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Home > Depression > Treatment
Depression, Not Just a Bad Mood Depression

Depression is a psychiatric disorder that is characterized by extreme feelings of sadness, anehedonia (or loss of pleasure), guilt, helplessness or hopelessness, an inability to concentrate, an increase or decrease of appetite, and thoughts of death. Depressive illness often interferes with an individual's normal functioning and often goes without being diagnosed for long periods of time causing a lot of problems for the both the individual with the illness and those around them.
Depression involves the body, mood and thoughts. It affects the way a person eats and sleeps, the way one feels about themselves and the way one approaches life in general.

 
Quick Facts   Symptoms
Types of Depression   Causes of Depression  
Depression in Women   Depression in Men  
Depression in the Elderly Depression in Children  
Treatment   Help For Depression  
 
Treatment
Diagnosis
In order to properly diagnosis an individual with depression, they need a thorough physical examination completed by a physician. There are medications as well as certain medical conditions that can mimic or create the same symptoms as depression; however, this may not be a depressive syndrome. If a physical cause for the depression is ruled out, a psychological evaluation should be done, by the physician or by referral to a psychiatrist or psychologist.

A good diagnostic evaluation will include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective.

Last, a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness. Treatment choice will depend on the outcome of the evaluation. There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders.

Some people with milder forms may do well with psychotherapy alone. People with moderate to severe depression most often benefit from antidepressants. Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depression. Depending on the patient's diagnosis and severity of symptoms, the therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression.

Electroconvulsive therapy (ECT) is useful; particularly for individuals whose depression is severe or life threatening or who cannot take antidepressant medication. ECT often is effective in cases where antidepressant medications do not provide sufficient relief of symptoms. In recent years, ECT has been much improved. A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses. The stimulation causes a brief (about 30 seconds) seizure within the brain. The person receiving ECT does not consciously experience the electrical stimulus. For full therapeutic benefit, at least several sessions of ECT, typically given at the rate of three per week, are required.

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