IV or ICD-10 criteria. Neither is with anxious features a specifier within DSM-IV, yet. up to 90% of patients have co-occurring anxiety symptoms, and approximately 50% of depressed patients meet, criteria for a comorbid anxiety disorder.19,20 This lack of syndrome independence on Axis 1 is a major limitation to the current concept, of comorbidity. Comorbid disorders should only exist, at a level expected by chance, yet. in the case of M’DD, comorbidity is the rule and not the exception.21.
A recent proposal for mood and anxiety spectrum disorders, to be considered in DSM-V, has been advanced by Watson22 who proposes three subclasses of emotional disorders: bipolar disorders,distress disorders, and fear disorders . This reflects a pendulum swing to the unitary position of Mapother23 and Lewis24 who viewed states of anxiety along a continuum with depressive disorders, in contrast. to the progressive separation of mood and anxiety disorders initiated more than three decades ago.25,26 It is likely that the inconsistent impact of some antidepressants on anxiety has distorted measurement of anxiety symptoms during treatment.
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How Is Depression Treated
Depression is among the most treatable of mental disorders. Between 80% and 90% percent of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.
Before a diagnosis or treatment, a health professional should conduct a thorough diagnostic evaluation, including an interview and a physical examination. In some cases, a blood test might be done to make sure the depression is not due to a medical condition like a thyroid problem or a vitamin deficiency . The evaluation will identify specific symptoms and explore medical and family histories as well as cultural and environmental factors with the goal of arriving at a diagnosis and planning a course of action.
Deterrence And Patient Education
Patient education has a profound impact on the overall outcome of major depressive disorder. Since MDD is one of the most common psychiatric disorders causing disability worldwide and people in different parts of the world are hesitant to discuss and seek treatment for depression due to the stigma associated with mental illness, educating patients is very crucial for their better understanding of the mental illness and better compliance with the mental health treatment. Family education also plays an important role in the successful treatment of MDD.
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Can Depression Be Prevented
You can help prevent depression by getting enough sleep, eating a healthy diet and practicing regular self-care activities such as exercise, meditation and yoga.
If youve had depression before, you may be more likely to experience it again. If you have depression symptoms, get help. Care can help you feel better sooner.
What Are The Signs Of Major Depression In Men
Depression in men is significantly underreported. Men who suffer from clinical depression are less likely to seek help or even talk about their experience.
Signs of depression in men may include irritability, anger, or drug and alcohol abuse . Suppressing negative feelings can result in violent behavior directed both inwardly and outwardly. It can also result in an increase in illness, suicide, and homicide.
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When To Talk With A Doctor
If you are experiencing symptoms of depression, its always best to talk with a healthcare professional, especially since some symptoms can be caused by underlying medical conditions rather than depression. The sooner you talk with them, the sooner you can get the help you need to start feeling better.
Its OK if youre feeling reluctant to talk to a mental health expert or doctor, but you have nothing to be ashamed of. Its OK to ask for help. If youre not comfortable sharing, then no one except you and your doctor has to know that youre seeking treatment.
We go to a doctor when our body isnt feeling well, and we go to a therapist when our emotions feel out of whack, says Heinemann. Depression is not your fault, nor is it something you can just snap out of.
Wondering if your symptoms might be depression? You can take our depression test to find out.
If youre ready to reach out, a therapist who practices interpersonal therapy or cognitive behavioral therapy may help.