Clinical Depression

Feeling sad or downhearted is a normal part of the human condition, just as happiness and joy are. But when those bleak feelings become pervasive and overwhelming, it is likely that the problem is related to a depressive disorder.

What is depression?

Depression is a common but serious mood disorder that affects how people feel, think, and handle daily activities. Not merely a weakness that someone can simply brush off, depression is a complex mental illness that needs professional depression treatment and support. 

Sufferers may experience a persistent sense of sadness that makes them struggle with day-to-day activities. It can affect sleep patterns and overall health, and at its worst, can lead to suicide or alcoholism. But it doesn’t always get that bad. Most people who have depression have only mild symptoms or a few episodes in their life.

Depression is hard to diagnose because it can be mistaken for other conditions. Also, it is not uncommon for sufferers to learn to mask the symptoms or develop various coping mechanisms. Some people are depressed but don’t know it or deny it to themselves or others. They may seem angry, anxious, lost, or hopeless instead of sad when they aren’t coping well.

Symptoms of depression

People with clinical depression may experience a wide range of symptoms, some of which can persist for extended periods. These include:

Ongoing sadness or sense of emptiness

Constant pessimism, or hopelessness

Irritability

Feelings of anxiety, guilt, or worthlessness

Constant fatigue

Disrupted sleep patterns

Over or undereating

Memory problems, poor concentration, and decision-making issues

Restlessness

Loss of interest in previously enjoyed activities

Sluggish speech or movement

Headaches, general aches and pains, stomach problems

Thoughts of death or suicide

However, not everyone with depression experiences all of these symptoms. Some may feel them to varying degrees, with the severity and duration differing from person to person. In some sufferers, symptoms may not be openly evident, since they have developed the ability to remain functional to those around them.

Causes of depression

There are many factors that can cause depression, and these include genetics, childhood trauma, social isolation, bullying, or abuse.

Major depressive disorders can affect people from all walks of life, although they are more common in women than in men. Depression can happen at any age, with symptoms now being recognized in children and adolescents. When occurring in midlife or older adults, it can coincide with other serious medical conditions, such as cancer, heart disease, Parkinson’s disease, or cancer. In some instances, the medications used to treat these illnesses cause depression as a side-effect.

Risk factors for depression

Some factors may make a person more likely to develop depression, while in other instances, risks are related to circumstances. Risk factors include:

Genetic predisposition, or family history of mental illness

Biological conditions, such as underlying illnesses or hormonal imbalances

Environmental influences, such as trauma, stress, or significant life changes

Medications that include depression as a side-effect

Substance abuse

Types of depression

Depression takes various forms, with mental health professionals identifying a number of distinct subcategories:

Persistent depressive disorder or dysthymia: A depressed state that persists for two years or more. It may be interrupted by lesser or more extreme symptoms, but must last a minimum of two years.

Postpartum depression:

A full-blown major depression – unlike more common ‘baby blues’ – which includes feelings of extreme sadness, anxiety, and exhaustion that occur after women have given birth. These feelings may impact new mothers’ ability to care for themselves and their babies.

Psychotic depression:

A depressed state that is accompanied by some form of psychosis, such as delusions or hallucinations, often attached to perceptions of guilt, poverty, or illness.

Seasonal affective disorder:

In this instance, symptoms of depression are related to seasonal changes, generally in the winter months when there is less sun. The disorder is often characterized by withdrawal, extended sleep, and weight gain.

Bipolar disorder:

While not strictly a depression, bipolar disorder includes very low moods that have many symptoms of a major depression. When not experiencing depression, sufferers generally experience extreme highs, which may manifest as euphoria or irritability.

Diagnosing Depression

Diagnosis may include a physical examination, along with questions regarding health and other potential causes of depression. There is no laboratory test for diagnosing depression, but testing may be done to rule out physical conditions that can cause similar symptoms.

In addition to examination and testing, many medical professionals will evaluate the patient based on criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Doctors may assess anxiety levels, psychotic behavior, melancholic features (sadness or lethargy), or catatonia (lack of movement or communication), as well as external conditions such as seasonal patterns, or recent pregnancy or childbirth.

Treatment for Depression

Depression treatment for major depressive disorders should ideally include a combination of counseling and depression medication

Medication alone can be effective, but patients have a better prognosis for long-term health if they are given skills to manage recurring bouts of depression. 

In extreme cases, if medications and psychotherapy are not effective, electroconvulsive therapy (ECT) and other brain stimulation therapies may be indicated. 

Hospitalization may be necessary in cases with a risk of harm to self or if other measures are not effective.

Depression Medications

There are numerous antidepressants available to treat depression. These include Selective Serotonin Reuptake Inhibitors (SSRIs) such as Zoloft or Prozac; Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta and Effexor; Atypical antidepressants such as Wellbutrin and Remeron; Tricyclic antidepressants such as Tofranil or Pamelor; Monoamine oxidase inhibitors (MAOIs) such as Parnate or Nardil. 

Each of these has different methods of working, along with varying side-effects. Doctors may prescribe them in combination or adjust protocols should one type of treatment prove ineffective. 

They may also be used along with other medications such as mood stabilizers, antipsychotics, and anti-anxiety medication.

Psychotherapy

Also known as psychological therapy or talk therapy, this may include various types of therapy such as cognitive behavioral therapy or interpersonal therapy. Based on the individual, a treatment plan can be designed to address certain issues. 

For instance, psychotherapy can help a patient:

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Adjust to a crisis

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Learn to identify negative behavior or beliefs and replace them with healthy ones

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Develop healthy coping skills

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Create realistic life goals

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Find ways to regain a sense of control to manage feelings of hopelessness or anger

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Identify issues that may be contributors to depression

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Build positive, healthy relationships with others

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Learn to handle distress in a healthy manner

Alternate Therapy

Some patients may prefer alternative therapy, such as online sessions, computer programs, or videos. Some health apps on smartphones or tablets can provide support and education, however, they should not be a substitute for professional assistance.

In-hospital Treatment

n severe cases, where there is potential for health issues or self-harm hospitalization may be required. Here, psychiatric treatment can assist until the patient is out of danger. Partial hospitalization and outpatient treatment can also be effective to help control symptoms.

Other Options

When medications are not effective or are contra-indicated, some patients may require other treatments. These include:

Electroconvulsive therapy (ECT), where electrical currents are run through the brain to affect neurotransmitters.

Transcranial magnetic stimulation (TMS) where magnetic pulses are used to stimulate nerve cells in the brain.

Incorporating healthy lifestyle changes to address diet and exercise can be beneficial in managing depression. Avoiding alcohol and recreational drugs, and establishing regular sleep patterns are also important.

People with depression have a better chance of recovery if they make an effort to educate themselves about the condition and stick to their treatment plans. It is wise to pay attention to warning signs to catch recurring bouts before they can start or get worse. Journaling can be helpful for this, along with establishing a strong support network to step in and assist when necessary. 

Isolation is often an indicator of the onset of depression, so maintaining social ties with friends or support groups is important. Taking steps to simplify life and structure time are good methods of avoiding feelings of being overwhelmed. 

It is advisable not to make major decisions during severe bouts of depression.

Get help for depression

While depression may feel like a debilitating condition to overcome, successful treatment is possible. With depression help from trained Psyclarity mental healthcare professionals, people with depression can look forward to a renewed perspective on life and a healthier skillset for dealing with potential triggers.

Get in touch with us today to see how we can help you with effective treatment for depression.

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