Treatment of major depressive disorder

Medically Reviewed by Dr Sravya, MBBS, MS

Introduction

Depression is a frequent mental health disease that results in changes in how you feel, think, sleep, eat, and behave. There are numerous patterns that demands talking to a therapist, taking medication on time or the combination of the both works well. It is always advice to seek medical assistance as soon as you have symptoms.

A significant mental condition, major depressive disorder is a mood disorder. Feeling gloomy or sorrowful daily for a minimum of two weeks is one of its hallmarks. The majority of episodes, however, go on longer. Major depression comprises other symptoms that affect how you appear, behave, and operate in addition to the mood disorder.

For instance, the association between depression and suicidal thoughts and actions is a major cause for concern. Although untreated serious depression can be crippling, there are effective therapies available. There are several ways to treatment of major depressive disorder, including therapy and medication. When people receive treatment, they can manage serious depression and have fulfilling lives.

Table of Contents

What Leads to Major Depression?

Major depression’s precise origin is still unknown. Major depression typically results from a complicated interaction of causes. These include biological, genetic, environmental, and psychological variables.

Some elements raise your lifetime chance of developing serious depression. The list consists of:

First-degree blood relations who have a history of serious depression
A non-mood disorder is present (such as anxiety, substance abuse, or obsessive-compulsive disorder);
Trauma history or unfavorable childhood memories
Being poor or marginalized
Severe medical conditions
Temperamentally pessimistic or neurotic

Upsetting and stressful life experiences may contribute to the onset of severe depression in some persons. The following situations in life could be stressful:

Divorce
Loss of a close relative
Employment loss
Pregnancy-related factors
Financial Anxiety
Persistent or severe medical disorders
Legal issues

What kinds of depression are there?

The Diagnostic and Statistical Manual of Mental Illnesses, Fifth Edition (DSM-5) published by the American Psychiatric Association divides depressive illnesses into the following categories:

Major depressive disorder, also called clinical depression, is characterized by feelings of sadness, hopelessness, or unworthiness on the majority of days for at least two weeks. It may also include other symptoms like trouble sleeping, loss of interest in previously enjoyed activities, or a change in appetite. The most severe and prevalent type of depression is this one.
Mild to moderate depression that lasts for at least two years is referred to as persistent depressive disorder (PDD). Compared to major depressive illness, the symptoms are less severe. Medical practitioners once referred to PDD as dysthymia.
Disruptive mood dysregulation disorder (DMDD): In children, DMDD results in repeated episodes of extreme irritability and persistent irritability. Typically, symptoms appear around the age of 10.
Premenstrual dysphoric disorder (PMDD): In addition to the symptoms of premenstrual syndrome (PMS), PMDD patients also have mood symptoms such as extreme irritability, anxiety, or depression.
Depression brought on by a different medical condition: Numerous medical problems might alter your body in ways that lead to depression. Examples include cancer, Parkinson's illness, heart disease, and hypothyroidism. When the underlying illness is successfully treated, depression typically gets better as well.

Multiple manifestations of major depressive illness include:

Seasonal depression: Seasonal depression is a type of major depressive disorder that normally develops in the fall and winter and subsides in the spring and summer.
Depression during pregnancy: Depression during pregnancy is referred to as prenatal depression, as is depression following childbirth. Depression that appears within four weeks following childbirth is known as postpartum depression. According to the DSM, these are "major depressive disorder (MDD) with peripartum onset."
Atypical depression: This ailment, also referred to as major depressive disorder with atypical features, has symptoms that are a little different from those of "typical" depression. The primary distinction is a brief rise in mood in response to happy occasions (mood reactivity). The signs of increased hunger and vulnerability to rejection are two more important ones. Along with manic or hypomanic periods, people with bipolar disorder also experience depressive episodes.

Who is affected by depression?

Depression can affect everyone, including adults as well as kids. Women and those assigned female at birth are more likely to develop depression than men and those assigned male at birth.

Certain risk factors increase your likelihood of developing depression. For instance, the following situations are associated with higher rates of depression:

Neurological disorders including Alzheimer's and Parkinson's illnesses.
Stroke.
Several sclerosis.
Epilepsy diseases.
Cancer.
Aging of the retina.
The ache that lasts for a long time.

What signs of depression are there?

Depending on the type, the symptoms of depression might vary slightly and can be anything from moderate to severe. Symptoms typically include:

Children and teenagers with depression may experience agitation instead of sadness.
They may stop enjoying activities that used to bring them delight.
Being prone to annoyance or frustration.
Eating excessively or insufficiently can lead to weight gain or reduction.
Having difficulty sleeping or sleeping excessively.
Feeling worn out or lacking in energy.
It's hard to concentrate, decide what to do, or recall things.
Experiencing physical issues like a headache, a stomachache, or sexual difficulties.
Having suicidal or self-destructive thoughts.

Call the Suicide and Crisis Lifeline at (988) if you or a loved one is having suicidal thoughts. Anytime you need someone, you can always count on them.

The best ways to treat major depressive disorder?

Medical experts may use one or both of the following approaches for treatment of major depressive disorder:

Each patient’s treatment strategy is determined by their symptoms, medical history, and short- and long-term recovery objectives. Starting with medicine and/or therapy, a treatment plan may be modified over time based on symptom changes, adverse effects, and desired outcomes. Finding the ideal course of treatment for a person may take some time and adjusting. Working collaboratively with your treatment team is crucial.

Medications

Treatment of Major depressive disorder plans frequently include psychopharmacology or medication-based therapy. Many depressed persons get relief from prescribed drugs. We refer to these as antidepressants. If antidepressants are the best course of action for your treatment plan, a mental health specialist will assist you in making that decision. Ask your doctor or pharmacist how to take the drug exactly if you get a prescription.

It usually takes antidepressants some time to start working. Although it usually takes between four and eight weeks, people can start to feel the benefits in as little as two weeks.10 Before enhancing a person’s mood, antidepressants frequently begin by treating the milder symptoms, such as irregular eating or sleep. According to some, their drugs prevent them from becoming “too depressed.”

Plan of Care

Finding the ideal drugs and comprehensive treatment plan for an individual can take some time. Depending on their particular depressive scenario. For instance, some individuals do not completely respond to their initial antidepressant therapy. In these circumstances, it is crucial to review the diagnostic evaluation, consider other options, and make sure the patient consistently takes their prescription. When depression symptoms worsen, a mental health practitioner might:

Increasing the present antidepressant's dosage
Alternate your antidepressant
Perhaps supplement the existing antidepressant with another drug
Lithium, bupropion, or atypical antipsychotic drugs like aripiprazole, brexpiprazole, or quetiapine are a few examples of additional medications that can be added to an existing antidepressant.

The following issues should be brought up with your medical team as soon as you start taking antidepressants:

Obtain information on how to use the drugs themselves. This covers a variety of topics, such as how much to take, when to take it, what to do if you miss a dose, potential adverse effects, and more. Get information about any possible interactions with particular foods, alcohol, substances, and prescriptions.

Discuss if you are currently pregnant or intend to get pregnant. Your medical team can assist you in weighing the risks of stopping antidepressants while pregnant against any possible dangers to the fetus.

Whenever you stop taking any medications or if you experience side effects that disturb you, make a plan to talk about the specifics.

Treatments for Depression

One of the most popular treatments for depression is psychotherapy. Therapy, also referred to as ” talk therapy” or “counseling,” benefits those who are depressed:

Recognize the actions, feelings, thoughts, and life experiences that lead to their depression.
Find ways to cope and develop your problem-solving abilities.
Regain control of your life and enjoyment of it.
A skilled, certified mental health expert conducts therapy sessions. They can be carried out in a group or one-on-one situation. Depending on their particular demands, of course.

Interpersonal therapy and cognitive behavioral therapy are the two most popular treatments for depression.

Cognitive behavioral therapy (CBT): Individuals can alter their thought and behavior patterns with the aid of cognitive behavioral therapy (CBT). They can identify and change any false perceptions they may have of themselves and the world around them with the use of CBT. The current events in a person’s life are the main emphasis. Through exercises during sessions and “homework” between sessions, CBT aids in the development of coping abilities in patients. They can learn to alter their thinking, troubling emotions, and undesirable behaviors via this training.

Interpersonal therapy (IBT): The focus of interpersonal therapy (IBT) is on acts and interactions with family and close friends that have a noticeable effect on a person’s mood. It aids people in developing better interpersonal communication skills, realistic expectations, increased self-esteem, and the creation of support systems. Through this work, IPT supports individuals in dealing with issues related to grief, marital discord, and life roles and identities.

Treatment of Depression Using Brain Stimulation

For some people who don’t respond to medicine and counseling, there are alternative options to think about. Therapies for brain stimulation such as electroconvulsive therapy and repeated transcranial magnetic stimulation fall under this category.

When various therapies have failed to help a patient with serious depression, electroconvulsive therapy (ECT) may be an option. It is a technique carried out while the patient is asleep. Each person receives a different amount of treatment. Most patients require six to twelve treatments, which are first administered three times each week.

A non-invasive method is repetitive transcranial magnetic stimulation (rTMS). It stimulates particular portions of the brain using a magnetic field. Initially, sessions usually take place five days a week for a few weeks.

These are the various methods for the treatment of depression.

When should I consult a medical professional regarding depression?

Consult a medical practitioner or mental health expert if you exhibit signs of depression. They can provide you with a precise diagnosis and therapy recommendations.

Speak with your provider if you’ve begun receiving therapy for depression but it isn’t helping or you are experiencing unpleasant side effects. They might advise choosing a different strategy.

What can I do at home to reduce my depression?

You should speak with a medical expert and follow their treatment recommendations religiously. These measures are essential for treating depression. There are methods you can utilize in addition to a treatment plan, though. You could use these tactics to combat and control your symptoms more effectively.

Here are a few instances:

Recognize the factors that could exacerbate your symptoms and, if at all possible, try to avoid them.
Recognize the warning indications of symptoms starting or worsening and seek help as soon as you can.
Include at least 30 minutes of physical exercise in your daily schedule, such as walking around the block, doing household chores, or climbing the stairs in your building.
Go back to the things you used to enjoy doing, like going out to dine, reading, doing puzzles, making phone calls to friends, or seeing a movie.
Concentrate on taking care of yourself; for instance, go for a haircut, a massage, or a manicure.
Establish a sleep regimen with regular wake-ups and bedtimes.
Consume balanced healthy meals and snacks.
Avoid using drugs and alcohol.
Frequently ask for help from close people

Conclusion:

Millions of people worldwide experience depression each year. Anyone can become depressed, even if there doesn’t appear to be a cause. Knowing that depression can be cured is a wonderful thing. For the treatment of major depressive disorder consult a medical expert if you suffer from the symptoms. You’ll heal more quickly the earlier you get help.