Physical symptoms of depression include persistent aches and pains, fatigue and insomnia, and appetite changes. Depression can also exacerbate other health problems, particularly chronic pain.
Several different forms of talk therapy have been shown to help patients with mild-to-moderate depression, including: cognitive behavioral, interpersonal and psychodynamic psychotherapy.
Pharmacotherapies for depression include treatment with selective seratonin reuptake inhibitors (SSRIs), norepinephrine and dopamine reuptake inhibitors, atypical antidepressants, tricyclic antidepressants and monoamine oxidase inhibitors.
Exercise releases endorphins that boost mood, making it a great treatment option for patients with mild-to-moderate depression. Regular exercise has been linked to higher self-esteem, better sleep, less stress and more energy.
Seasonal affective disorder (SAD) is a form of depression linked to seasonal changes with onset usually occurring in the late fall and early winter as the days get shorter. About 3% of the U.S. population experiences SAD. Light therapy, which involves patients sitting in front of a specially designed light box, can be an effective therapy in conjunction with other treatments.
The active ingredient in the herbal supplement St. John’s Wort, hypericin, is thought to exert a mild serotonin reuptake inhibitory effect, thereby maintaining higher levels of intrasynaptic serotonin and improving mood. Clinical trials of St. John’s Wort for depression have shown mixed results, with better efficacy demonstrated for milder forms of depression than severe. Be sure to discuss how St. John’s Wort can interact with other medications with your patients.
Encouraging patients to develop a social support network can be an important part of depression treatment, since loneliness is common aspect of the condition. This can include making an effort to see family and friends more often, taking a class or joining a gym.
For patients with severe melancholic forms of depression or treatment-resistant depression, clinicians may consider electroconvulsive therapy, which consists of administering electric charges to create a controlled seizure in unconscious patients.
Transcranial magnetic stimulation is another option for patients with treatment-resistant depression, in which repeated electromagnetic pulses are used to stimulate electrical currents in the parts of the brain associated with depression without inducing seizure.
One-in-10 U.S. adults are affected by depression, according to the CDC, with certain groups more prone to the condition than others. Depression is most common among people aged 45 to 65 years, women and people of black, Hispanic or mixed race/ethnicity.The exact causes of depression remain unknown, but a variety of factors are thought to be involved including imbalances in the brain’s neurotransmitters; hormone changes linked to thyroid problems, menopause and other conditions; stressful life events; and genetic predisposition. View the slideshow to learn more about the signs and symptoms of depression.