Your doctor may diagnose major depression if you have five or more of these symptoms most days for 2 weeks or more. At least one of the symptoms should be a depressed mood or loss of interest in activities. If you have depression that lasts 2 years or more, it's called persistent depressive disorder. This term is used to describe two conditions formerly known as dysthymia (persistent low-grade depression) and chronic major depression.
A person with bipolar disorder, which is also sometimes called manic depression, has mood episodes that range from high-energy extremes with a high mood to low depressive periods. When you're in the low phase, you'll have symptoms of major depression. Traditional antidepressants are not always recommended as first-line treatments for bipolar depression because there is no evidence that these drugs are more useful than a placebo (a sugar pill) for treating depression in people with bipolar disorder. In addition, for a small percentage of people with bipolar disorder, some traditional antidepressants may increase the risk of causing a high phase of the disease or speed up the frequency of having more episodes over time.
Seasonal affective disorder is a period of major depression that occurs most often during the winter months, when days get shorter and you get less and less sunlight. It usually disappears in spring and summer. Women who have major depression in the weeks and months after childbirth may have peripartum depression. About 1 in 10 men also experience depression in the peripartum period.
Antidepressant medications may help in a similar way to treating major depression that is not related to childbirth. Persistent depressive disorder is a depressive disorder that affects people for at least two years. The severity of depressive symptoms may vary from person to person, but this type of depression is typically “persistent” in nature for anyone suffering from it. Postpartum depression affects women during pregnancy or after giving birth, and the severity of depression can often be quite severe.
The goal of treatment in the acute phase is to induce remission. For patients with severe major depression, evidence supports drug therapy alone or combination of pharmacotherapy and psychotherapy. There is not enough evidence that psychotherapy alone is effective for major depression. For patients with mild to moderate major depression, initial treatment modalities may include drug therapy alone, psychotherapy alone, or the combination of medical treatment and psychotherapy.
Patients with mild or moderate depression may use antidepressant medications as an initial treatment modality. Clinical features that may suggest that antidepressant medication is preferred over other modalities are a positive response to previous antidepressant treatment, significant disturbances in sleep and appetite, severity of symptoms, or anticipation by the physician that maintenance therapy will be necessary. The patient's preference for antidepressant medication alone should be taken into account. Most primary care physicians can medically treat these patients in their office, as long as they continue to monitor the patient's symptoms closely.
The frequency of monitoring in the acute phase of drug therapy is from once a week to several times a week. Psychotherapy alone can be considered as an initial treatment modality for patients with mild to moderate depressive disorder. Clinical features suggesting the use of psychotherapy are the presence of psychosocial stressors, interpersonal difficulties, intrapsychic conflicts and personality disorders. In addition, the patient's preference for psychotherapy alone should be taken into account, as well as the woman's desire to become pregnant, be pregnant or breastfeed.
Most primary care physicians will refer these patients to a professional psychotherapist for management. The frequency of monitoring in the acute phase of psychotherapy is from once a week to several times a week. Bipolar disorder used to be known as “manic depression” because the person experiences periods of depression and periods of mania, with periods of normal mood between them. Bipolar disorder seems to be more closely related to family history.
Stress and conflict can trigger episodes in people with this condition, and it's not uncommon for bipolar disorder to be misdiagnosed as depression, alcohol or drug abuse, attention deficit hyperactivity disorder (ADHD), or schizophrenia. The diagnosis depends on whether the person has had an episode of mania and, unless observed, may be difficult to detect. It's not uncommon for people to spend years before they get an accurate diagnosis of bipolar disorder. If you're experiencing ups and downs, it's helpful to make it clear to the doctor or healthcare professional who treats you.
Bipolar disorder affects approximately 2 percent of the population. Cyclothymic disorder is often described as a milder form of bipolar disorder. The person experiences chronic fluctuating moods for at least two years, including periods of hypomania (a mild to moderate level of mania) and periods of depressive symptoms, with very short periods (no more than two months) of normal between. The duration of symptoms is shorter, less severe and not as regular and therefore does not fit the criteria for bipolar disorder or major depression.
The symptoms of dysthymia are similar to those of major depression, but are less severe. However, in the case of dysthymia, the symptoms last longer. A person has to have this milder depression for more than two years to be diagnosed with dysthymia. Some people describe depression as a set of symptoms, while others describe depression as a set of stages much like how people articulate the periods of grief they experience.
As mentioned above, depression affects people differently, but it is believed that people experience depression at stages similar to how people experience grief. . .
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