Most people have felt sad or depressed at a certain point in their lives. This feeling can be a normal reaction to loss, life’s struggles, or an injured self-esteem.
Clinical depression is a treatable condition which is characterized by feelings of intense sadness — including feeling helpless, hopeless, and worthless — last for many days to weeks and keep you from functioning normally
- Feeling depressed most of the time for most days of the week.
- Other Symptoms:
- Loss of interest or pleasure in activities
- Weight loss or gain
- Trouble sleeping or daytime sleepiness
- Feelings of being “sped up” or “slowed down”
- Constant tiredness or lack of energy
- Feelings of worthlessness or guilt
- Trouble concentrating or making decisions
- Suicidal thoughts
- Doctors may make a diagnosis if a person has five or more of these symptoms on most days for 2 weeks or longer. Also , at least one of the symptoms must be a depressed mood or loss of interest in activities.
Persistent Depressive Disorder
- Depression that lasts for 2 years or longer. It used to be known as dysthymia.
- Change in your appetite
- Excessive or lack of sleep
- Fatigue or Lack of energy
- Low self-esteem
- Trouble concentrating or making decisions
- Feel hopeless
- Mood episodes that range from extremes of high energy with an “up” mood to low “depressive” periods.
- The low phase consists of symptoms of major depression
Seasonal Affective Disorder (SAD)
- Period of major depression that most often happens during the winter months, when the days grow short and you get less and less sunlight.
- Presents with symptoms of major depression along with “psychotic” symptoms, such as:
- Hallucinations (seeing or hearing things that aren’t there)
- Delusions (false beliefs)
- Paranoia (wrongly believing that others are trying to harm you)
- Major depression in the weeks and months after childbirth
Premenstrual Dysphoric Disorder (PMDD)
- Occurs in women who experience depression and other symptoms at the start of their period
- Other symptoms:
- Mood swings
- Trouble concentrating
- Change in appetite or sleep habits
- Feelings of being overwhelmed
Physician may do/request:
- History & Physical Exam
- Talking with the patient may be the most important diagnostic tool the doctor has.
- The doctor must hear about specific symptoms of depression by talking with a patient and learning about other things that are relevant to making a depression diagnosis.
- It is important to keep these points in mind:
- Only about 30% of people with depression go into full remission after taking their first course of antidepressants. That’s according to a 2006 study funded by the National Institutes of Health. Those who got better were more likely to be taking slightly higher doses for longer periods.
- Some antidepressants work better for certain individuals than others. It’s not uncommon to try different depression medicines during treatment.
- Some people need more than one medicine for depression treatment.
- Antidepressants carry a boxed warning about increased risk compared to placebo for suicidal thinking and behavior in children, adolescents, and young adults 18-24 years old.
- Consult your doctor for the risks and benefits of treatment and the optimization of the medication that best relieves your symptoms.
Types of Anti-depressants:
- Selective serotonin reuptake inhibitors (SSRIs)
- Most common class used for depression. Examples include citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), fluoxetine (Prozac, Sarafem), vortioxetine (Brintellix), and sertraline (Zoloft).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Newer type of antidepressant. Examples include venlafaxine (Effexor), desvenlafaxine (Pristiq and Khedezla), duloxetine (Cymbalta), and, levomilnacipran (Fetzima)
- Tricyclic antidepressants (TCAs)
- Among the first medications used to treat depression. Examples are amitriptyline (Elavil), desipramine (Norpramin, Pertofrane), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil).
- Monoamine oxidase inhibitors (MAOIs)
- Among the earliest treatments for depression. Examples are phenelzine (Nardil), tranylcypromine (Parnate) , isocarboxazid (Marplan), and transdermal selegiline (the EMSAMskin patch).
- Not prescribed very often because of the risk of dangerous reactions
- Bupropion (Wellbutrin, Aplenzin
- Mirtazapine (Remeron)
- Trazodone (Desyrel)