Then they will determine the severity of your depression using the HAM-D17 depression severity rating scale:. After your depression severity is determined, your healthcare provider will speak with you about ways to lessen your depression and improve your score.
According to a quick reference guide, Treating Major Depressive Disorder note: this links to a PDF , available from the American Psychiatric Association APA , the severity of depression helps your healthcare provider determine an appropriate course of treatment. The provider will likely discuss your history, including medical, psychiatric, prescription, personal, and family. Taking into consideration your clinical condition, they will decide whether your treatment should take place at home outpatient or in the hospital inpatient.
The APA advises healthcare providers to consider the following when selecting the initial treatment:. There are many ways to treat MDD, including therapeutic medication, psychotherapy or talk therapy , a combination of medication and talk therapy, electroconvulsive therapy ECT or other forms of therapy.
Additionally, some healthcare providers incorporate non-clinical approaches including diet and exercise changes. During the medication selection process, your healthcare provider may suggest that you could be a good candidate for the GeneSight Psychotropic test. If you are a patient who has tried and failed depression medications, it may feel like the doctor is throwing darts at a dartboard from a mile away.
Talk therapy only works if you feel open and comfortable talking about your depression and other aspects of your life. With talk therapy, what you typically get out of it is based on the effort you put in.
This makes sense to me because it suggests that we continue to use the reflective lens in thinking about, talking about and expressing feelings about our inner lives after we end treatment.
The whole talking-with-the-therapist process gets internalized so that self-therapy picks up where the actual therapy leaves off.
Achieving remission can be a long, hard road for people who suffer from clinical depression. The APA guide reports that most treatments take approximately four to eight weeks before a healthcare provider can determine whether the treatment is effective.
Specifically, your healthcare provider may use the following terms to discuss depression treatment goals:. Sometimes, though, the decided-upon treatments do not provide the relief that you need.
After the four to eight weeks, if the recommended treatment does not seem to be effective, your healthcare provider may modify components. Depending on your side effects and other factors, the provider may take several different courses of action.
The low mood will persist for at least 2 weeks, and will be experienced on most days. Sub-types of major depression include:. Bipolar disorder is characterised by extreme mood changes that disrupt daily life.
Symptoms of manic episodes include showing extremely high energy in speech and activity, agitation and a reduced need for sleep. Symptoms of depressive episodes are similar to those of major depression. Cyclothymic disorder is sometimes described as a milder form of bipolar disorder.
The person experiences changing moods for at least 2 years. They have periods of hypomania a mild-to-moderate level of mania and episodes of depressive symptoms. They may also have very short periods of even moods, with fewer than 2 months in between.
Symptoms tend to be less severe and are shorter lasting than in bipolar disorder or major depression. Dysthymic disorder is similar to major depression but with fewer severe symptoms that persist for at least 2 years. Seasonal affective disorder SAD is a mood disorder either depression or mania that has a seasonal pattern. Depressive symptoms tend to start in winter and fade by spring. It can take several winters to diagnose this type of depression.
SAD is thought to be triggered by changes in exposure to light in the winter and is more prevalent in countries with short days and long periods of darkness, such as in the cold climate areas of the Northern Hemisphere. SAD is very rare in Australia. Perinatal and postnatal depression occurs during pregnancy or after the birth of a baby and affects up to 1 in every 5 women in Australia.
It is associated with the challenges and demands of parenthood as well as changes in hormones. For men, new routines and roles can also trigger depression.
All types of depression can be treated and the earlier you seek support, the better. Speak with your doctor about which treatment might be most effective for you. Every person with depression is different, and everyone with depression has a unique set of circumstances. Usually, a combination of factors will contribute.
While you often can't pinpoint the cause of the depression, understanding the circumstances can sometimes help you understand how to best manage it. Life events such as long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness, and constant work stress are all associated with depression. Recent life events such as losing your job, illness, an accident, or the death of someone close to you can trigger depression — particularly if you are already at risk.
Many Australians have been adversely affected by events such as the COVID pandemic and natural disasters such as bushfires. Events like this can sometimes induce symptoms of anxiety and depression. Personal factors such as family history, personality and drug and alcohol use can leave you more vulnerable to depression. People with a family history of depression are at greater risk, possibly because of genetic factors.
However not everyone who has a parent or sibling with depression will develop it themselves. Personality traits — such as perfectionism, low self-esteem and a tendency to worry — can also make depression more likely, but here too the link is not direct. Drug and alcohol use can be both the cause and a consequence of depression.
Reducing alcohol consumption can be very helpful for people with depression, and you can get help from the National Alcohol and Other Drug Hotline on Complex chemical changes that occur in the body, particularly in the brain, when people have depression. Medical conditions can affect the way your brain regulates your moods. Many of the medicines used to treat depression work on these chemical aspects of depression, and have been shown to be very effective in helping to manage severe depression.
A mental health assessment usually involves a discussion or answering a questionnaire, as well as a physical examination. This will help your doctor differentiate between mental and physical health problems.
Your doctor will want to understand how you feel and think, and check for any symptoms of depression, such as in your energy levels, appetite, sleep and whether you are feeling restless, hopeless or sad. If you have a family history of mental illness — either depression or some other condition — tell your GP since this can help with your diagnosis.
Your answers will help your GP determine whether a specialist such as a counsellor, psychologist or psychiatrist might be helpful. If you are experiencing symptoms of depression, its best to seek help early and your GP is a good place to start. There's no need to struggle on your own. Alternative medicine is the use of a nonconventional approach instead of conventional medicine.
Complementary medicine is a nonconventional approach used along with conventional medicine — sometimes called integrative medicine. Make sure you understand the risks as well as possible benefits if you pursue alternative or complementary therapy.
Don't replace conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternative treatments aren't a substitute for medical care.
Nutritional and dietary products aren't monitored by the FDA the same way medications are. You can't always be certain of what you're getting and whether it's safe.
Also, because some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions, talk to your doctor or pharmacist before taking any supplements. Integrative medicine practitioners believe the mind and body must be in harmony for you to stay healthy.
Examples of mind-body techniques that may be helpful for depression include:. Relying solely on these therapies is generally not enough to treat depression. They may be helpful when used in addition to medication and psychotherapy. You may see your primary care doctor, or your doctor may refer you to a mental health professional. Here's some information to help you get ready for your appointment. Take a family member or friend along, if possible, to help you remember all of the information provided during the appointment.
Your doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:. Depression major depressive disorder care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
This content does not have an English version. This content does not have an Arabic version. Diagnosis Your doctor may determine a diagnosis of depression based on: Physical exam. Your doctor may do a physical exam and ask questions about your health.
In some cases, depression may be linked to an underlying physical health problem. Lab tests. For example, your doctor may do a blood test called a complete blood count or test your thyroid to make sure it's functioning properly.
Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions. Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your depression major depressive disorder -related health concerns Start Here. Antidepressants and alcohol: What's the concern? Antidepressants and weight gain: What causes it? Antidepressants: Can they stop working?
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Show references Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn.
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