Depressive disorders are characterized under mood disorders and cause severe symptoms that affect how one thinks, feels, and interacts with others. Individuals with depression may not even report depressive signs and symptoms and instead present to their physician for somatic or physical symptoms such as headaches, abdominal pain, muscle pain, and fatigue. Individuals may also complain of irritability or problems concentrating.
This disorder may be difficult to initially diagnose, as many individuals may not show the clear-cut signs and symptoms of depression. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V), at least five of the following symptoms must be present within a two-week period with at least one of the symptoms being depressed mood. Additionally, these symptoms must cause apparent distress in social and occupational functioning.
Living with untreated depression can potentially lead to self-harm, eating disorders and even suicide and therefore recognizing the signs and symptoms and seeking the appropriate treatment is imperative to overcoming the battle with depression and living a health and fulfilling life.
Treatment for depression consists of a combination of medications and psychotherapy. Although studies have shown that these medications and psychotherapy approaches can be used alone for mild depression, when used in combination, individuals receive the best outcomes in terms of symptoms relief for moderate depression. The most common pharmacological treatments include antidepressant classes such as selective serotonin reuptake inhibitors (SSRIs), serotonin/norepinephrine reuptake inhibitors (SNRIs), atypical antipsychotics, and tricyclic antidepressants (TCAs).
Medication generally takes approximately 6-8 weeks for results to take effect. Psychotherapy includes cognitive behavioral therapy, interpersonal therapy, problem-solving therapy and mindfulness-based cognitive therapy.
Cognitive behavioral therapy and interpersonal psychotherapy are the two most common therapy approaches to treating depression. Cognitive behavioral therapy focuses on reducing depressive symptoms by recognizing the thought the irrational thought patterns, emotions, beliefs and distorted attitudes toward oneself and their environment that results in symptoms of depression. Once the recognition of maladaptive thoughts occurs, an individual can then work on their behavioral patterns to turn these negative symptoms around into positive outlooks, and gain insight and self-appreciation in order to develop behavioral techniques such as self-control therapy, problem solving, and social skill training. Interpersonal psychotherapy focuses on acknowledging the triggers associated depression such as the loss of a loved one, a stressful social situation, the loss of a job, financial burdens, social isolations, or the loss of a romantic relationship. In this form of therapy, depression is viewed as a medical illness and the illness is the cause of the depression. Techniques that involve building relationships, learning coping mechanisms, and developing conflict resolution skills can help diminish these triggers and form positive insight in future conflicts. Other forms of psychotherapy that have been implanted to treat depression include the following:
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An antidepressant medication is usually the first-step in the treatment plan for an individual with mild to moderate depression. There is a vast array of medications available and the initial selection often depends on the known medication side effects, safety and tolerability of these side effects, duration of timing it takes for the drug to work, an individual’s response to prior antidepressant medications, cost of the medication, interactions with other medication and the individual’s preference. Antidepressants take two-six weeks, at the correct dosage, for a clinical response to occur and therefore it is imperative individuals stay motivated and compliant during this time period. Additionally, psychotherapy can be initiated at the start while these medications take their time to produce clinical effects. The following are classes of antidepressants widely used in the general population to treat depression: