Depression

Depression is a common mental illness that can cause a variety of problems, including sexual decline, poor interpersonal relationships, and leave of absence.

Fortunately, depression is a medical condition that can be treated effectively, with a 70% to 80% initial remission rate within two months. Counseling and psychiatric treatment are essential for depression, and antidepressant medications are necessary for moderate to severe depression. In particular, recently developed antidepressants can increase depressed serotonin in the brain to improve depressive symptoms and safely improve depression with little side effects.

Definition

Feeling depressed can be common in everyday life. Depression in psychiatry, however, does not mean a state in which mood is temporarily reduced, but a state in which overall mental functions such as thought content, thought process, motivation, motivation, interest, behavior, sleep, and physical activity are deteriorated. If these symptoms appear almost daily, almost all day, they are called depression and require professional treatment, not just mood swings.

Causes

1. Biological Causes

Depression is caused by an imbalance in the brain’s neurotransmitters. Depression of neurotransmitters in the brain, often called serotonin, is associated with depression. Antidepressants regulate these neurotransmitters to treat the cause of depression.

2. Genetic Causes

Depression is not a genetic disease. However, if you have depressed parents, siblings, or relatives, your chances of becoming depressed may be slightly higher than for the general population.

3. Life and Environmental Stresses

Stress, such as the death of a loved one, parting, loneliness, unemployment, or financial worry, can cause or worsen depression.

4. Physical Illnesses or Drugs

Cancer, endocrine disease, and stroke can cause depression. Even treatment medications can cause some depression. It is reported that more than 20% of internal and external hospital patients who are admitted to the hospital need depression. These depressions need to be diagnosed differently because treating them can improve depression.

Symptoms

1. Main Symptoms

• persistent depression
• Lower motivation, lower interest
• Sleep disorders such as insomnia
• Weight change associated with decreased appetite or increased appetite
• Reduced concentration
• repeatedly thinking about suicide, suicide attempt
• Negative thinking, worthlessness, excessive guilt
• Decreased daily living skills, reduced academic ability, absence from school, reduced productivity, family conflict, divorce, etc.

Depressive patients aren’t happy to do things they used to overcome stress, such as watching movies or meeting friends. Depressed patients may not be able to overcome these things, and these pains may seem to last forever.

2. Characteristic Symptoms of Depression According to Age

• Depression is most common in people in their 30s and 40s, but it can develop at any age. Depression is the most common symptom of depression, but because it is uniquely expressed by age and sex, it is helpful to know the following characteristics.
• In societies where it is considered a virtue to conceal rather than express emotions, depression is often expressed as a physical condition rather than a depressed emotion.
• Women are at increased risk of depression during certain periods, such as postpartum depression and menopausal depression.
• Sometimes the result of depression is alcohol dependence or abuse, which is called secondary alcohol dependence. In this case, treating depression can also improve alcohol problems, so early detection is important.

3. When You Need to Visit a Hospital

If your symptoms persist for more than two weeks and interfere with your daily life, you should consult a psychiatrist. However, when depression is severe, negative thoughts are more likely to dominate, and for this reason, expectation for treatment is often negative. That is why the support and role of guardians, including family and friends, is important. When visiting a hospital, it is also helpful to have a guardian who knows you well and give specific information to your doctor. In particular, if there is a risk of suicide, you should visit immediately.

Diagnoses

1. Self Diagnosis

The CES-D scale is one of the most commonly used self-report scales for screening depression. If you have a total score of 16 or more, you will have a mild depression. If you have a score of 21 or more, you should have a moderate depression. The results of the questionnaire do not necessarily mean the diagnosis of depression. An accurate diagnosis can be obtained by visiting a doctor.

2. Diagnosis Criteria for Depression

Below are the criteria for diagnosing depression, with five or more symptoms out of nine lasting more than two weeks and can be diagnosed if there is an apparent disability compared to conventional function. However, the diagnosis of depression is not made mechanically according to the diagnostic criteria. The most important is the clinical diagnosis through interviews with skilled professionals.

• The depression of most of the day, and almost every day, is manifested in subjective reports (feeling sad or empty) or objective observations (which seem to cry).
  • Note: Children and adolescents may be overly sensitive.
• The interest or enjoyment of all or almost all daily activities is markedly deteriorated most of the day or almost every day (as indicated by subjective explanations or observations by others).
• When you have no weight control (e.g. a change of more than 5% of weight in a month)
• Insomnia or excessive sleep that occur almost every day
• Almost daily psychomotor irritation or delay (subjective left anxiety or drooping feelings can be observed by others)
• Almost daily fatigue or loss of energy
• Feeling worthless or excessive or inappropriate guilt almost every day (not just rebuke or guilt for being sick)
• Decrease in thinking, concentration, or indecisiveness that occurs almost daily (in subjective appeal or observation)
• Thoughts of repeated deaths (not just fear of death), repeated thoughts of suicide without specific plans, or specific plans for committing suicide or conducting suicide

3. Physical Examination

Various physical conditions can cause depression, including hypothyroidism. Therefore, it is important to evaluate other diseases with appropriate tests.

4. Psychological Testing

Self-reporting self-report scales, such as the Beck Depression scale introduced earlier, are helpful. Psychological testing with an experienced clinical psychologist can help you plan your treatment by evaluating your symptoms and evaluating your defense mechanisms and internal resources.

Treatments

Fortunately, depression is a disease that can be effectively treated. The initial rate of completeness reaches 70-80% within two months. The main treatments are psychotherapy and medication.

Counseling may be enough for mild depression, but medication is essential for moderate to severe depression. In particular, recently developed antidepressants increase the level of serotonin that is lowered in the brain, treating the cause of depression and safely improving depression with little side effects.

1. When Treatment Must be Considered

• If the discomfort persists in daily life due to symptoms of depression
• Deterioration in occupational and academic skills
• Risk of suicide
• has a negative impact on the treatment of accompanying medical diseases

Depression is a medical condition that can be treated well. The psychiatrist comprehensively reviews the patient’s symptoms and systemic condition, the progress of the disease, the patient’s preferences, and selects the appropriate treatment with the patient.

2. Stages of Treatment

Treatment of depression is divided into three stages: acute, persistent, and maintenance.

• Acute treatment (2-3 months); For the purpose of symptom related.
• Continuous treatment (4-6 months); It is intended to keep you responsive.
• Maintenance phase treatment (6-24 months); In the case of recurrent depression, the goal is to prevent recurrence.

It usually takes 1 to 2 weeks after taking antidepressants, and at 8 weeks, 70-80% of the symptoms go away. However, depression is often recurrent, so maintenance therapy for 4 to 6 months after acute treatment is a good way to prevent it.

3. Drug Therapy

Antidepressants have played a key role in the treatment of depression, with significant improvements in stability and effectiveness over the past decade.

1) Antidepressants

Usually, it is a drug that acts on serotonin and acts on the nerves of the brain to increase serotonin and normalize the number of receptors to treat depression. Several types of antidepressants are used, it is important to choose the appropriate drug based on the patient’s symptoms and preferences.

Antidepressants, in particular, appear slowly, but have the advantage of not being resistant or dependent. Early treatment may cause side effects such as dry mouth, constipation, and orthostatic hypotension. This should not stop treatment, it is important to talk with your doctor to learn how to deal with the side effects, to adjust the dose or to replace it with another drug.

2) Sleeping pills

Behavioral therapy is important, such as increasing activity without having to sleep or lie down during the day. However, if you have severe insomnia, temporarily using sleeping pills may help improve your symptoms. Anti-anxiety drugs are mainly used, and non-addictive sleeping pills are also useful.

3) Anti-anxiety drugs

It is mainly used in the acute stage of depression for the treatment of accompanying anxiety. Since benzodiazepines are of some resistance and risk of dependence, it is advisable to take the required amount as long as required by a specialist.

4. Psychotherapy

Depending on your needs, you can offer a range of psychiatric consultations, including supportive psychotherapy, psychoanalysis, cognitive behavioral therapy, and interpersonal therapy. This can help prevent depression by reducing the negative thoughts characteristic of depression and improving your ability to cope with stress. Most psychiatrists combine psychotherapy with antidepressants and are known to be the most effective.

5. Other Nonpharmacologic Treatments

Although not commonly used, electrospasm and brain stimulation are also useful treatments.

Electroconvulsive therapy has recently been used safely under general anesthesia, and it is still being used because of the very fast treatment effect in case of high depression or suicide risk.

Brain stimulation is also known to be effective in treating refractory depression.

Frequently Asked Questions

1. How Can I Cope with Depression?

Some patients choose to commit suicide after leaving depression not seen as a disease. Therefore, you must first recognize depression as a disease and know the early signs of depression. You should also be aware of the internal and internal events that shake your mood and design your own response to the symptoms of depression. You may need help around you. In severe cases, consultation with a specialist is essential. Remember that depression is a well treated disease.

2. How a Family Member or Friend Helps a Depressed Patient?

• Do not blame the patient for changes in symptoms (depression, lethargy, non-promise, etc.) due to the symptoms of depression, doubt about whether the depression and talk quietly.
• Careful consideration is given to the difficulties of friends, understanding, empathy and encouragement.
• Encourage the treatment of depression and help to take antidepressant medications for moderate to severe depression.
• Help your friends to express their feelings by listening rather than by giving advice.
• It’s fine to do a variety of activities, such as exercise, without leaving the patient alone, but if you force it too much, the patient may think you don’t know how hard it is.
• If you talk about suicide, ask in detail and seek immediate medical attention if you are at risk of suicide.

3. What are the Lifestyles to Overcome Depression?

• Have positive thoughts.
• Have a habit of exercising.
• Have a regular and balanced diet.
• Alcohol is the enemy of depression, so be sure to avoid.
• Meditation, yoga, relaxation therapy is helpful.
• Take a nap within 30 minutes and use the bed only for sleeping.

4. What Do I Do If I Suspect Depression?

Diagnosis of depression is best advised by a psychiatrist, but there are many ways to get free information on treatment for depression.