Depression

Unipolar major depression/ major depressive disorder is diagnosed in patients who have previously experienced at least one major depressive episode which is not caused by medication. These patient also do not have a history of mania, which is defined as periods of excessive enthusiasm or euphoria due to mental illness. A major depressive episode will last at least two weeks and can include the following symptoms:
– down mood
– Insomnia ( not able to sleep)
– Hypersomnia ( excessive sleeping)
– Drastic change in appetite
– Weight gain or weight loss
– Agitation
– Lack of interest or motivation
– Lack of concentration
– Feeling worthless
– Guilt or other negative feelings
– Reoccurring thoughts about death or suicide
There are psychotherapy and pharmacotherapies available for the treatment of unipolar major depression. For the initial treatment of major depressive disorder, combination of the two treatments are recommended to decrease symptoms and restore baseline functioning.
Another option for treatment would be using pharmacotherapy or psychotherapy on its own. Antidepressants have been commonly used as an effective treatment due to its availability and convenience. If you suspect you might be suffering from a major depressive disorder, you should contact a mental health professional to get a diagnosis and see what the available treatment options are. It is important to consult with a professional because each patient is different and the treatment regime for each patient will be different as well.
There are side effect associated with all medications including antidepressants. These side effects include diarrhea, sexual dysfunction, nausea/vomiting, and weight gain.
There are also alternative treatment methods used for milder episodes of major depressive disorder such as relaxation techniques, positive activities, and exercising to boost mood and motivation in patients.

The diagnosis of unipolar major depression in the geriatric population and pregnant population is different and will be discussed more later.
Severe major depression is when a high number of symptoms are being experienced nearly everyday. Patients who are severely affected will often report suicidal thoughts, show harmful behavior, have impaired functioning, and could develop psychotic symptoms as well. Such patients need to refer to a mental health care provider as soon as possible and might require hospitalization as well.

Persistent Depressive Disorder is demonstrated through dysphoria and at least 2 other recurring symptoms of depression. These symptoms would occur more often than not and they last for 2+ years.

Depression can affect anybody no matter their age, race, or social class. Common symptoms include sadness, loss of interest, lack of energy and motivation, low self-esteem, changes in appetite and sleep, feelings of guilt and despair. All of these symptoms can appear in men, women, children, and the elderly. The manifestation of these symptoms may appear different in each individual and in different groups of people.

Affects on Children

Depression can be found in any age group starting from preschool all the way up to adolescents but the rate of depression is lower in preschoolers and increases as they grow up and reach adolescence. Symptoms in children manifest differently and it is more common for parents and professionals to fail to recognize the problem. Symptoms in children manifest as changes in behavior, mood, appetite, and sleep.

Affects on Seniors

Many people think that aging comes with depression due to quality of life deteriorating, increase in illness and disability, and the experience of loss. All of these factors do create sadness but that is expected, it does not necessarily mean that all seniors are suffering from depression. The symptoms in seniors are very similar to those in anyone, however, the elderly do tend to focus more on physical pain and express more remorse about past events in their life. Depression interferes with memory, and it can be mistaken for Alzheimer’s or dementia in seniors. Also, it increases the chance of death/suicide in elderly people and their age might prevent them from seeking proper treatment.

Affects on men

Men tend to experience depression with feelings of anger, irritability, fatigue, sleep problems, and loss of interest in most things. Men are less likely to acknowledge the negative feelings that come with this disorder such as hopelessness and self hate, but instead symptoms manifest as aggression, reckless behavior, and substance abuse.

Affects on women

Depression in women tends to manifest more as feelings of guilt, self hate, helplessness, excessive sleeping and eating, and increase in weight. Women are highly impacted by hormonal factors especially during pregnancy, menstruation, and menopause which also impacts their symptoms.

Early signs of depression

There are early signs of depression that people can look out for which can help them reach out for help when needed. Feeling sad or disappointed from time to time is normal, but when negative feelings such as despair, hopelessness, and sadness take over and won’t go away, then you might be suffering from depression. This disorder can change how a person feels, thinks, and overall affect the daily functions of a person. It can interfere with mood, sleep, eating, school, work, and relationships. Any activity or just getting through the day can be overwhelming and feel impossible. Symptoms of depressive disorders can manifest differently. Anger and restlessness are symptoms that are seen mostly in men. Some might feel empty, lifeless, and as if they are living in a dark hole. Knowing all these early signs of depression are important because you can remember that these are just symptoms of the disorder and not the reality of your life, and help is available. As mentioned, signs and symptoms can look different in each person but there are some common early signs of depression to look out for. The longer and stronger these symptoms are, the higher the chance that you might be dealing with major depressive disorder.
Common early signs of depression include feelings of hopelessness, feeling defeated, loss of interest in activities, lack of energy and motivation, anger and irritability, feelings of self hate, change in appetite and sleep, lack of concentration, and unexplained aches.

Depression vs. Manic depression

Manic depression is commonly known as bipolar disorder which causes drastic shifts in mood, mindset, and behavior. The low phase of bipolar disorder is so similar to depression that it is commonly misdiagnosed. It is very important to be correctly diagnosed because medications such as antidepressants which help with depressive disorders, actually worsen conditions such as bipolar disorder. Bipolar disorder is characterized to have low phases that feel like depressive disorder, and high phases with feelings of euphoria, increased energy, no need for sleep, and erratic and impulsive thoughts and behaviors.

Clinical depression

Clinical depression refers to the more severe form of depression which we mentioned earlier, also known as major depressive disorder. There are many reasons that could cause clinical depression or even multiple life events that go hand in hand to cause it. Factors that could increase the risk of developing depressive disorder include stressful or traumatic life events, personality traits, family history, childbirth, substance abuse, loneliness, and major illness or injury. The symptoms of clinical depression are similar to mild or moderate depression, as they all come on gradually and it might be difficult to recognize them at first. Clinical depression does severely impact a person’s life and makes it almost impossible to get through the day.
Other types of depressive disorders include postnatal depression, bipolar disorder which was mentioned above, and seasonal affective depression (SAD).
Postnatal or postpartum depression is caused by the experience of childbirth. Mothers, fathers, and partners can experience this after the birth of a child. If you would like to read more about postnatal depression, you can refer to the more detailed article about it on our website www.mental-md.com**
Seasonal affective depression (SAD) which can also be called winter depression, has a seasonal pattern. It is usually related to winter or colder months which is when symptoms start to rise and peak.

Treatment

Treatment options for depressive disorder usually include a combination of therapy, medication, and self-help. Depending on the type and severity, medical providers will diagnose and come up with the proper treatment plan for you. Antidepressants are usually prescribed to patients who are suffering from moderate to severe depression. Antidepressants are medications that treat the symptoms and there are different types that are available. Combination therapy is when medication such as antidepressants are given along with some kind of therapy which will increase the chance of treatment working.

Antidepressants

Antidepressant are usually prescribed to patients with moderate to severe depression, but not everybody benefits from the use of antidepressants. Since there are different kinds, sometimes patients have to try multiple before finding one that works for them. Different people experience different kinds of side effects and different results. Once you start taking antidepressants, you should be getting a check up every two weeks for at-least a month to track your progress. If they are working well, the same dose will need to be continued for 4-6 months even after symptoms have improved. Antidepressants are not considered to be addictive but some people might experience withdrawal symptoms if they stop taking their medication suddenly.
Two common types of antidepressants include Selective Serotonin reuptake inhibitors (SSRIs) and Tricyclic antidepressants (TCA). There are also other new antidepressants that work slightly in different ways than these two.
SSRIs increase the natural level of serotonin, which is known as the “happy” chemical, in the brain. SSRIs work well and are said to have less side affects. TCA is a group of antidepressants that is usually used to treat moderate to severe depression. This drug raises the level of serotonin and noradrenaline in the brain which helps improve mood. Side effects of TCAs vary from person to person but tend to improve within 10 days of using the medication.

Recovery

There are some very important steps that you can take to help your recovery process. First step is staying on your medication regimen and taking antidepressants exactly as they are prescribed. Suddenly stoping or missing doses could lead to the return of symptoms and withdrawal symptoms. Talk to your doctor about any changes, concerns, or if you plan to take any other medications. Second step would be to self-help as much as possible. Diet and exercise can help improve your general health which will lead to better recovery from depression as well. Being active and keeping a healthy diet can improve mood, increase energy, and overall lessen the symptoms of depression. Third step would be to pay attention to your mental health and be mindful of your feelings and thoughts. Meditation and therapy are both great options to consider which will help your recovery. Fourth step would be abstain from drugs, cigarettes, and alcohol. You may think that these things will make you feel better, but they all affect your health in a negative way in the long run and can make things worse. You have to be very cautious when it comes to drugs and alcohol because they can make symptoms worse, decrease response to antidepressants, can cause earlier relapse, and keep you from fully recovering. Lastly, it is important to have a support system and to have insight into your problems. Sharing your problems or being part of a group can really help you express your feelings and acknowledge them, which will help you cope better and recover from depression. There are many support groups and medical providers who you can reach out to for help. You can also visit our website www.mental-md.com to schedule an appointment and start your recover process.