Charlotte, NC
Vikram Karna, MD
Dinesh Sangroula, MD
Serena is a 45-year-old woman. She is married with two kids. She has been under a lot of stress lately. She says it is hard for her to be happy these days, and she has trouble sleeping at night. Could she be depressed?
Depression(Depressive disorder) is a mood disorder that causes feelings of sadness or emptiness. It can affect the way you sleep, eat, feel about yourself, and think about things.
While most of us may normally feel down for a few days, a person who is depressed may persistently feel sad for a long time. For many, depressive disorder happens in recurrent cycles. Depression is a significant cause of disability among adults in the United States. It impacts individuals and their families, children, and work environments. Depressive disorder can also lead to impairment at work, school, and relationships, but it can be treated as long as one seeks medical help.
The Shocking Truth about Depression and COPD
If you have the following symptoms every day for at least two weeks, talk to your family doctor, you could be dealing with depression:
Depression can present differently according to age groups and can be hard to identify.
Children with depression can be anxious and cranky, pretend to be sick often, refuse to go to school, or cling to a parent.
Older children and teenagers with depressive disorder may get into trouble at school, get easily frustrated, or have low self-esteem. They may also deal with anxiety, eating disorders, attention-deficit hyperactivity, or substance use disorder.
Older adults with depressive disorder commonly experience less apparent symptoms. They may report a lack of emotions but refrain from mentioning they are depressed.
Depression affects about 3.8% of the United States population, but everyone is at risk. You are more susceptible to depressive disorder if you have a strong family history of depression and/or negative life experiences and trauma, especially in childhood, or if you lack social support. You could also be at a higher risk if you have chronic medical conditions or lower socioeconomic status. If you use drugs or other substances, you could have depression as well. Hormonal problems surrounding menstruation and childbirth can also place you at a higher risk of depression.
Your doctor will ask questions about your mood, behavior, and how often you experience feelings of depression. You will be asked how you feel and if you are having suicidal thoughts. They may also ask if you have access to firearms. You will need to provide your medical history of mania/hypomania, anxiety, substance use disorder, and psychosis. Your doctor will also review the medicines you are taking and can ask about other substances you use.
Depending on your need, your doctor will develop an individualized plan to treat your depressive disorder with therapy, medicine, or a combination of both. You and your doctor will work together to identify a plan that works best for you. For some people, depression improves over weeks to months, and your doctor can stop treatment according to your needs. For others, long-term and continuous treatment is necessary to help manage symptoms of depression, especially for recurrent depression. Maintaining social support such as friends, coworkers, or family and regular physical activity can help avoid future depression. Your primary care physician can often treat depression. However, sometimes, a referral to a psychiatrist can be more effective in exploring more advanced therapy options.
Medication: There are many types of antidepressants on the market. Your doctor will help you choose the best one for you. If you have problems with sleeping, you will be prescribed medications that will allow you to have healthy sleeping habits. Sometimes if you have a poor appetite, you may be prescribed medications that increase it. Do note that the medications may take several weeks before they begin working.
Your doctor will decide the type of antidepressant medication based on your severity of depression and your symptoms. It is essential to know the side effects of the drug. Side effects are common in the first few weeks but improve over time. Notify your doctor before stopping any medication because of side effects. Your doctor can help you with a medication plan to treat your depressive disorder safely.
Psychotherapy: Psychotherapy is best described as ’talk therapy and has proven effective for depressive disorder. The most evidence-based therapy for depressive disorder is called cognitive behavioral therapy. This process involves evaluating and changing your thoughts and behaviors and improving your coping ability. Psychotherapy does help and can often be as effective as medication for mild to moderate depressive disorder and in lowering the risk of future relapses. However, medication and therapy combinations have been proven to be most effective for moderate to severe depression.
It may take one to two months (for medication) or longer (for therapy) before you start feeling better. If you do not feel better after two months of treatment, talk to your doctor and adjust your treatment plan.
Once you begin treatment, you should gradually feel better. This will eventually improve your mood. It will also help if you keep trying new things or put yourself in situations where you enjoy yourself.
Here are some things you can do to lower your risk for depressive disorder or to prevent relapses
Depression is the most common cause of suicide. Do not be afraid to ask for help. If you feel you may harm yourself or need help, call 911 or the local suicidal hotline or go to the emergency department immediately.
Incze, M. A. (2019). I’m Worried About Depression—What Should I Know? JAMA Internal Medicine, 179(11), 1612. https://doi.org/10.1001/jamainternmed.2019.0637
Jin, J. (2016). Screening for Depression. Journal of the American Medical Association, 315(4), 428. https://doi.org/10.1001/jama.2015.19234
National Institute of Mental Health. (2022, September). Depression. https://www.nimh.nih.gov/health/topics/depression
Torpy, J. M. (2010). Depression. Journal of the American Medical Association, 303(19), 1994. https://doi.org/10.1001/jama.303.19.1994
