Depression

Types of depression

There are several forms of depression including:

• Perinatal depression — typically develops within two weeks after having a baby, women who suffer from perinatal depression feel extreme anxiety, sadness and exhaustion.
• Psychotic depression — a person with severe depression coupled with delusions or hallucinations may have psychotic depression.
• Persistent depressive disorder — if you have depression that lasts two years or more, you may have persistent depressive disorder.
• Seasonal affective disorder — if you experience symptoms of depression in the winter year after year, you may have seasonal affective disorder.
• Bipolar disorder — people with bipolar disorder experience a roller coaster of emotions going from very high to very low in a short period of time.

Causes of depression

Although no one knows exactly what causes depression, there are many factors that can contribute to it including:

• Medications — certain medications such as antiviral drugs or corticosteroids can lead to depression.
• Conflict
• Major life changes such as death or a break up — changes such as death of a loved one or a break up with a significant other can cause depression.
• Genetics — depression can be passed down through generations of a family.
• Abuse (physical or mental) — people who have been abused may develop depression later in life.

Risk factors for depression

People who are more likely to suffer from depression include:

• People who have been (or are being) physically, sexually or emotionally abused are more likely to suffer from depression
• People who take certain medications such as corticosteroids
• People who have a family history of mental illnesses
• People who have suffered a traumatic loss or death
• People addicted to alcohol or tobacco or other illicit drugs
• People going through major life events such as divorce or bankruptcy

Symptoms of depression

Most people experience sadness, loneliness or mild depression at some point in their lives. When these feelings become overwhelming, impact your day-to-day life and last longer than two weeks at a time, you may have clinical depression.

Symptoms of depression include:

• Excessive sadness
• Feeling of hopelessness
• Insomnia
• Fatigue
• Trouble concentrating
• Loss of appetite
• Suicidal thoughts
• Gastrointestinal problems

Diagnosis of depression

A primary care doctor can diagnose depression in a physical exam. During the exam, your doctor will take a full medical history to evaluate your symptoms, how long they have lasted as well as how severe they are. The physician will also get a full family history and ask questions to determine if you have a history of substance abuse.

If the physician diagnoses you with severe depression, you may be referred to a mental health specialist for further testing and care.

Treatment for depression

Treatment for depression will depend on how severe your case is. Treatment options may include medication or psychotherapy. In some cases, you may be prescribed both medication and psychotherapy.

Medications

Medications are successful for most people who suffer from depression. Types of antidepressants include:

• Selective serotonin reuptake inhibitors — SSRIs are the first-line medication used to treat depression, including Paxil, Celexa, Zoloft and Prozac.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) — Cymbalta, Effexor XR and Fetzima are examples of this medication.
• Other antidepressants — examples include Wellbutrin, Wellbutrin SR and Aplenzin, which are not SSRIs or SNRIs
• Tricyclic antidepressants — less commonly used antidepressant that is used after SSRIs fail, these medications have dangerous side effects.
• Monoamine oxidase inhibitors (MAOIs) — these medications have serious side effects and are typically only prescribed as a last resort.

Patients on antidepressants should be closely monitored by their doctor. There are risks associated with taking antidepressants, such as increased suicide risk, that need to be closely monitored.

Psychotherapy

Many patients who suffer from depression are referred to mental health professionals such as psychiatrists or psychologists who can help patients deal with challenging situations. The benefits of psychotherapy include:

• Turn around negative thoughts
• Learn to deal with problems
• Determine how to set goals
• Evaluate the emotions causing the depression

Severely depressed or suicidal patients may need advanced hospital or residential based treatments. These types of treatment programs can help keep you safe until you are more stable.