Depression Treatment Is Different for Everyone
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Depression is a mood disorder marked by feelings of sadness and a loss of interest in things you usually enjoy doing. You might also have a hard time thinking or getting things done, among other symptoms. Thoughts of suicide are possible in more severe cases.
The good news? There are lots of ways to treat depression and get you back to your best self. Hereâs what you need to know.
Depression vs. Depressed Mood
A diagnosis of depression is different from feeling down one day or being in a crappy mood for a few days. These are normal reactions if you lose your job, a loved one dies, or something else happens. But with major depression disorder (MDD), chemicals in your brain donât always work the way theyâre supposed to. Other things, like genetics, sometimes play a role. So you feel this way for a much longer period of time — typically 2 or more weeks.
David A. Adler, MD, a senior psychiatrist and director of the Mental Health Services Research Group at Tufts Medical Center, says that 50% of people diagnosed with MDD will have a second episode of depression. And if youâve had two episodes, thereâs a 75% chance itâll happen a third time, and then a 95% chance of a fourth.
Depression can come on by itself or be triggered by a life event. There are different kinds, some of which include:
Major depression disorder (MDD). This is considered the classic type. It includes common symptoms like loss of interest in hobbies, trouble sleeping, and more.
Persistent depressive disorder. This lasts for at least 2 years, but it may not be as intense as major depression. It used to be called dysthymia.
Postpartum depression. This type of depression happens after giving birth.
Seasonal affective disorder. This can happen as the seasons change and the days get shorter. Experts think it may have something to do with not getting enough sunlight, among other things.
Bipolar disorder. If you have this condition, you may get depressed but also have periods of really high or intense energy levels.
Treating Major Depression Disorder
Treatment depends on the person. What worked for a friend or family member may not work for you. And just because they had certain side effects doesnât mean thatâll happen to you. For example, just because a certain antidepressant triggered weight gain in your mom doesnât mean the same thing will happen to you. Itâs important to approach treatment with an open mind.
Options include:
Psychotherapy. Also called talk therapy, this involves meeting with a mental health professional in person or virtually to talk about and work through your feelings. It âhelps the person optimize their coping strategies to deal with lifeâs stressors,â says James Murrough, MD, PhD, director of the Depression and Anxiety Center for Discovery and Treatment at Mount Sinai.
Antidepressants. These are prescription medications that help balance brain chemicals.
Brain stimulation therapies. This is when doctors use electrical pulses in hopes of changing brain activity. Itâs an option for people who donât respond to psychotherapy or antidepressants.
Electroconvulsive therapy (ECT). This is used for severe depression. Unlike brain stimulation therapies, your doctor puts you to sleep during the procedure. They send electrical currents through the brain to cause a short seizure. This seems to ease symptoms of some mental health conditions.
Murrough says talk therapy and medication are equally likely to be effective in treating a person with MDD. John Greden, MD, founder of the Eisenberg Family Depression Center in Michigan, says he believes people with MDD who receive both psychotherapy and antidepressants fare better.
âIt shouldnât be [psychotherapy] versus [antidepressants],â Greden says.
Itâs important to talk with your doctor honestly about whatâs going on so they can help you decide what might work best. It may take a few tries, but youâll figure it out together.
âThe best evidenced-based treatments follow an individualâs preference, since both medication therapy and the psychotherapies have demonstrated good outcomes,â Adler says.
Side Effects
These also depend on the person. Some people have zero side effects, while others have to try a few antidepressants before they find one whose side effects they can handle.
The older class of traditional antidepressants (monoamine oxidase inhibitors, or MAOIs) were known to cause significant weight gain or lower your sex drive. They worked, but people tend to choose the newer ones that have better âside effect profiles,â Greden says
Lifestyle Changes and Alternative Treatments
Itâs hard to get good data on how lifestyle changes can help manage depression, says Murrough, but âexercise has been shown to have antidepressant effects.â
He says thereâs also evidence to suggest that stress management, whether through meditation or other mindfulness practices, is helpful.
Researchers are also looking into ketamine for treating severe depression.
If youâre having suicidal thoughts or feelings of self-harm, know that youâre not alone. There are resources and people that can help. Reach out to your doctor, a family member, or friend. You can also call the National Suicide Prevention Lifeline at 800-273-8255 or the Substance Abuse and Mental Health Services Administration Helpline at 800-662-4357.
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