Depression

Overview

What is depression?

Depression is a common mental disorder that affects millions of Americans annually. At least one in six adults will develop depression once in their lifetimes. Depression, also known as major depressive disorder or clinical depression, may seriously impact an individual’s daily activities and mood. Emotional and physical problems may also arise from this condition due to the continued feeling of sadness and despair. It is a biological condition and not just a reaction to life’s circumstances or a “bad day.”

When can you develop depression?

This mental disorder can occur anytime in an individual’s life, but depression is usually initially seen in young adults. Adolescents can also be impacted, and this age group represents over 3 million Americans suffering from depression annually. 

Who is at risk of developing depression?

Women may be more prone to developing depression than men. There is substantial evidence that some individuals may be genetically predisposed to develop depression if a first-degree relative suffers from this illness.

Causes

What causes depression?

Depression can impact anyone at any time in their lives. There are several risk factors that place someone at risk of suffering from depression.

  • Environmental: One example is environmental factors which may play a major role in the development of depression. This may include living under stressful conditions such as abuse, violence, poverty, or neglect.
  • Genetics: Hereditary traits also pose risks for individuals to develop depression as depression is known to run in families.
  • Neurochemicals: Depression also can occur due to certain chemical imbalances in the brain; therefore, someone’s biochemistry may need to be examined for deficiencies to determine if this may be a cause for their depression.
  • Hormones: Hormone imbalance has also been shown to be a cause of depression. This may be related to thyroid problems, pregnancy, weeks or months after delivery of a child, and menopause.
  • Personality traits: Finally, certain personality types may be more prone to developing depression. Those who are easily anxious or stressed, those with low self-confidence, or excessively negative individuals appear to be many of the personality types that are impacted with depression the most.

Symptoms

What are the symptoms of depression?

Depression has a variety of symptoms that ranges from mild to severe. However, over 60% of those diagnosed with depression have a severe impairment. It is important to note that symptoms must be present for at least two weeks to be diagnosed as depression. The symptoms must also represent a change from your previous level of activity. Many common symptoms for depression include:

  • Sadness or depressed mood
  • Thoughts of not wanting to live
  • Extreme weight loss or weight gain
  • Feeling guilty
  • Unexplained medical ailments such as headaches or back pain
  • Low self-esteem
  • Problems with concentration or completing tasks
  • Restlessness
  • Insomnia
  • Slowed speech, thinking, or movements
  • Abnormal fatigue
  • Irritability, even with minor issues
  • Loss of interest in activities that were once enjoyable (anhedonia)

 

Is sadness or grief the same as depression?

Sadness and grief are not the same as depression. People commonly experience traumatic events such as the loss of a loved one, job, or relationship. These are normal feelings for these types of tragic situations. However, grief and depression can coincide after a major traumatic event. Grief and sadness can lead to depression which causes grief and sadness to last longer and be more severe than usual cases.

 

Diagnosis

Who can properly diagnose depression?

If there is suspicion of depression, a healthcare provider can correctly diagnose individuals. Many depressive symptoms may mimic other medical conditions- diseases from vitamin deficiencies, thyroid problems, or neurological disorders.

 

How to diagnose depression?

To accurately diagnose depression, a healthcare provider will need to perform a thorough history and physical examination. Change in medications will be reviewed along with family members’ medical and mental history to determine if there are any genetic links to your symptoms. A comprehensive review of current and past symptoms will be addressed. Lastly, any contributing environmental factors will be taken into consideration to make an accurate diagnosis and effective treatment plan.

 

Can tests be taken to confirm depression?

Bloodwork may be obtained to check for other medical conditions that may cause similar symptoms, but other than this, there is no formal diagnostic test to confirm depression.

 

Treatment

What are treatment success rates for depression?

The treatment success rates for depression vary by individual. Most people suffering from depression will be able to receive relief from their symptoms from a variety of treatment options.

 

What are self-care treatment options for depression?

Initially, many individuals may attempt to relieve their symptoms on their own with self-help treatments. This may include eating a healthy diet, receiving good quality of sleep, regular exercise, and avoiding drugs and alcohol.

 

What are the standard medical treatments for depression?

The major professional forms of treatment for depression include antidepressant medication, psychotherapy, ketamine/esketamine, and transcranial magnetic stimulation (TMS).

 

What is an antidepressant?

Antidepressant medication is a first-line treatment for depression. Usually, symptoms can improve with medication after a few weeks, but full effects of the medication may not occur until six weeks. Modifications of the medication may need to be made if there are no signs of symptoms improving after several weeks of use.

 

How long does someone need to be on antidepressants?

Most healthcare providers will recommend that medication for depression be continued for six months or more. Long-term use may also be recommended for prevention.

 

What is psychotherapy?

Psychotherapy, also known as talk therapy, involves talking with a trained therapist to build coping skills, uncover unhealthy patterns of behavior or relating to people, or just venting.  When combined with medication, the combination can be very effective for treating depression.

 

How long does psychotherapy last?

Treatments may only last a few weeks or can be longer depending on the severity of the depression. The average is 10-15 sessions.

 

What is the most common form of psychotherapy used?

Cognitive behavior therapy is a common therapy technique used for depression as it focuses on problem-solving. It has been shown to help with changing negative thoughts and behaviors to positive ones.

 

When to seek help?

Unfortunately, more than a third of individuals suffering from depression do not seek the help they need for this mental disorder. If you or anyone you may know may show signs of depression, the first step is to get a diagnosis from a licensed healthcare provider. Our experienced healthcare professionals at the Speciality Clinic of Austin are capable of helping diagnose and effectively treat symptoms of depression.

 

References

Hammen, C. (2005). Stress and Depression.  Annual Review of Clinical Psychology 2005 1:1, 293-319.

National Institute of Mental Health.   (2019, February).  Major Depression.  https://www.nimh.nih.gov/health/statistics/major-depression.shtml

Torres, F.  M.D., MBA, DFAPA.  (2020, October).  What is Depression?  American Psychiatric Association.   https://www.psychiatry.org/patients-families/depression/what-is-depression

Information

Medically reviewed by:

Charles Sweet, MD, MPH

Dr. Sweet is a native Texan and attended The University of Texas at Austin for undergraduate studies. He earned his Doctor of Medicine and Master of Public Health degrees at the University of Illinois and then did residency training at the prestigious Johns Hopkins Hospital, Dr. Sweet came back to Austin, TX for specialized training in Child and Adolescent Psychiatry and has been in practice since 2009.

Dr. Sweet believes strongly in working with, and training Physician Assistants to treat the behavioral health needs of adults, children and adolescents.

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