"It is important to keep taking medication until it has a chance to work, though side effects (see section on Side Effects, pages 19 20) may appear before antidepressant activity does."

"There are no long-term studies that show what kind of impact this medication will have on a child's development."

 

Diagnostic Evaluation And Treatment

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Diagnostic Evaluation And Treatment

Diagnostic Evaluation and Treatment


The first step to getting appropriate treatment for depression is a physical examination by a physician. Certain medications as well as some medical conditions such as a viral infection can cause the same symptoms as depression, and the physician should rule out these possibilities through examination, interview, and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation should be done, by the physician or by referral to a psychiatrist or psychologist.

A good diagnostic evaluation will include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective.

Last, a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness.

Treatment choice will depend on the outcome of the evaluation. There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders. Some people with milder forms may do well with psychotherapy alone. People with moderate to severe depression most often benefit from antidepressants. Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depression. Depending on the patient's diagnosis and severity of symptoms, the therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression.

Electroconvulsive therapy (ECT) is useful, particularly for individuals whose depression is severe or life threatening or who cannot take antidepressant medication. ECT often is effective in cases where antidepressant medications do not provide sufficient relief of symptoms. In recent years, ECT has been much improved. A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses. The stimulation causes a brief (about 30 seconds) seizure within the brain. The person receiving ECT does not consciously experience the electrical stimulus. For full therapeutic benefit, at least several sessions of ECT, typically given at the rate of three per week, are required.

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It's easy to talk about treating the disease when you don't have the symptoms. My point is that when you're diagnosing someone else and telling them what they "ought" to do, it's easy to be levelheaded about the whole thing. When you're the one who's suffering, it's a different story. Take anxiety panic attacks for instance
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Of course, as with any condition, there are plenty of medications on the market. In the case of Agoraphobia, though, medication may not be your best bet. Medication can treat symptoms and lessen the frequency of panic attacks, and it can help you relax, but in the end, you still have the issue of distinguishing between safe and unsafe places
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"Efforts are underway to develop a skin patch system for one of the newer MAOIs, selegiline."

Depression Symptoms Facts

  • Over 70 percent of older suicide victims visit their primary care physician within the month of their death; many have a depressive illness that goes undetected during these visits.
  • Medications alone appear to be helpful in approximately 50% of the cases.
  • Research has revealed that people with alcoholism are almost twice as likely as those without alcoholism to also suffer from major depression.
  • While studies generally indicate that about 25 percent of people with cancer have depression, only 2 percent of cancer patients in one study were receiving antidepressant medication.
  • In 2002, suicide was the third leading cause of death among young males, age 15 to 24.

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Depression Symptoms Article Excerpts

Psychotherapies

"Research has shown that anxiety disorderswhich include post traumatic stress disorder (PTSD), obsessive compulsive disorder, panic disorder, social phobia, and generalized anxiety disordercommonly accompany depression."

Childhood Depression

"We still do not know if depression is truly less common among men, or if men are just less likely than women to recognize, acknowledge, and seek help for depression."

Where To Get Help

"The first step to getting appropriate treatment for depression is a physical examination by a physician."

How To Help Yourself If You Are Depressed

"Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate (or increase) the depression."

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