Understanding Depression -- Diagnosis and Treatment
How Is Depression Diagnosed?
Although very common, depression is often ignored or misdiagnosed and left untreated. Such inattention can be life-threatening; major depression, in particular, has a high suicide rate.
If you or a loved one have symptoms of depression, seek help from a qualified health care provider. Many primary care doctors diagnose and treat depression. But if your symptoms do not improve within four to eight weeks of treatment, ask your health care provider for a referral to a psychiatrist for diagnosis and treatment. Clearly, for more severe symptoms -- and always if you have thoughts about death or hurting yourself or someone else -- you should see a psychiatrist as soon as possible.
To diagnose depression, your health care provider will ask you questions about your symptoms and family history. You may be asked to fill out a questionnaire about your symptoms. You may be given medical tests to rule out other conditions that may be causing your symptoms, such as nutrient deficiencies, underactive thyroid or hormone levels, or reactions to drugs (either prescription or recreational) and/or alcohol.
What Are the Treatments for Depression?
The stigma depression carries drives many people to hide it, try to tough it out, or self-medicate with alcohol, drugs, or herbal remedies to get relief. To effectively treat depression, it is important to seek care from a licensed mental health professional and get a correct diagnosis and treatment plan. Many treatments for depression are available and typically include a combination of psychotherapy and medication.
Psychotherapy teaches patients how to overcome negative attitudes and feelings and helps them return to normal activities.
Drug therapy is intended to treat symptoms that are thought to result from abnormalities in brain circuits that regulate mood, thinking and behavior. It may take several weeks for an antidepressant to fully work to ease depression symptoms, so it's important to stay on the medication.
As with any chronic illness, getting an early medical diagnosis and medical treatment may help reduce the intensity and duration of depression symptoms. It may also reduce the likelihood of a relapse.
Medication for Depression
The group of antidepressants most frequently prescribed today consists of drugs that regulate the chemical serotonin. Known as selective serotonin reuptake inhibitors (SSRIs), the group includes Paxil, Prozac, Celexa, Lexapro, Zoloft and Viibryd. Serotonin norepinephrine reuptake inhibitors (SNRIs) including Effexor, Pristiq, and Cymbalta, also act on serotonin and norepinephrine but in a different way than SSRIs. Other antidepressants include Wellbutrin, a drug that appears to affect dopamine and norepinephrine regulation, and Remeron, which increases levels of serotonin and norepinephrine by a different mechanism than SNRIs. For children and adolescents, the SSRIs are among the best-studied and therefore often the drugs of choice.
The tricyclic antidepressants (TCAs), which have been used to treat depression since the 1950s, are another option, although they are apt to have more side effects than the SSRIs. Like all antidepressant drugs, you must take them for a while before they take effect. TCAs include Amitriptyline, Amoxapine, Desipramine, Doxepin, Imipramine, Nortriptyline, Protriptyline, and Trimipramine.