We so often hear others say “I feel so depressed.” But are they really DEPRESSED? What is “clinical” depression and how can it be treated.
According to the DSM V, the current version of the Diagnostic and Statistical Manual of Mental Illness, major depressive disorder must last for at least two weeks and there must be five of the following nine symptoms.
The first and most important of these is severe dysphoria (meaning bad mood) or anhedonia (means loss of pleasure in what one usually found pleasurable). Without one of these, there is no “real depression”. So if you find that you no longer enjoy reading a good romance novel, or watching your favorite TV show, or something like that, you are experiencing anhedonia. Feeling really sad, hopeless, and bleak illustrates dysphoria.
The next symptoms are body-centered. Such as problems sleeping, either too much or too little, unintentional gaining or losing 5% of one’s body weight, a change in appetite is another body symptom. Loss of sex drive is another. Lack of energy or uncharacteristic slowness of body movement or agitation are symptoms, as well as a pervasive sense of fatigue. Symptoms may follow a daytime pattern, being worse in the morning and somewhat better in the late afternoon or evening.
There are also mental symptoms, too. An inability to concentrate or focus is often a depressive symptom. Decision-making may become very difficult or impossible. Recurring thoughts of death and/or suicide often occur. Feelings of worthlessness or excessive guilt are often also present.
As I said earlier, of these nine symptoms, at least five must be present, every day, for most of the day for at least two weeks.
If you or a loved one is showing these symptoms, it is important to seek treatment.
Okay, what kind of treatment? There are four distinct treatment areas. The first and most important is suicide prevention. Since major depression can lead to suicide, that possibility must be looked at first and acted upon if necessary. This may involve others such as family and friends, and medical/psychological intervention as well.
The second is medication such as antidepressants. There are several types of antidepressants, none of which are addictive. A medical doctor or psychiatrist can prescribe these, choosing which type is expected to be the most effective. Today the most commonly prescribed are Selective Seratonin Reuptake Inhibitors, or SSRI’s. Most antidepressants take from two to six weeks to reach an effective blood level and begin to work.
During this time, and continuing as needed by the patient, psychotherapy is used to support and later to facilitate insight into the depressive episode, its causes and life changes, and will lessen the depression and may prevent recurrence.
The fourth treatment area, involves the patient’s support system. Spouses, friends, adult children and other family members may need to take an active part in the patient’s treatment. There are three reasons for the family to be involved in the treatment—to support the patient, to support the family, and in some cases, to treat the family. Family treatment may be called for if there a dysfunctional family system is a major stressor, contributing to the depression.
So, what I would like to leave you with today is the information that a Major Depressive Episode, contains at least 5 out of 9 identifiable symptoms, that it can be effectively treated by first assessing for suicidality, the use of anti-depressants along with psychotherapy and by the support or the patient’s family and friends.
If you or a loved one is having these symptoms, GET HELP. Although depression is common, it is serious and is also very painful and very treatable.