Warning Signs, Diagnosis, And Treatment For Depression

Depression is a very common mental health condition affecting millions of people. In 2019, more than 19 million adults in the United States¹ experienced a major depressive episode. Depression can make you feel sad, empty, or hopeless for periods of time. There are many different types of depression with various symptoms, and it's always important to seek treatment. A combination of medication, therapy, and lifestyle changes can help you recover and stay well. 

What are the warning signs and symptoms of depression?

It's normal to feel sad sometimes. Problems at work, losing a loved one, or financial stresses can leave you feeling down. However, if these feelings of sadness are persistent for most of the day and nearly every day for more than two weeks, you may be experiencing a depressive episode.

Other symptoms of depression can include:

• Feelings of worthlessness or inappropriate guilt 

• Loss of energy 

• Loss of interest or enjoyment in hobbies or activities

• Changes in your appetite, including eating too much or not eating enough

• Changes in your sleep patterns, including sleeping more or less than usual

• Feelings of restlessness or being slowed down 

• Poor concentration 

• Withdrawing from friends and family

• Being unable to motivate yourself for basic tasks like cleaning or showering

• Having thoughts about harming yourself

Depression can impact your daily life and leave you struggling to function at home or work. If you think you may be suffering from depression, it's important to contact your doctor to discuss your symptoms. They will evaluate you for depression and rule out any underlying medical causes contributing to your symptoms. If your doctor suspects you are suffering from depression, they can create a treatment plan or refer you to a mental health professional for an evaluation. 

How is depression treated?

There are many treatment options to recover from depression. Finding the right treatment is key, but everyone responds differently; what works for one person might not work for another. Your physician or mental health team will work with you to create a treatment plan that’s right for you. This plan may include a combination of medication, therapy, and lifestyle changes to support mental wellness.

Therapy

Talking to a mental health professional in a confidential setting about your thoughts and feelings can ease the symptoms of depression. Therapy can teach you coping skills, so you have tools to work through symptoms and prevent them from overwhelming you.

Cognitive behavioral therapy (CBT) is the most common therapy for treating depression. CBT is effective because it challenges negative thought patterns, teaching you to replace them with healthier, more positive ones.

While CBT is the most common talk therapy for depression, it's not the only option. Another common treatment is interpersonal therapy, which focuses on your relationships with other people and developing better communication skills. Interpersonal therapy is based on the understanding that relationship troubles can worsen or cause depression. The goal is for you to build healthy relationships with others to develop a strong support network. It’s important to have people to rely on during depressive episodes to prevent isolation.

Your therapist may ask you to complete a survey about your symptoms during your first appointment. They will want to know more about you, your medical history, and your lifestyle. Discussing your symptoms can assist your therapist in creating a treatment plan. They may also help you identify and change behaviors that contribute to your symptoms and demonstrate methods to target specific depression symptoms, such as insomnia.

Medication

There are many medications available to treat depression, and the various types treat symptoms differently. Finding the one that works best for you can take time as there are many options. Here’s a benefit, though: if one type of medication isn't working, there are many alternatives to try. The most common types of medications prescribed for depression include:

Selective serotonin reuptake inhibitors (SSRIs)

Doctors most commonly prescribe SSRIs to treat depression, including Lexapro, Prozac, and Zoloft. These medications increase the level of serotonin in your brain, and doctors often prescribe them alongside talk therapy.

Serotonin-norepinephrine reuptake inhibitor (SNRIs)

SNRIs work like SSRIs, but they increase norepinephrine and serotonin, affecting your brain chemistry. These chemicals help the brain transmit signals better and relieve symptoms of depression. Common SNRIs include Cymbalta, Effexor, and Pristiq.

While many people tolerate SSRIs and SNRIs well, they can cause side effects such as:

• Headaches

• Nausea

• Insomnia

• Dizziness

• Change in appetite 

• Sexual dysfunction

If you experience side effects when taking antidepressants, talk to your doctor. They may prescribe something to counteract the side effects or discuss changing your medication to something you may tolerate better. Often, the benefits of these medications outweigh any side effects. However, if they start to impact your well-being, it's important to contact your healthcare provider to discuss alternatives. Abruptly stopping your medication can cause dangerous withdrawal symptoms, so consult a doctor first.

In addition to these two classes, your doctor may recommend other antidepressants.

Natural remedies and lifestyle changes

Along with medication and therapy, certain lifestyle changes can be effective for depression. You can try these alongside your treatment:

Get more exercise

Exercise is incredibly effective at easing depression symptoms. Physical activities can release more endorphins, which increase your sense of well-being and happiness. Find an activity that you enjoy and do it consistently. Exercise can alleviate symptoms, build self-confidence, help you meet new people, and give you something healthy to look forward to.

Improve the quality of your sleep

Deep, restful sleep allows your brain and body to recharge. Develop a healthy nighttime routine by avoiding electronics an hour before bed, keeping your room cool, and going to bed at the same time every day. Be consistent with bedtime routines and avoid long naps.

Skip the alcohol

While alcohol doesn't cause depression, it’s a depressant that can worsen symptoms. Alcohol can increase the frequency and severity of depressive episodes and make antidepressants less effective. Limit your alcohol intake, especially when you’re dealing with symptoms. If you think you may have a drinking problem, speak to your doctor or find a recovery group near you for support.

Eat a healthy and balanced diet

A 2017 study found that depression symptoms eased² for people who received nutritional counseling and stuck to a healthy diet for 12 weeks. Focus on eating a nutritionally balanced diet by including more oily fish, whole grains, and plenty of antioxidants.

Practice meditation and mindfulness

Mindfulness practice focuses your mind on the present rather than worrying about the future or dwelling on the past. Activities like meditation, adult coloring books, or craft projects can keep your mind in the present.

Because there are so many treatment options, it may take time to find the one that's best for you. While it can be difficult to wait for relief, it's important to stick with your treatment plan even if you don't feel like it's working right away. Certain treatments, particularly medication and therapy, can take weeks to kick in. If your symptoms don't improve or worsen after a few weeks, contact your mental health professional for advice.

How is depression diagnosed?

A healthcare or mental health professional can evaluate and diagnose depression. They may diagnose you after performing several tests, including:

A physical examination

Your medical doctor can rule out other underlying causes of your symptoms. Your doctor might also want to run lab tests to rule out other potential causes, such as thyroid issues. If your physical exam and lab results are normal, your doctor may refer you to a mental health professional for an evaluation.

A psychiatric assessment

A mental health professional will perform this assessment. They may ask about your current mood and the symptoms you've been experiencing. Your history and your family's psychiatric history are also relevant, as these can contribute to certain mood disorders. 

To diagnose depression, your healthcare professional will use the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). This book lists the criteria for a diagnosis of depression. Once diagnosed, you'll work with your healthcare team to create a treatment plan.

The lowdown

Depression affects millions of people. Warning signs include feelings of hopelessness, insomnia, changes in appetite or sex drive, or thoughts of harming yourself.

A doctor or mental health professional can diagnose depression. Once diagnosed, there are many treatment options for depression, usually a combination of therapy, medication, and lifestyle changes. The most common therapy recommended for treating depression is cognitive behavioral therapy (CBT).

Medications for depression include SSRIs and SNRIs, focusing on altering brain chemistry. While most people tolerate these medications, there may be side effects such as nausea, headaches, and insomnia. Lifestyle changes can also help with symptoms.

It's important to seek treatment for depression and to stick with your treatment plan, even if you don't think it's working at first. It can often take a few weeks to feel better. Talk to your doctor or mental health professional if your symptoms worsen during this time. There are many treatment options available, and the right combination can get you on the road to recovery and wellness.