With true depression, you have a low mood and other symptoms each day for at least two weeks. Symptoms can also become severe enough to interfere with normal day-to-day activities.

What are the symptoms of depression?

Core (key) symptoms:

  • Persistent sadness or low mood. This may be with or without weepiness.
  • Marked loss of interest or pleasure in activities, even for activities that you normally enjoy.

Other common symptoms:

  • Disturbed sleep compared with your usual pattern.
  • Change in appetite.
  • Fatigue (tiredness) or loss of energy.
  • Agitation or slowing of movements.
  • Poor concentration or indecisiveness.
  • Feelings of worthlessness, or excessive or inappropriate guilt.
  • Recurrent thoughts of death.

An episode of depression is usually diagnosed if:

You have at least five out of the above nine symptoms, with at least one of these a core symptom; and symptoms cause you distress or impair your normal functioning, such as affecting your work performance; and

Many people with depression say that their symptoms are often worse first thing each day. Also, with depression, it is common to develop physical symptoms such as headaches, palpitations, chest pains, and general aches.

Some people with severe depression also develop delusions and/or hallucinations. These are called psychotic symptoms.

Severity of depression

  • Severe depression - you would normally have most or all of the nine symptoms listed above. Also, symptoms markedly interfere with your normal functioning.
  • Moderate depression - you would normally have more than the five symptoms that are needed to make the diagnosis of depression. Also, symptoms will usually include both core symptoms.
  • Mild depression - you would normally have five of the symptoms listed above that are required to make the diagnosis of depression. Also, your normal functioning is only mildly impaired.

What causes depression?

The exact cause is not known. Anyone can develop depression. There may be some genetic factor involved that makes some people more prone to depression than others. An episode of depression may also be triggered by a life event such as a relationship problem, bereavement, redundancy, illness, etc.

Depression and physical conditions

Known physical conditions

Depression is more common than average in people coping with serious or severe physical diseases.

Undiagnosed physical conditions

  • An underactive thyroid gland - can make you feel quite low, weepy, and tired. A blood test can diagnose this.
  • An underactive pituitary gland (hypopituitarism).
  • Head injury - even a relatively mild one, even many years ago.
  • Polymyalgia rheumatica - this condition mainly affects older people. Typical symptoms include stiffness, pain, aching, feeling depressed and tenderness of the large muscles around the shoulders and upper arms.
  • Early dementia.

What are the treatment options for depression?

In general, treatments are divided into those used for mild depression and those used for moderate and severe depression.

Treatment options for moderate or severe depression

Antidepressant medicines

Antidepressant medicines are commonly used to treat moderate or severe depression. A medicine cannot alter your circumstances but symptoms such as low mood, poor sleep, poor concentration, etc, are often eased with an antidepressant.

An antidepressant does not usually work straight away. It can take 2-4 weeks before the effect builds up fully.

Psychological (talking) treatments

Various psychological treatments have been shown in research trials to be good treatments for depression. These are briefly listed below. In general, a combination of an antidepressant plus a psychological treatment is better than either treatment alone. Typically, most psychological treatments for depression last in the range of 12-20 weekly sessions of 1-2 hours per session.

Those most commonly used for moderate or severe depression are:

  • Cognitive behavioural therapy (CBT). Briefly, cognitive therapy is based on the idea that certain ways of thinking can trigger, or fuel, certain mental health problems such as depression. The therapist helps you to understand your thought patterns. In particular, to identify any harmful or unhelpful ideas or thoughts which you have that can make you depressed. The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful.
  • Interpersonal therapy (IPT). IPT is based on the idea that your personal relationships may play a large role in affecting your mood and mental state. The therapist helps you to change your thinking and behaviour and improve your interaction with others.
  • Behavioural activation. The basis of this therapy is that behaviours such as inactivity and ruminating on certain thoughts can be key factors in maintaining depression. The therapist aims to help you to combat these unhelpful behaviours.
  • Couple therapy. This may be an option for people who have a regular partner and where the relationship contributes to the depression. Or, where involving the partner is considered to be of potential useful benefit.

Other treatments

Electroconvulsive therapy (ECT) may be advised as a last resort if you have severe depression which has not improved with other treatments.

Treatment options for mild depression

  • A guided self-help programme
  • Computer-based cognitive behavioural therapy
  • Group-based cognitive behavioural therapy
  • Group-based peer support
    • This is an option for people with depression who also have an ongoing (chronic) physical problem. This allows sharing of experiences and feelings with a group of people who understand the difficulties and issues facing group members.
  • Antidepressant medicines

Some related conditions

Postnatal depression-Some women develop depression just after having a baby.

Bipolar disorder

In some people, depression can alternate with periods of elation and overactivity (mania or hypomania). This is called bipolar disorder (sometimes called manic depression). Treatment tends to include mood stabiliser medicines such as lithium.

Seasonal affective disorder

Some people develop recurrent depression in the winter months only. This is called seasonal affective disorder (SAD).

To know the Top Psychiatrists in Delhi/NCR click here

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