Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead-end job, the best treatment might be finding a more satisfying career rather than simply taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.
Research utilizing brain-imaging technologies, such as magnetic resonance imaging (MRI), shows that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite, and behavior appear to function abnormally. It is not clear which changes seen in the brain may be the cause of depression and which ones the effect.
Interpersonal and cognitive/behavioral therapies are two of the short-term psychotherapies that research has shown to be helpful for some forms of depression. Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate the depression. Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving that are often associated with depression. A form of cognitive behavioral therapy, dialectical behavior therapy (DBT) tends to focus on intensive, simultaneous acceptance of the depression sufferer's abilities, while motivating emotionally healthy changes using a highly structured approach. This form of therapy treats severely or chronically depressed people. Psychodynamic therapies sometimes treat depression. They focus on resolving the patient's internal psychological conflicts rooted in childhood. Long-term psychodynamic therapies are particularly important if there seems to be a lifelong history and pattern of inadequate ways of coping (maladaptive coping mechanisms) by using negative or self-injurious behavior.
ECT involves the application of a brief electric current to carefully selected sites on the scalp. These electric currents, which are administered by a psychiatrist and anaesthetist, produce a minor seizure in the brain. Prior to the procedure, the person is given a short-acting general anaesthetic and a muscle relaxant to reduce awareness of the procedure and to prevent a physical seizure.
It helps to try to think about the last two weeks, rather than just when you felt very anxious or stressed. Also remember that this test is just one part of an assessment of whether anxiety might be a problem for you. There’s more to it, like getting feedback from people who know you well, and looking at how long anxiety’s been a problem for you and how it impacts on your life.
Depressive disorders can make those afflicted feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depressive illness and typically do not accurately reflect the actual situation. Negative thinking fades as treatment begins to take effect. In the meantime, the following are helpful tips for how to fight depression:
There is a danger that, in some people, antidepressant treatment will cause an increase, rather than a decrease, in depression. In fact, the U.S. Food and Drug Administration (FDA) requires that all depression medications include a warning label about the increased risk of suicide in children and young adults. The suicide risk is particularly great during the first month to two months of treatment.
People who are depressed will usually show a style of thinking that focuses on negative views of the world. They often think of themselves as worthless and of the world as being a bad or unfair place, and they are without hope that their lives will improve in the future. When something bad happens, they blame themselves, but when good things happen, they tell themselves they are just lucky. Furthermore, people with depression are less likely to recognize and appreciate positive events when they happen; rather, they tend to be more tuned into the bad things in their lives and brood over those events.
MAOIs also impair the ability to break down tyramine, a substance found in aged cheese, wines, most nuts, chocolate, certain processed meats, and some other foods. Tyramine, like norepinephrine, can elevate blood pressure. Therefore, the consumption of tyramine-containing foods by a patient taking an MAOI drug can cause elevated blood levels of tyramine and dangerously high blood pressure. In addition, MAOIs can interact with over-the-counter cold and cough medications to cause dangerously high blood pressure. The reason for this is that these cold and cough medications often contain drugs that likewise can increase blood pressure. Because of these potentially serious drug and food interactions, MAOIs are usually only prescribed for people who are thought to be willing and able to manage the many dietary restrictions required by these medications and after other treatment options have failed.
Major Depressive Disorder (Clinical Depression); a mental health condition characterized by an inescapable and ongoing low mood often accompanied by low self-esteem and loss of interest or pleasure in activities that a person used to find enjoyable. To meet the criteria for Major Depressive Disorder (MDD), symptoms must be present nearly every day for at least 2 weeks. MDD is also often referred to as Major Depression.
Stimulants such as methylphenidate (Ritalin) or dextroamphetamine (Dexedrine), or their derivatives (for example, Concerta, Metadate or Focalin; Adderall or Vyvanse, or extended-release mixed salts of amphetamine [Mydayis] respectively), which are primarily used to treat attention deficit hyperactivity disorder (ADHD), are also used for the treatment of depression that is resistant to other medications. The stimulants are most commonly used along with other antidepressants or other medications, such as mood stabilizers, antipsychotics, or even thyroid hormone. They are sometimes used alone to treat depression but rarely. The reason they are usually used sparingly and with other medications for depression is that unlike the other medications, they may induce an emotional rush and a high in both depressed and nondepressed people, particularly if taken in doses or ways other than how they are prescribed. Therefore, the stimulants are potentially addictive drugs.
Cognitive behavioral therapy. Pain is demoralizing as well as hurtful. Cognitive behavioral therapy (CBT) is not only an established treatment for anxiety and depression, it is also the best studied psychotherapy for treating pain. CBT is based on the premise that thoughts, feelings, and sensations are all related. Therapists use CBT to help patients learn coping skills so that they can manage, rather than be victimized by, their pain.
Depression is different from anxiety. Rather than feeling anxious and nervous, feelings of gloom and melancholy overwhelm. Feeling sad or down after experiencing a loss or disappointment is an emotion that everyone feels at one time or another. But when low mood and sadness is severe and lasts for long periods of time, it could be due to depression.
“[If there was] certainty that an acute episode [of depression] will last only a week, a month, even a year, it would change everything. It would still be a ghastly ordeal, but the worst thing about it — the incessant yearning for death, the compulsion toward suicide — would drop away. But no, a limited depression, a depression with hope, is a contradiction. … [T]he conviction that it will never end except in death — that is the definition of a severe depression.”
Monoamine oxidase inhibitors (MAOIs) are the earliest developed antidepressants. Examples of MAOIs include phenelzine (Nardil) and tranylcypromine (Parnate). MAOIs elevate the levels of neurochemicals in the brain synapses by inhibiting monoamine oxidase. Monoamine oxidase is the main enzyme that breaks down neurochemicals, such as norepinephrine. When monoamine oxidase is inhibited, the norepinephrine is not broken down and, therefore, the amount of norepinephrine in the brain is increased.
The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.