Understanding Depression - Diagnosis & Treatment

WEBMD MEDICAL ALERT:

On Oct. 15, 2004, the FDA concluded that antidepressant medications can increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider. Learn more.

Understanding depression is the first step to getting help.

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.

Studies show that 74% of people seeking help for depression go to their primary care physician, and that 50% of these cases are misdiagnosed. Of the cases that are correctly diagnosed by a primary care doctor, 80% are given too little medication for too short a time. Some of this mishandling may occur because patients seek a doctor's help with -- and physicians prescribe for -- physical symptoms, such as sleep problems, fatigue or weight loss, without considering depression as a possible root cause.

Tests should also be made to rule out any organic factors -- such as nutrient deficiencies, underactive thyroid or hormone levels, reactions to drugs (either prescription or recreational) -- that can produce similar symptoms.

The elderly are at greatest risk of being overlooked or misdiagnosed for depression. Frequently, primary care physicians, and the elderly themselves, dismiss symptoms of depression as a part of growing old or categorize it as senile dementia -- an irreversible condition that causes loss of memory and concentration. Sometimes, both depression and dementia are part of the picture. But depression, unlike dementia, can be treated effectively and is reversible, so it is important to recognize depression in the elderly population.

For all of these reasons, it is important to be clear and honest with your health care provider about your symptoms and response to treatment. If symptoms do not improve within four to eight weeks of treatment, tell your doctor that you would like to see 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.

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 effectively treat depression, see a good mental health professional and get a correct diagnosis and treatment plan. Many treatments for depression are available. They vary according to the cause of the depression and its severity.

Major depression and dysthymia are usually treated with a combination of psychotherapy and antidepressants. Psychotherapy aims to teach patients how to overcome negative attitudes and feelings and to encourage them to return to normal activities. Drug therapy is intended to moderate or correct chemical imbalances that affect moods.