Depressive Disorder Treatment

What are Depressive Disorders?

A recent report by Gallup shows that about 18 percent of US adults struggle with depression. That’s over 1 in 6, and the rate has increased by over 7 percentage points since 2015. It also shows that about 3 in 10 adults have received a diagnosis of depression at some point during their life. But why is this rate consistently growing? To understand these statistics, we need to know how mood disorders occur, what can cause them, and available treatment options.

Depressive disorders are a category of mental disorders that have one thing in common: persistent low mood and lack of interest in activities to the extent that it interferes with everyday functions.The disorders classified in the Fifth Edition of the Diagnostic Statistical Manual of Mental Disorders are major, persistent, and other/ unspecified depressive disorders. Based on reports by the National Institute of Mental Health, over 20 million US adults have faced a major depressive disorder.

The disorders classified in the Fifth Edition of the Diagnostic Statistical Manual of Mental Disorders are major, persistent, and other/ unspecified depressive disorders. Based on reports by the National Institute of Mental Health, over 20 million US adults have faced a major depressive disorder.

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Who Does Clinical Depression Affect?

According to the Anxiety and Depression Association of America, 1 out of 8 women experience depression during their lifetime. In men, the risk of depression drops by half. In most cases, people start experiencing symptoms during young adulthood. The National Institute of Mental Health explains that Americans aged 18 to 25 have a higher prevalence of the disorder, i.e., 17 percent. Nevertheless,

the condition itself can occur at any age. The Centers for Disease Control report that over 2 million children between the ages of 3 and 17 are diagnosed with depression.

Of course, being a certain age or gender doesn’t mean that you’ll suffer from depression as well. There are other risk factors associated with the condition.

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Risk Factors for Depression

Certain risk factors can increase your risk of developing a depressive disorder. These include:

Genetics and Family History:

Although there’s no specific gene that causes depression, some combinations of inherited genes can predispose you to develop depression. So if a closely related family member has depression, you’re twice as likely to develop the condition.

Traumatic Experiences:

Research indicates that people with major depressive disorder go are exposed to more traumatic experiences, specifically during their childhood. A study shows that over 60 percent of participants with the disorder face more than two traumatic experiences. In contrast, only about 28 percent of control group participants experienced more than two traumatic experiences.

Gender:

Females have a higher likelihood of developing major depression than males. They also experience greater rates of seasonal affective and persistent depressive disorder, as well as depressive symptoms in bipolar disorder.

Chronic Stress:

Studies have found a significant correlation between stress and depression. This could be the result of a hyperactive HPA axis and high cortisol levels, both of which are common in some mood and anxiety disorders.

Substance Abuse:

Prolonged substance abuse can make the body dependent on drugs or alcohol to produce mood-stabilizing neurotransmitters. This can lead to a higher risk of developing a depressive disorder.

Nutritional Deficiency:

Studies that compare the diets of depressed and non-depressed individuals show that low folate levels reduce your body’s response to antidepressant medication. Similarly, zinc, selenium, iron, and vitamin B12 deficiencies are common in people with depression.

Loss of a Loved One:

Grieving the loss of a loved one is a natural response, and it takes time to recover from such an event. Normally, the intense feelings surrounding the loss of a loved one reduce over time. However, some people find it more difficult to heal, which results in a depressive disorder.

The Difference Between Clinical Depression and Depression

Depression is a mental disorder, while clinical is a sub-type. The type of depression you experience can range from temporary episodes to persistent ones. Clinical depression is characterized by intense feelings of sadness that don’t subside.

Other Disorders that Cause Depression Symptoms

Understanding the cause of your depressive symptoms is crucial to treating it. In some cases, people develop depression as a result of another disorder. This could be a medical condition or mental illness.

Some conditions associated with a higher vulnerability to depression include cancer, Parkinson’s disease, cardiovascular issues, and hypothyroidism. Therefore, treating the existing condition is crucial to improving depressive symptoms.

Similarly, there’s comorbidity between mental health disorders and depression. Some illnesses that commonly co-occur with depression include post-traumatic stress disorder, substance use disorder, and some anxiety disorders.

How is Depression Diagnosed

To receive a diagnosis of depression, you need to meet the diagnostic criteria. Your psychiatrist will evaluate you to determine whether you experience the symptoms outlined by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition.

Low mood throughout the day and almost every day
Low interest in previously enjoyable activities throughout the day and almost every day
Increased or decreased appetite, accompanied by noticeable weight gain or weight loss.
Observable and persistent psychomotor retardation or agitation
Loss of energy almost every day
Feelings of guilt or worthlessness almost every day
Low concentration almost every day
Recurrent suicidal ideation without a plan or a plan to commit suicide

To get a diagnosis, you need to experience at least five of the above-mentioned symptoms, out of which at least one should be among the first two: low mood or a marked loss of pleasure. Moreover, the symptoms must result in impaired functioning and distress. Also, they shouldn’t occur due to a medical condition or substance abuse.

Persistent Depressive Disorder

Previously known as dysthymia, persistent depressive disorder is a chronic form of depression. It’s different from major depressive disorder because of its long duration. So even though the intensity of symptoms is the same, it continues for at least 2 years. It’s characterized by symptoms such as:

low mood for most of the day, every day
feelings of hopelessness
poor concentration
changes in appetite
insomnia or hypersomnia

Compared to major depression, which occurs in episodes, persistent depression is constant. Sometimes, people develop the disorder as far back as childhood. This can lead them to think that depression is simply a part of their life, so they don’t consider seeking any treatment. In these situations, awareness among family members and close friends is crucial for encouraging recovery.

How is Clinical Depression Treated?

Treatment for clinical depression includes a combination of therapy, medication, and an inpatient approach where possible. The most effective methodology involves prescribing antidepressants to help stabilize your mood.

This can help manage your symptoms to a certain extent so you can attend therapy. You’ll work with different therapists and mental health experts to build coping skills, identify harmful thought patterns, and practice relaxation strategies.

Inpatient Program for Treating Depression

For the best outcomes, it’s crucial that you attend therapy regularly and complete the entire course of sessions as prescribed by your psychiatrist. However, in some cases, symptoms can become increasingly debilitating, which can cause you to miss therapy sessions. In such situations, your psychiatrist may recommend a residential program to ensure that you stay on the path to recovery.

URP Behavioral Health offers an extensive residential treatment program that’s designed to help you recover in a comfortable and safe environment. Before you begin therapy, you’ll go through a medical evaluation to rule out the possibility that your symptoms are due to a medical condition of nutritional deficiency. Then, you’ll undergo psychiatric evaluation and assessments to determine your main concerns.

Based on the results, a team of therapists, psychiatrists, physicians, and registered nurses will prepare an individualized plan. During inpatient treatment, you can expect

Individual, group, and family-focused therapy
Medication management counseling
Evidence-based treatments to help you develop coping strategies
Alternative treatments to complement your treatment plan
Nutritional counseling and exercise
Educational support to help residents become financially independent
Life skill training such as communication, vocational, and anger management

Your psychiatrist will monitor your progress and update your treatment plan accordingly. They may recommend a longer stay at the residential program or help you transition to an outpatient model. In outpatient treatment, you visit the treatment center a few times a week to receive therapy. This is suitable for when you’re showing signs of recovery, and symptoms are no longer severe.

Evidence-Based Therapies

At URP Behavioral Health, we offer a range of evidence-based therapies to help you manage depressive symptoms.

Cognitive Behavioral Therapy: A technique used to identify unhelpful and distorted thoughts so you can start working on changing them.
Dialectical Behavioral Therapy: Therapists use DBT to help you build coping skills and address challenges. Its main purpose is to help with emotional regulation.
Family Therapy: In family therapy, your therapist will counsel your loved ones on how to support you during recovery. This is important to create an environment that’s conducive to healing.
Group Therapy: In group therapy, you receive a supportive environment to talk about your experience. When you’re surrounded by people who can relate to your struggles, you’re less likely to feel alone.

Besides the above-mentioned options, you can expect individual psychotherapy and non-verbal methods, such as art and sound therapy. While different treatments are available, the therapies provided will depend on your diagnosis and individualized treatment plan.

Medications for Depression Treatment

To help manage the symptoms of depression, your psychiatrist may prescribe antidepressants such as selective serotonin reuptake inhibitors. This type of medication works by increasing the levels of neurotransmitters in your body. Consequently, you feel better and experience fewer symptoms.

One of the symptoms they help manage includes pain, and they do this by increasing neurotransmitter levels and disrupting pain signals.

At first, you’ll only feel a subtle change in your ability to perform everyday functions. Therefore, you need to be patient when it comes to observing results.

Of course, keep in mind that antidepressants don’t address the cause of the disorder. For instance, if you’ve developed major depression because of traumatic events, medication does little to help you process those hurtful memories. Therefore, mental health specialists recommend seeking therapy in combination with taking medication.

Antidepressants and Increased Suicide Risk

Although antidepressant medications are helpful for reducing some symptoms, they come with certain side effects. One example is that of increased suicide risk. Now, it’s important to remember that these medications don’t induce suicidal thoughts. Rather, people with severe depression already struggle with suicidal ideation.

So, even if you’re no longer struggling with a depressed mood, feelings of hopelessness may persist. Typically, depression symptoms like psychomotor retardation and fatigue can render you incapable of acting out on a suicide plan. After taking antidepressant medication, you’re no longer low on energy, and this can allow you to take steps for a suicide attempt. It’s why professional treatment centers focus on supervising you to ensure that you don’t make the decision to self-harm.

How Long Does Depression Treatment Take to Start Working?

Depending on the medication prescribed to you, it can take a few weeks for it to start working. During this time, it’s important that you don’t miss any doses and take the prescribed dosage. Initially, you may experience some side effects, but these wear off fairly quickly, so you shouldn’t stop taking your dosage.

Other Treatment Options

As a modern treatment center for mental health conditions, URP Behavioral Health adopts a holistic approach to treatment. Therefore, experts at the facility don’t just focus on treating the condition but the entire person. To heal you on a mental, physical, and spiritual level, we provide alternative therapies that work in conjunction with evidence-based treatment to improve the chances of a successful recovery.

There’s evidence that yoga can help boost your body’s serotonin production, which is crucial for the treatment of depression. Similarly, yoga can increase levels of GABA, a brain chemical that can induce a calming effect. It also lowers limbic system activity to curb emotional reactivity. As a result, you maintain a calm response during stressful situations.

A common symptom of depression is fatigue and low energy levels. This can prevent you from getting enough physical activity. A growing body of evidence shows that exercise stimulates the release of endorphins that induce a feeling of well-being. Moreover, it acts as an effective coping strategy for symptoms. It’s why treatment centers like URP Behavioral Health offer different fitness-related amenities.

Animal-assisted therapy is a complementary technique used to alleviate symptoms through interaction with an animal. According to researchers, it can result in the release of endorphins and oxytocin. Studies show that people who received animal-assisted therapy scored lower on depression than people who only received conventional psychotherapy.

Many people with depression report physical symptoms such as pain in areas such as the limbs, back, and head. Alternative treatments such as acupuncture and therapeutic massage are helpful for alleviating muscle pain and relaxing tense muscles. By providing pain relief benefits, these therapies allow you to focus on recovery.

For successful treatment and a better chance at recovery, it’s crucial that mental health experts adopt an interdisciplinary approach. It involves the collaboration between therapists, case managers, physicians, and nurses.

The first person you approached was likely your primary care physician, who evaluated physical symptoms like pain and fatigue. It’s why screening people for depression in primary care settings is crucial. When physicians know what signs to look for, they can refer people to a mental health specialist before symptoms worsen.

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References

FAQ for Depressive Disorders

Here are some of the most commonly asked questions about depressive disorders.

Depressive disorder is characterized by symptoms such as feelings of hopelessness, poor concentration, lack of interest in activities you previously enjoyed, and changes in appetite and sleeping patterns. If these symptoms persist for more than two weeks, you should consider seeing a mental health professional.

Start by speaking to someone you can trust, like a close friend or family member, about your suicidal thoughts. If you don’t have someone like that in your life, call a suicide hotline to speak with a crisis counselor for emotional support and guidance. Next, you should change your environment by going to a calm, public space, a friend’s house, or any safe place where you’re less likely to act on your suicidal thoughts. Make sure ti remove dangerous weapons, substances, and alcohol from your environment and practice grounding techniques.

You can experience physical symptoms of depression, such as gastrointestinal issues, backaches, joint pain, and pain in the limbs. Some symptoms, such as changes in appetite, can lead to overeating or not eating enough, which can cause a higher risk of obesity and nutritional deficiencies, respectively. And because depression is closely linked to stress, you’re prone to higher stress levels as well, which can increase the likelihood of developing cardiovascular issues, inflammation, and low immunity.

The most effective way to treat major depressive disorder is to take medication to alleviate symptoms and go to psychotherapy sessions. Seeing a therapist is crucial for long-term recovery because it helps challenge depressive thoughts and teaches you to change them.

You can try a variety of alternative treatments to alleviate the symptoms of major depressive disorder. These include methods such as yoga, meditation, exercise, and a balanced diet. These treatments can help stabilize your mood because of their effect on brain chemistry. Studies show that exercise can stimulate the release of ‘feel-good’ endorphins that improve your mood.

Author/Medically Reviewed by:

Dr. Emilio Mantero-Atienza, MD, Ph.D, MPH

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