As you know depression is a mental disorder. It is a term to describe sadness or low mood. We have already discussed common causes of depression. In this article you can find how to treat depression.
Before enter into topic I would like to discuss some point. You have to know the classification of depression. Because the treatment of depression is depend on the classification. You may remember the following ICD-10 diagnostic criteria for depression.
- depressed mood or low mood
- loss of interest and enjoyment
- reduced energy leading to diminished activity and tiredness
Other common symptoms are:
- poor concentration and attention
- low self esteem and self confidence
- ideas of guilt and unworthiness
- bleak and pessimistic views of the future
- ideas or acts of self harm or suicide
- sleep disturbances
- loss of appetite
We can classify depression as mild, moderate and severe according to these symptoms. Let me explain how:
If you have at least 2 typical symptoms and 2 other symptoms from above list it’s mild depression. But it’s not affecting your day to day activities that much. You can continue your ordinary work and social activities as usual.
If you have at least 2 typical symptoms and 3 other symptoms from above list it’s moderate depression. Some symptoms may distress you. And also there may be a considerable difficulty in continuing with social, work or other activities.
You should have all 3 typical symptoms and four other symptoms to diagnose severe depression. Usually symptoms are severe. It’s unlikely that the person will be able to continue with normal work. Not only above symptoms but also some other symptoms can be seen in severe depression.
- Delusions of guilt – feels guilty that you are responsible for some negative event.
- Delusions of nihilism – strongly believe that your internal organs are dead. Or else you are dead or you have lost all your possessions.
- Auditory hallucinations – hearing some voices without anyone nearby.
So above types of depression are very important in the treatment of depression.
How to treat depression?
Treating a patient with depression is not easy. Because most of the patients’ insight is poor. They have no idea what’s going on and about their surrounding. Therefore everyone in the management team has a responsibility. Even the patient’s family members have a big roll.
We can divide our goals of treatment of depression as follow:
- Deciding on the treatment setting
- Educating the patient and family
- Providing a support environment
- Minimizing risk of harm
- Pharmacological treatment
- Electroconvulsive therapy
- Psychological therapy
- Follow up
Deciding on the treatment setting
It’s an important aspect in the management. Patients with severe depression can’t be managed at home. Because they have high risk of suicide. So most of the patients with depression should admit to a hospital.
However, mild and sometime moderate depression patients can stay at home. But frequent review by the doctor is necessary. So if your doctors say you have only mild or moderate depression, nothing to be worried. You can continue your normal life without any issue.
Educating the patient and family
As I said before both patient and family members have their own roles here. Therefore it’s better to learn about disease, causes, symptoms, treatment options and prognosis. Then it’s easy to treat depression.
Here are some nice to know things:
- Depression is caused by a combination of biological and psycho-social factors.
- Genes has a major role
- There is alteration of chemicals in the brain. These can be corrected by drugs.
- Treatment options of depression includes drugs, electroconvulsive therapy (ECT) and psychological therapy.
- Antidepressant drugs don’t produce immediate effect. Usually they take at least 2 weeks.
- Any unpleasant or worrisome side-effects must be reported to the doctor.
- Doctors will decide the duration of treatment.
Providing a supportive environment and minimizing the harm
If you having treatments for depression you can take a medical leave. Because it is necessary in depression treatment. Then you don’t have to work under stressful circumstances. So consult with your doctor and get a medical leave from your work place.
Also family members can support a depressed person by helping him. They can help with the care of children, household work and providing emotional support.
They also need to be encouraged to engage in activities. Because it helps them to lift the mood.
If a person having severe depression best thing is admit to the hospital. Because hospital environment is the safest place for them. Nursing staff can observe him/her regularly.
Medical treatments of depression
Antidepressants are the main class of medications in treatment of depression.
There are several classes of antidepressants available to treat depression. Here are the commonly using ones:
Selective serotonin re-uptake inhibitors – SSRI
Fluoxetine, citalopram, fluoxamine, paroxetine and sertraline are some examples. They are more effective as mild to moderate depression treatment.
Tricyclic antidepressants – TCA
Amitriptyline, imipramine and clomipramine are some examples. They are effective in severe depression.
Serotonin noradrenaline re-uptake inhibitors – SNRI
SNRI also very effective to treat depression. Specially in the treatment of severe depression. Venlafaxine is the commonest example.
Apart from above drug classes there are other drugs in treatment of depression.
Antisychotics like Olanzapine is used in severe depression.
Lithium is a drug used in bipolar disorder associated depression. And it’s very effective.
But every drug must be prescribed by a doctor.
Electroconvulsive therapy – ECT
ECT is another method to treat depression. But it’s effective in the treatment of severe depression and post partum depression. It acts faster than drugs.
Electroconvulsive therapy (ECT) is used to treat several psychiatric disorders. It involves passing a carefully controlled electric current through the brain. It’s safe and effective.
Cognitive Behavior Therapy (CBT) is the main aspect in psychological therapy. However it’s effective in many patients. There are well trained therapists for this. But it’s not widely available. It can use together with drugs.
Doctor should assess you frequently. As other follow up is also necessary to treat depression. Usually this is done at hospital clinics.