Depression

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), depression occurs when you have at least five of these symptoms at the same time for at least two weeks: depressed mood during most of the day, fatigue or loss of energy, feelings of worthless or guilt, impaired concentration, insomnia or hypersomnia, markedly diminished interest or pleasure in almost all activities, recurring thoughts of death or suicide, sense of restlessness or being slowed down, significant weight loss or gain. However, there is no single known cause of depression. Rather, it likely results from a combination of genetic, biochemical, environmental and psychological factors. Depression could be difficult to diagnose, because sometimes people fail to realize or accept that there is a physical cause. Physical symptoms of depression are: headaches, neck aches, dizziness, chest pain, rapid heartbeat, digestive problems, stomach pain, appetite changes, muscle aches, muscle spasms and back pain. Why patients have physical symptoms' Because the brain chemicals or neurotransmitters, serotonin and norepinephrine, influence mood and pain. According to the National Institute of Mental Health in United States, about 14.8 million adults suffer from major depression. Unfortunately, most people with clinical depression never seek treatment. Suicide is the third leading cause of death in people between ages of 10 and 24. Depression can get worst if it is untreated and could end it in suicide. Warnings of suicide are: thoughts or talk of self harm or harm to others, aggressive behavior or impulsiveness, previous suicide attempts can increase the risk for future attempts. When I hear the word depression I think in a big umbrella, because there are different types of depression: major depression – affects about 6.7% of the US population over age 18. It could be undiagnosed and untreated in children and the elderly. Also, about twice as many women as men have major depression. Why' Because of the women hormonal changes during puberty, menstruation, pregnancy, miscarriage, and menopause may increase the risk of having a major depression. Men are less likely to seek help or talk about their experience. Chronic depression or dysthymia – affects about 10.9 million of people in US over age 18. It can begin in childhood or in adulthood. Seems to be more common in women. Bipolar depression - usually appears between ages 15 and 24, and persist throughout a lifetime. Seasonal depression or SAD (seasonal affective disorder) – usually starts in young, adulthood and it is more common in females than in males. Psychotic depression – forms of psychosis: hallucinations, delusions, and / or break with reality. Post partum depression – the onset is within 4 weeks after delivering the child. Atypical depression – the first experience could be at an early age (teenage years). It is not that common and can be under diagnose. Also there are other types of depression: double depression – when a person with chronic depression experiences an episode of major depression. Secondary depression – is a depression that develops after a medical condition or psychiatric problem. Chronic treatment-resistant depression – a condition that last over a year and it is extremely difficult to treat with antidepressant, psychopharmacologic drug and psychotherapies. Marked depression – is when the depression is hidden behind physical complaints and no ho organic cause can be found. Usually depression occurs with other illnesses such as: anxiety, panic disorder, phobias, obsessive compulsive disorder and eating disorder. The most important tool the doctor has to diagnose depression is talking with the patient. The doctor must hear about specific signs and symptoms to make an effective diagnose and to find the best treatment. However, diagnosis depression is often difficult to make, because clinical depression can manifest in many ways. The doctor can make a proper diagnosis if he/she reviews the information given, signs, symptom, patient history, family history, physical exam and some lab test to rule out other serious diseases such as: CT scan, MRI of the brain, ECG (electrocardiogram) and EEG (electroencephalogram). The good news is that once the depression is diagnosed, it is highly treatable and by following the treatment people can get better and have a healthier life. Treatment options are based on the type of depression and the patient. Some options are: medicines, psychotherapy, electric shock treatment, interpersonal therapy, psychodynamic therapy and / or cognitive-behavioral therapy. What are depression drugs' Depression drugs include many types of antidepressants and mood stabilizers. There are four major types of antidepressants: SSRIs (selective serotonin reuptake inhibitors) which alter the amount of serotonin in the brain. SNRIs (serotonin and norepinephrine reuptake inhibitors) which increase availability of serotonin and norepinephrine in the brain. TCAs (tricyclic antidepressants) affect the levels of norepinephrine and serotonin in the brain. It has more side effects, so it’s not going to be the first drug to be prescribed. MAOIs (monoamine oxidase inhibitors). It’s effective in people who do not respond to other treatments. The psychotherapy helps the patient to develop appropriate and workable coping strategies such as: how to deal with everyday stressors. Different types of psychotherapy are: individual, family and group therapy. The ECT or electroconvulsive therapy is used to treat severe depression in patients who were unresponsive to other forms of therapy. During the electroshock therapy the doctor applies a brief electric current through the scalp to the brain and induces a seizure. This therapy seems to work effectively in patients. The interpersonal therapy is a short term, limited focus treatment. It’s been effective in adults, adolescents and children. The therapy puts emphasis on the ways symptoms are related to the person’s relationships, family and peers. The goal is a rapid reduction of symptoms and improves social adjustment. The psychodynamic therapy helps patients to explore the full range of their emotions, including feelings that may not be aware of. By making the non conscious elements of their life a part of their present experience this therapy will help people to understand how their behavior and mood are affected by unresolved issues and unconscious feelings. The cognitive behavioral therapy goal is to help a patient learn to recognize negative patterns of thought, evaluate their validity and replace them with healthier ways of thinking. Coping with depression can be challenging, but improving the coping skills can be very helpful. Also trying the following tips may be beneficial: simplify your life, write a journal, read books, join a support group, don’t become isolated, take care of yourself, learn ways to relax, manage your stress, structure your time and don’t make important decisions when you are down. Depression is a mental illness that affects approximately 18.8 million people or about 9.5% of the US population.