Depression - treatment and symptoms

What is the treatment for depression?

The first step in treatment is a comprehensive assessment of your symptoms and their background by a psychiatrist. He will also do a physical examination and may get some tests done to exclude physical problems that can present as depression. You will be asked to complete questionnaires to assess the severity of your depression.

Treatment options are based on the findings of your assessment. These options will be discussed with you. The treatment of depression rests on two pillars Medication, and Psychotherapy or Counselling.

Medication

7 facts about the treatment of Depression with medication

• 1. Medication is required for moderate and severe depressions.

  2. Formal psychotherapy or counselling can be started later once concentration and thinking improve.

  3. Antidepressant medications are not addicting.

  4. Side effects if any are usually mild, transient, and reversible.

  5. Antidepressants must be taken for at least 4-6 weeks to experience their beneficial effect.

  6. You should continue the full course of medication even if you are feeling better to prevent a relapse.

  7. Suddenly stopping antidepressants can precipitate a relapse. Medication needs be tapered gradually under your doctor’s supervision.

If you follow your doctor's advice regarding follow up visits your treatment will be optimal.

Psychotherapy and Counselling for Depression

Psychotherapy alone may be used in mild depression. It is combined with medication for moderate and severe depressions. Psychotherapy is of two types:

Cognitive Behaviour Therapy (CBT)

Identifies self-defeating, ‘negative thoughts’ and behaviours that perpetuate clinical depression in a vicious cycle. Your therapist then works with you to replace these thoughts and behaviours with ‘positive’ ones to help you recover from the illness.

Interpersonal Therapy (IPT)

Helps people understand and work through troubled relationships that may be at the root of depression or making it worse.

Symptoms of Depression

The hallmark of Clinical Depression is a pervasive depressed mood. This depressed mood is not responsive to positive events. There is associated slowness of thinking and movement; and there are thoughts related to guilt, self-blame, hopelessness and suicide. These features of constitute the classical triad of symptoms for the diagnosis of Clinical Depression.

For a more formal diagnosis some or all of the symptoms below are used

• 1. Persistent sadness. Frequent crying, irritability, ‘emotional outbursts’

  2. Slowing of movement and thoughts

  3. Feelings of guilt - ‘I shouldn’t have done that’, ‘it is all my fault’

  4. Worthlessness - ‘I haven’t achieved anything’, ‘I let my parents down’, ‘what I do has no value’

  5. Hopelessness - ‘What’s the point?’, ‘I don’t see things getting better’

  6. Thoughts of dying and suicide - ‘I would be better off dead’ Loss of interest in activities and hobbies that were once pleasurable

  7. Difficulty concentrating, remembering details, making decisions

  8. Insomnia, early morning wakefulness, excessive sleeping.

  9. Change in appetite – appetite loss or overeating.

  10. Fatigue, lethargy, decreased energy

  11. Unexplained physical symptoms headache, cramps or digestive problems

When do you need help for depression?

Depressed mood or sadness lasting two weeks or more requires treatment. We all feel depressed, sad, or ‘blue’ occasionally. Moods and feelings change in response to events in our external environment. Usually depressive feelings or sadness last for a day or two; longer in case of loss or bereavement. However, if these feelings of sadness and hopelessness persist for more than 2 weeks and interfere with daily life, it indicates a clinical depression.

Depression cannot be overcome by willpower. Depression is not a sign of weakness. Depression is a medical illness resulting from neuro-chemical changes in the brain. Depression is a treatable medical condition. You don't have to live with it.

Take an appointment today to ensure an early return to your normal level of functioning