Apart from the common symptoms of depression, young people may also experience symptoms like:
Aches and pains
Being overweight or underweight.
In teens, symptoms may include:
Excessive negativity in thoughts
Poor academic performance
Alcohol or drug abuse
Excessive eating or sleeping
Loss of interest in normally pleasurable activities
Note that attention-deficit/hyperactivity disorder (ADHD) can also make children irritable but without sadness or loss of interest. However, major depression may accompany ADHD.
Depression symptoms in older adults
Depression at any age is a serious issue which needs proper care. But in older adults, depression may not be detected or treated because it is still believed that getting sad is a part of growing older. While many older people accept this as a reality and refrain from getting treated. Symptoms of depression in older adults include:
Physical manifestations include aches or pain
Tiredness unrelated to age
Difficulty falling or sustaining sleep
Loss of appetite
Rumination and alienation
Suicidal thoughts or attempts
When to see a doctor?
If you have persistent feelings of sadness, visit your doctor immediately. If you're not ready to face your doctor, talk to a friend, partner, family member, a health care professional, a faith leader, or someone you trust.
When to get emergency help?
Thinking of hurting yourself or others? Just stop, take a deep breath and think again or call 911 or your local emergency number immediately.
Here are some options if you are going through thoughts of suicide:
Call your mental health specialist.
Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Use that same number and press "1" to reach the Veterans Crisis Line.
Ask for immediate help from your primary doctor or other health care provider.
Call your friend or partner.
Contact a spiritual leader or someone else in your faith community.
If you find your loved one is on the verge of attempting suicide or has already made an attempt:
Do not leave him/her alone and immediately call 911 or your local emergency number immediately. Or if you can handle the situation, you can take him/her to the nearest hospital emergency room.
The exact cause of depression is not known. Like many mental disorders, depression develops as a result of combined effect of various factors, such as:
Physical abnormalities in the brain may cause depression. However, it’s not clear if these changes really cause depression.
Changes in the levels of chemical messengers in the brain, neurotransmitters, can cause depression and other psychiatric disorders.
Hormonal changes such as those occurring during pregnancy or from menopause or thyroid problems, can either trigger or cause depression.
Your risk for depression may be affected by your genes.
4 Making a Diagnosis
The diagnosis of depression begins after you visit your primary care doctor who may refer you to a mental health specialist.
How to prepare yourself for the visit?
Getting prepared for the visit can optimize the therapy and help make the visit more fruitful. List out all the symptoms.
Write down your key medical information. Mention any recent trauma or stressful event in your life, if any. Write down the names of all your medications, vitamins or supplements. Ask a friend or a family member to accompany you during the visit.
Make a list of the questions to ask your mental health provider
Some typical questions can be:
Could depression be most likely causing my symptoms?
What are the tests needed?
Is there any treatment that is likely to suit me?
Do I need to follow any restrictions?
Do I need to see a psychiatrist or other mental health provider?
What are the side effects of the medications you're recommending?
What your doctor wants to know?
A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your mental health provider who might ask you typical questions like:
When did the symptoms first appear?
How long have you been going through low moods?
Do you have mood fluctuations or it generally remains low?
Do you experience moods swings?
Have you ever thought of suicide during your low times?
Does your condition affect your daily life or relationships?
Do you have a family history of depression or another mood disorder?
Do you have any other mental or physical health conditions? If so, please describe.
Do you take alcohol or recreational drugs?
How’s your sleep? Is it the same or has changes?
Does anything improve or aggravate your symptoms?
Following exams and tests are used to exclude other causes behind your symptoms, establish the diagnosis and identify any related complications:
Along with general physical exam, it includes a conversation between you and your doctor, about your health condition.
It includes various tests such as a complete blood count or a thyroid test to detect if your thyroid is working properly.
Your doctor can ask about your symptoms, thoughts, feelings and behavior patterns. You may also need to fill out a questionnaire.
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
It is manual on mental disorders published by the American Psychiatric Association, which provides diagnostic criteria for many mental disorders including depression. Insurance companies follow this manual when reimbursing for treatment.
For depression treatment, a combination of medications and psychological counseling (psychotherapy) show promising outcomes.
The treatment options for depression include:
Selective serotonin reuptake inhibitors (SSRIs): SSRIs such as fluoxetine, paroxetine, sertraline, citalopram and escitalopram are given at the beginning of therapy.
Serotonin-norepinephrine reuptake inhibitors (SNRIs): Some drugs of this class are duloxetine, venlafaxine, desvenlafaxine and levomilnacipran.
Norepinephrine-dopamine reuptake inhibitors (NDRIs): Bupropion, a drug of this class does not cause any sexual side effects, common with SSRIs.
Atypical antidepressants: Trazodone and mirtazapine due to their sedating effect, are taken in the evening. Newer members of this class include vortioxetine and vilazodone.
Tricyclic antidepressants: They are effective but have more severe side effects and are used if newer medications do not improve the symptoms. Examples include imipramine, nortriptyline, amitriptyline, doxepin, trimipramine and desipramine.
Monoamine oxidase inhibitors (MAOIs): MAOIs such as tranylcypromine, phenelzine and isocarboxazid are used when other medications fail. Follow a strict diet when taking MAOIs as interactions with certain cheeses, pickles and wines, birth control pills, decongestants and certain herbal supplements, can be fatal. Selegiline is available in the form of a skin patch, which causes fewer side effects. Remember MAOIs should not be taken with SSRIs.
Combinations of medications for depression include a combination of
A mood stabilizers or antipsychotics and an antidepressant.
Anti-anxiety and stimulant medications and an antidepressant.
Which medication is right for you?
Finding the answer takes time. Also, medications take time to show their full effects. Have patience till you find the medication that best suits your needs.
You may also try genetic tests to find out how your body responds to a particular antidepressant.
What should you know about antidepressants?
Don’t abruptly discontinue any antidepressant. Talk to your doctor to know further about discontinuation of antidepressant.
Some antidepressants can cause harm to the developing baby or nursing child.
Antidepressants and increased suicide risk
All antidepressant should carry a black box warning, the strictest warning for prescriptions. Children, teenagers and young adults below 25 develop suicidal tendencies during the first weeks after starting or changing the dose. If your loved one is taking antidepressant, keep a close eye on him/her. If s/he develops suicidal thoughts, immediately contact your doctor or get emergency help. Note that antidepressants are meant to improve your mood. Side effects of these drugs slowly reduce over time.
It is a talk therapy which involves talking about your condition and related issues with a mental health provider. Other types of psychotherapy such as cognitive behavioral therapy or interpersonal therapy can also be used to manage symptoms. Other treatments for depression include:
Electroconvulsive therapy (ECT)
This therapy is used in severe and medication-resistant depression or in patients with serious suicidal tendencies. This therapy aims to treat depression by altering the functions of neurotransmitters, which is done by passing electrical currents through the brain. It can cause side effects like headache and temporary memory loss.
Transcranial magnetic stimulation (TMS)
TMS is used when antidepressants become ineffective. It uses magnetic pulses to stimulate brain nerve cells that are involved in mood regulation and depression.
Simply, depression cannot be prevented but risks can be minimized.
To minimize the risk, you may:
Work on to keep stress under control and to boost your self-esteem.
Stay close to family and friends.
Get immediate treatment when depression peeps into your life.
Prevent relapse through long-term maintenance treatment.
7 Alternative and Homeopathic Remedies
Remember alternative remedies used for depression cannot replace medications.
Following supplements have been used in depression:
Some supplements used in depression include:
St. John's wort
It’s a popular depression treating supplement that has not yet been approved by the Food and Drug Administration (FDA) to treat depression in the U.S. People with mild or moderate depression may benefit from St. John’s wort.
DON’T use St. John’s wort along with other antidepressants.
These therapies alone cannot treat depression. Rather, they can be used along with medication and psychotherapy.
8 Lifestyle and Coping
Depression is a disease that requires medical help, but simple lifestyle changes can sometime work wonders in improving your condition and preventing relapse.
Here are some tips:
Stick to your treatment plan: DON’T skip any medication, psychotherapy sessions or appointments.
Expand your knowledge about depression.
DON’T miss the warning signs.
Stay away from alcohol and recreational drugs.
Take a good care of yourself by taking healthy food, exercising and sleeping well.
Here are some tips to help you cope better with the condition
Simplify your life. Don’t strain and be practical.
Write a diary to express your feelings and emotions.
A good book is your best friend
Connect to organizations working to provide education and counseling, 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.
Don't walk away from people and surrounding.
Learn stress management techniques like meditation, progressive muscle relaxation, yoga and tai chi.
9 Risks and Complications
There are several risks and complications associated with depression.
Age: Depression is common in the teens, 20s or 30s, but it can affect person of any age.
Sex: Women seem to be at a greater risk compared to men.
Personality traits, such as low self-esteem, self-critical or pessimistic
Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a damaged relationship, or financial problems
Childhood trauma or depression
A history of depression, bipolar disorder, alcoholism or suicide Being lesbian, gay, bisexual or transgender in an unsupportive situation
History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
Alcohol and drug abuse
Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before discontinuing any medication)
Untreated depression can cause negative impact on every aspect of your life.
Excess weight or obesity, which can lead to heart disease and diabetes
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