Your repair may determine a diagnosis of depression based on :
- Physical exam. Your doctor may do a physical exam and ask questions about your health. In some cases, depression may be linked to an underlying physical health problem.
- Lab tests. For example, your doctor may do a blood test called a complete blood count or test your thyroid to make sure it’s functioning properly.
- Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.
- DSM-5. Your mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Types of depression
Symptoms caused by major depression can vary from person to person. To clarify the type of low you have, your doctor of the church may add one or more specifiers. A specifier means that you have depression with specific features, such as :
- Anxious distress — depression with unusual restlessness or worry about possible events or loss of control
- Mixed features — simultaneous depression and mania, which includes elevated self-esteem, talking too much and increased energy
- Melancholic features — severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation or sluggishness
- Atypical features — depression that includes the ability to temporarily be cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in the arms or legs
- Psychotic features — depression accompanied by delusions or hallucinations, which may involve personal inadequacy or other negative themes
- Catatonia — depression that includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture
- Peripartum onset — depression that occurs during pregnancy or in the weeks or months after delivery (postpartum)
- Seasonal pattern — depression related to changes in seasons and reduced exposure to sunlight
Other disorders that cause depression symptoms
respective other disorders, such as those below, include depression as a symptom. It ‘s significant to get an accurate diagnosis, so you can get appropriate treatment.
- Bipolar I and II disorders. These mood disorders include mood swings that range from highs (mania) to lows (depression). It’s sometimes difficult to distinguish between bipolar disorder and depression.
- Cyclothymic disorder. Cyclothymic (sy-kloe-THIE-mik) disorder involves highs and lows that are milder than those of bipolar disorder.
- Disruptive mood dysregulation disorder. This mood disorder in children includes chronic and severe irritability and anger with frequent extreme temper outbursts. This disorder typically develops into depressive disorder or anxiety disorder during the teen years or adulthood.
- Persistent depressive disorder. Sometimes called dysthymia (dis-THIE-me-uh), this is a less severe but more chronic form of depression. While it’s usually not disabling, persistent depressive disorder can prevent you from functioning normally in your daily routine and from living life to its fullest.
- Premenstrual dysphoric disorder. This involves depression symptoms associated with hormone changes that begin a week before and improve within a few days after the onset of your period, and are minimal or gone after completion of your period.
- Other depression disorders. This includes depression that’s caused by the use of recreational drugs, some prescribed medications or another medical condition.
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Medications and psychotherapy are effective for most people with depression. Your primary coil care doctor or psychiatrist can prescribe medications to relieve symptoms. however, many people with depression besides benefit from seeing a psychiatrist, psychologist or other mental health professional .
If you have austere depression, you may need a hospital stay, or you may need to participate in an outpatient treatment broadcast until your symptoms improve .
here ‘s a close look at depression discussion options .
many types of antidepressants are available, including those below. Be certain to discuss potential major side effects with your doctor or pharmacist .
- Selective serotonin reuptake inhibitors (SSRIs). Doctors often start by prescribing an SSRI. These drugs are considered safer and generally cause fewer bothersome side effects than other types of antidepressants. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and vilazodone (Viibryd).
- Serotonin-norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima).
- Atypical antidepressants. These medications don’t fit neatly into any of the other antidepressant categories. They include bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone and vortioxetine (Trintellix).
- Tricyclic antidepressants. These drugs — such as imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivactil) — can be very effective, but tend to cause more-severe side effects than newer antidepressants. So tricyclics generally aren’t prescribed unless you’ve tried an SSRI first without improvement.
- Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan) — may be prescribed, typically when other drugs haven’t worked, because they can have serious side effects. Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods ― such as certain cheeses, pickles and wines ― and some medications and herbal supplements. Selegiline (Emsam), a newer MAOI that sticks on the skin as a patch, may cause fewer side effects than other MAOIs do. These medications can’t be combined with SSRIs.
- Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects. Your doctor may recommend combining two antidepressants or adding medications such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications also may be added for short-term use.
Finding the right medication
If a family penis has responded well to an antidepressant, it may be one that could help you. Or you may need to try several medications or a combination of medications before you find one that works. This requires solitaire, as some medications need several weeks or longer to take broad consequence and for side effects to ease as your soundbox adjusts .
Inherited traits play a function in how antidepressants affect you. In some cases, where available, results of genic tests ( done by a blood test or impudence dab ) may offer clues about how your body may respond to a finical antidepressant. however, other variables besides genetics can affect your response to medication .
Risks of abruptly stopping medication
Do n’t stop taking an antidepressant without talking to your doctor first. Antidepressants are n’t considered addictive, but sometimes physical dependence ( which is different from addiction ) can occur .
Stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms, and quitting suddenly may cause a sudden worsening of depression. exploit with your repair to gradually and safely decrease your dose .
Antidepressants and pregnancy
If you ‘re meaning or breast-feeding, some antidepressants may pose an increase health gamble to your unborn child or nursing child. Talk with your sophisticate if you become meaning or you ‘re planning to become meaning .
Antidepressants and increased suicide risk
Most antidepressants are by and large safe, but the Food and Drug Administration ( FDA ) requires all antidepressants to carry a black box warn, the strictest warn for prescriptions. In some cases, children, teenagers and young adults under old age 25 may have an increase in self-destructive thoughts or behavior when taking antidepressants, specially in the first few weeks after starting or when the dose is changed .
Anyone taking an antidepressant should be watched closely for worsening depressive disorder or unusual demeanor, particularly when starting a fresh medicine or with a change in dose. If you or person you know has suicidal thoughts when taking an antidepressant, immediately contact a sophisticate or get emergency help .
Keep in mind that antidepressants are more probably to reduce suicide risk in the long run by improving climate .
Psychotherapy is a general term for treating natural depression by talking about your condition and associate issues with a mental health professional. Psychotherapy is besides known as speak therapy or psychological therapy .
Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or interpersonal therapy. Your mental health professional may besides recommend other types of therapies. Psychotherapy can help you :
- Adjust to a crisis or other current difficulty
- Identify negative beliefs and behaviors and replace them with healthy, positive ones
- Explore relationships and experiences, and develop positive interactions with others
- Find better ways to cope and solve problems
- Identify issues that contribute to your depression and change behaviors that make it worse
- Regain a sense of satisfaction and control in your life and help ease depression symptoms, such as hopelessness and anger
- Learn to set realistic goals for your life
- Develop the ability to tolerate and accept distress using healthier behaviors
Alternate formats for therapy
Formats for depression therapy as an alternative to face-to-face office sessions are available and may be an effective choice for some people. therapy can be provided, for exercise, as a computer program, by on-line sessions, or using videos or workbooks. Programs can be guided by a therapist or be partially or wholly independent .
Before you choose one of these options, discuss these formats with your therapist to determine if they may be helpful for you. besides, ask your therapist if he or she can recommend a hope source or course of study. Some may not be covered by your insurance and not all developers and on-line therapists have the proper credentials or coach .
Smartphones and tablets that offer mobile health apps, such as support and general department of education about depression, are not a alternate for seeing your doctor or therapist .
Hospital and residential treatment
In some people, depressive disorder is so austere that a hospital stay is needed. This may be necessity if you ca n’t care for yourself by rights or when you ‘re in contiguous risk of harming yourself or person else. psychiatric treatment at a hospital can help keep you composure and safe until your temper improves .
fond hospitalization or day treatment programs besides may help some people. These programs provide the outpatient corroborate and rede needed to get symptoms under control .
Other treatment options
For some people, other procedures, sometimes called mind stimulation therapies, may be suggested :
- Electroconvulsive therapy (ECT). In ECT, electrical currents are passed through the brain to impact the function and effect of neurotransmitters in your brain to relieve depression. ECT is usually used for people who don’t get better with medications, can’t take antidepressants for health reasons or are at high risk of suicide.
- Transcranial magnetic stimulation (TMS). TMS may be an option for those who haven’t responded to antidepressants. During TMS, a treatment coil placed against your scalp sends brief magnetic pulses to stimulate nerve cells in your brain that are involved in mood regulation and depression.
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Lifestyle and home remedies
Depression broadly is n’t a disorder that you can treat on your own. But in summation to professional discussion, these self-care steps can help :
- Stick to your treatment plan. Don’t skip psychotherapy sessions or appointments. Even if you’re feeling well, don’t skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-like symptoms. Recognize that it will take time to feel better.
- Learn about depression. Education about your condition can empower you and motivate you to stick to your treatment plan. Encourage your family to learn about depression to help them understand and support you.
- Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your depression symptoms. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Ask relatives or friends to help watch for warning signs.
- Avoid alcohol and recreational drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms and make depression harder to treat. Talk with your doctor or therapist if you need help with alcohol or substance use.
- Take care of yourself. Eat healthy, be physically active and get plenty of sleep. Consider walking, jogging, swimming, gardening or another activity that you enjoy. Sleeping well is important for both your physical and mental well-being. If you’re having trouble sleeping, talk to your doctor about what you can do.
alternative medicine is the use of a nonconventional overture rather of conventional medicine. complementary medicine is a nonconventional approach used along with conventional medicine — sometimes called integrative music .
Make certain you understand the risks arsenic good as potential benefits if you pursue option or complemental therapy. Do n’t replace conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternate treatments are n’t a substitute for medical wish .
Examples of supplements that are sometimes used for low admit :
- St. John’s wort. Although this herbal supplement isn’t approved by the Food and Drug Administration (FDA) to treat depression in the U.S., it may be helpful for mild or moderate depression. But if you choose to use it, be careful — St. John’s wort can interfere with a number of medications, such as heart drugs, blood-thinning drugs, birth control pills, chemotherapy, HIV/AIDS medications and drugs to prevent organ rejection after a transplant. Also, avoid taking St. John’s wort while taking antidepressants because the combination can cause serious side effects.
- SAMe. Pronounced “sam-E,” this dietary supplement is a synthetic form of a chemical that occurs naturally in the body. The name is short for S-adenosylmethionine (es-uh-den-o-sul-muh-THIE-o-neen). SAMe isn’t approved by the FDA to treat depression in the U.S. It may be helpful, but more research is needed. SAMe may trigger mania in people with bipolar disorder.
- Omega-3 fatty acids. These healthy fats are found in cold-water fish, flaxseed, flax oil, walnuts and some other foods. Omega-3 supplements are being studied as a possible treatment for depression. While considered generally safe, in high doses, omega-3 supplements may interact with other medications. More research is needed to determine if eating foods with omega-3 fatty acids can help relieve depression.
Nutritional and dietary products are n’t monitored by the FDA the lapp way medications are. You ca n’t always be certain of what you ‘re getting and whether it ‘s safe. besides, because some herb tea and dietary supplements can interfere with prescription medications or cause dangerous interactions, speak to your doctor or pharmacist before taking any supplements .
consolidative medicine practitioners believe the take care and torso must be in harmony for you to stay healthy. Examples of mind-body techniques that may be helpful for depression include :
- Relaxation techniques such as yoga or tai chi
- Guided imagery
- Massage therapy
- Music or art therapy
- Aerobic exercise
Relying entirely on these therapies is broadly not enough to treat depression. They may be helpful when used in addition to medicine and psychotherapy .
Coping and support
talk with your doctor or therapist about improving your coping skills, and try these tips :
- Simplify your life. Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.
- Write in a journal. Journaling, as part of your treatment, may improve mood by allowing you to express pain, anger, fear or other emotions.
- Read reputable self-help books and websites. Your doctor or therapist may be able to recommend books or websites to read.
- Locate helpful groups. Many organizations, such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance, offer education, support groups, counseling and other resources to help with depression. Employee assistance programs and religious groups also may offer help for mental health concerns.
- Don’t become isolated. Try to participate in social activities, and get together with family or friends regularly. Support groups for people with depression can help you connect to others facing similar challenges and share experiences.
- Learn ways to relax and manage your stress. Examples include meditation, progressive muscle relaxation, yoga and tai chi.
- Structure your time. Plan your day. You may find it helps to make a list of daily tasks, use sticky notes as reminders or use a planner to stay organized.
- Don’t make important decisions when you’re down. Avoid decision-making when you’re feeling depressed, since you may not be thinking clearly.
Preparing for your appointment
You may see your primary care doctor of the church, or your doctor may refer you to a mental health professional. here ‘s some information to help you get ready for your appointee .
What you can do
Before your appointment, make a list of :
- Any symptoms you’ve had, including any that may seem unrelated to the reason for your appointment
- Key personal information, including any major stresses or recent life changes
- All medications, vitamins or other supplements that you’re taking, including dosages
- Questions to ask your doctor or mental health professional
Take a family member or supporter along, if possible, to help you remember all of the information provided during the appointment.
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Some basic questions to ask your doctor of the church include :
- Is depression the most likely cause of my symptoms?
- What are other possible causes for my symptoms?
- What kinds of tests will I need?
- What treatment is likely to work best for me?
- What are the alternatives to the primary approach that you’re suggesting?
- I have these other health conditions. How can I best manage them together?
- Are there any restrictions that I need to follow?
- Should I see a psychiatrist or other mental health professional?
- What are the main side effects of the medications you’re recommending?
- Is there a generic alternative to the medicine you’re prescribing?
- Are there any brochures or other printed material that I can have? What websites do you recommend?
Do n’t hesitate to ask other questions during your date .
What to expect from your doctor
Your sophisticate will probable ask you a total of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your sophisticate may ask :
- When did you or your loved ones first notice your symptoms of depression?
- How long have you felt depressed? Do you generally always feel down, or does your mood fluctuate?
- Does your mood ever swing from feeling down to feeling intensely happy (euphoric) and full of energy?
- Do you ever have suicidal thoughts when you’re feeling down?
- Do your symptoms interfere with your daily life or relationships?
- Do you have any blood relatives with depression or another mood disorder?
- What other mental or physical health conditions do you have?
- Do you drink alcohol or use recreational drugs?
- How much do you sleep at night? Does it change over time?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?