Depression is a mental illness that affects the way people think and feel about themselves and the people around them. Like other mental disorders, depression can cause behavioral changes that make it difficult to attend school, hold down a job or follow through on family commitments. Fortunately, it’s possible to treat depression and relieve many of these symptoms.
Depression doesn’t affect everyone the same way, but it does cause some common symptoms. In many cases, these symptoms can be treated with outpatient therapy and/or medication, but severe symptoms may require residential treatment. To be diagnosed with clinical depression, a patient must have symptoms for at least two weeks. The patient’s symptoms must also represent a departure from their normal level of functioning. For example, someone may be diagnosed with major depression if their symptoms are causing a sudden decline in grades.
People with depressive disorders may experience some of the following symptoms:
- Persistent sadness
- Lack of interest in normal activities
- Unexpected weight changes
- Difficulty concentrating
- Suicidal thoughts
- Poor sleep habits
- Feelings of worthlessness
- Lack of energy
Types of Depression
The term “depression” can be used to refer to several mental health conditions, including persistent depressive disorder, bipolar depression, seasonal affective disorder (SAD) and postpartum depression. Persistent depressive disorder is diagnosed when someone has a depressed mood that lasts for at least two years. Their depressive symptoms may improve from time to time, but they never completely go away.
Bipolar disorder isn’t the same thing as major depressive disorder (MDD), but the two conditions share some of the same symptoms. People with bipolar disorder typically experience episodes of depression and mania or hypomania. The depressive episodes cause symptoms similar to the ones caused by MDD, including depressed mood, lack of interest in regular activities, appetite changes, fatigue and inability to concentrate.
People with SAD typically display depression symptoms in the winter, which is when there’s less natural sunlight available. A lack of sunlight can cause people with SAD to sleep more, withdraw from social activities and gain weight due to a lack of activity.
Postpartum depression occurs following the birth of a baby. Hormonal changes, the stress of caring for a new baby and other factors can cause normal “baby blues” to turn into a more serious case of depression. Women with this condition may experience severe mood swings, appetite changes, insomnia, feelings of hopelessness or recurrent thoughts of death.
Therapy for Major Depressive Disorder
Cognitive Behavioral Therapy
CBT is used to help patients change their thought patterns so they can better cope with difficult situations. During a CBT session, a skilled mental health professional helps the patient develop confidence and learn how to understand how other people behave, resulting in improved problem-solving capabilities. CBT can also help patients with depression calm their minds and face their fears.
Behavioral activation is a specific type of CBT that helps people with depression understand how their behavior influences their emotions. This option is helpful for people who recognize that they feel better when they can overcome negative thoughts and participate in pleasurable activities. Behavioral activation involves monitoring daily activities, setting goals and working to make gradual changes.
IPT seeks to help patients improve their relationships and address current problems rather than focusing on the past. It can be delivered individually or in a group setting, with a typical program lasting 12 to 16 weeks. During each therapy session, the patient focuses on relationship conflict, life changes and other aspects of life that can affect the way people think about themselves and others.
Dialectical Behavior Therapy
DBT is typically used for people with borderline personality disorder, but it can also be used as a substance abuse treatment or as a treatment for depression in elderly adults. People getting DBT participate in individual therapy and group therapy to help them change their thought patterns, which can increase motivation and enhance their capabilities.
Medications for Depression
Therapy is often used in combination with antidepressant medications, which helps people manage their symptoms and improve their overall functioning. SSRIs, SNRIs, monoamine oxidase inhibitors, tricyclic antidepressants (TCAs) and NDRIs are all classified as depression medicines. They relieve the symptoms of depression by changing a person’s brain chemistry.
- SSRIs: Zoloft, Paxil and Prozac are some of the most common SSRIs, or selective serotonin reuptake inhibitors. These prescription medications treat depression by increasing the amount of serotonin in the brain.
- SNRIs: Cymbalta and Effexor are examples of SNRIs, or serotonin and noradrenaline reuptake inhibitors. These antidepressants increase the amount of serotonin and norepinephrine in the brain.
- MAO inhibitors: These medications treat depression by preventing a substance called monoamine oxidase from removing serotonin, dopamine and norepinephrine from the brain. MAO inhibitors were the first antidepressants on the market.
- TCAs: Like MAO inhibitors, TCAs were some of the first drugs used for treating depression. Since newer medications have fewer side effects, TCAs aren’t prescribed as often as they used to be. Elavil is one of the most common TCAs on the market.
- NDRIs: Norepinephrine and dopamine reuptake inhibitors are prescribed for people who have depression and SAD. They may also be used to treat anxiety disorders and attention deficit hyperactivity disorder. NDRIs prevent the reuptake of norepinephrine and dopamine, leaving more of these chemicals in the brain. Wellbutrin is an example of an NDRI.
Treatment for Severe Depression
Some people develop treatment-resistant depression, which is depression that doesn’t respond to medications or talk therapy. These people may benefit from transcranial magnetic stimulation (TMS), a noninvasive treatment that can relieve symptoms by stimulating the brain with painless magnetic pulses. Unlike other brain stimulation therapies, TMS doesn’t require sedation, making it a safer alternative to electroconvulsive therapy.
During a TMS session, an experienced professional places a magnetic coil against the patient’s head. When the coil is on, it delivers painless magnetic pulses to the brain, producing a clicking or tapping sound.