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Depression
The difference between a depressive episode and depression
Depressive episodes and depression refer to the same condition; depressive episodes are also known as depression. Especially clinically, when patients experience depressive episodes, they mainly exhibit low mood, slow thinking, lack of interest and pleasure, diminished will and activity, overall subdued emotional state, sluggish and blank brain responses, lack of interest in daily life, and importantly, an inability to feel pleasure or control. Patients often feel passive, lethargic, and lack anticipation for future life. They typically experience decreased appetite, sleep disturbances, reduced sexual function, and fatigue. Patients frequently describe themselves as incapable, useless, incompetent, and hopeless, leading to low self-esteem and self-blame significantly contributes to their issues. They also feel like a burden to society, and thus, severe cases may include suicidal thoughts and behaviors, which are relatively common symptoms in clinical settings.
How is depression diagnosed?
The diagnosis of depression in clinical practice includes understanding the patient's clinical manifestations, conducting in-depth psychiatric examinations, scale measurements, and excluding auxiliary examinations related to depression. Clinically, it is important to fully understand the occurrence, development, progression, and treatment process of depression-related manifestations in patients. Additionally, psychiatric examinations focus on detailed assessments of the patients’ sensations, perceptions, consciousness, thinking, emotions, attention, memory, intelligence, and self-control, to further understand their overall psychological state. Scale measurements often involve self-assessment scales, depressive symptom self-rating scales or external assessment scales for comprehensive evaluation. Exclusion diagnostics primarily involve corresponding tests, such as thyroid examinations, to rule out physical diseases that may cause symptoms related to depression. After compiling all the information mentioned above, a definitive diagnosis of depression can be made.
What is the best treatment for mild depression?
In clinical practice, the first choice of treatment for mild depression is generally psychotherapy, especially recommended cognitive behavioral therapy, psychodynamic therapy, and interpersonal therapy. In cognitive behavioral therapy, it is particularly important to help patients identify automatic thoughts, including teaching patients to recognize automatic thoughts, emotions, and behaviors. By correcting irrational cognitive patterns, such as catastrophizing, magnifying, and overgeneralization, a new cognitive system is reestablished to achieve effective treatment goals. Additionally, physical therapies like repetitive transcranial magnetic stimulation can also be chosen to alleviate symptoms of mild depression. However, for some patients with depression, pharmacotherapy can also be considered, particularly recommended are first-line serotonin reuptake inhibitors. It is crucial to follow the doctor's advice during the clinical treatment process and adhere to a systematic and standardized medication treatment throughout the illness.
What should I do about depression?
Once diagnosed with depression clinically, it is necessary to optimize and grade the treatment based on the severity of the patient's condition. Particularly for patients with moderate to severe depression, clinical doctors primarily consider pharmacotherapy, especially drugs that improve neurochemicals like serotonin and norepinephrine in the brain. The first-line medications recommended are serotonin reuptake inhibitors. In addition, during the medication process, it is important to ensure adequate dosage, full treatment duration, and systematic standardized treatment throughout the course of the disease. Additionally, in terms of psychological and physical therapies, cognitive-behavioral therapy is predominant in psychological treatment. It includes helping patients identify emotions, thoughts, behaviors, and effectively reconstructing systems to achieve therapeutic goals. For physical therapy options, repeated transcranial magnetic stimulation, light therapy, and electroconvulsive therapy can be considered. (Please follow professional medical advice for medication usage.)
Does mild depression affect pregnancy?
"[Generally, mild depression does not affect the ability to become pregnant normally, but it is not recommended to take medication during pregnancy, as some medications can affect the normal development of the fetus, even impacting the baby's brain development. If mild depression can be managed through psychological adjustment, that is best; it's important not to use medication lightly. In daily life, family and friends should also provide psychological comfort to the pregnant woman, helping her to safely get through the pregnancy. However, if mild depression is not treated effectively and timely, it can impact the entire pregnancy.]"
How to treat geriatric depression effectively?
Elderly depression should be treated comprehensively. Firstly, it is important to enhance the diet and supplement nutrition. Secondly, through psychotherapy, mainly to alleviate or relieve symptoms, improve patients' compliance with drug treatment, and reduce or eliminate the adverse consequences of the disease. Thirdly, pharmacotherapy can involve the use of selective serotonin reuptake inhibitors, selective serotonin, and norepinephrine reuptake inhibitors, which are widely used in the treatment of elderly patients with depression. Fourth, modified electroconvulsive therapy is an option. Through the aforementioned comprehensive treatment, the clinical symptoms of depression can be improved. (Medication should be used under the guidance of a physician.)
Is depression prone to recurrence?
Depression is a disease with a high incidence rate, so in clinical practice, the treatment of depression requires systematic standardization, adequate dosages, and full courses of treatment, and it is also a disease with a high cure rate. After standardized systemic treatment, a cure rate of over 85% can be achieved. However, nearly 50% of the patients may relapse one year after undergoing standardized treatment. Therefore, during the treatment process, not only pharmacotherapy is needed but also psychotherapy and self-adjustment methods. A comprehensive and systematic treatment can ultimately improve the cure rate of patients, reduce the recurrence rate, and effectively treat the disease.
Where is the best place to massage for depression?
The massage points for depression vary according to different diagnostic types of the condition in Chinese medicine. For example, for patients with liver depression and spleen deficiency, massage can be given at Taichong, Fenglong, Zusanli, and Tiantu. For patients with liver depression and qi stagnation, points such as Baihui, Yintang, Shenmen, Neiguan, and Taichong can be massaged. In cases of heart and spleen deficiencies, the massage points include Shenmen, Xinshu, Pishu, Sanyinjiao, Zusanli, and Zhangmen. For patients with kidney deficiency and liver depression, key points are Taichong, Qimen, Neiguan, Danzhong, and Guanyuan. As for patients with heavy damp-heat in liver and gallbladder, massage points like Xingjian, Sanyinjiao, and Zhongji can be selected during massage.
Is elderly depression easy to treat?
Depression in the elderly is difficult to treat because compared to younger patients, depression in the elderly tends to last longer with an average duration often exceeding one year, and episodes occur more frequently, often becoming chronic. Additionally, the prognosis for elderly depression is worse compared to other age groups, primarily due to the coexistence of cerebrovascular diseases and other physical comorbidities, recent acute illnesses, long-term ongoing diseases, as well as the presence of delusions and a lack of social support systems. Thus, depression in the elderly is quite challenging to treat.
Is moderate depression serious?
Patients with moderate depression are quite serious. The core manifestations in clinical practice include low mood, inability to feel happy, reduced energy, and predominantly negative thinking. These symptoms often lead to a decline in the patient's social and occupational functioning, affecting their work, study, life, social interactions, and family life. Patients typically present with a lack of desire to groom themselves or pay attention to their attire, and they often have a dull gaze and an unpleasant emotional experience. There is generally a lack of energy and interest. In terms of cognitive thinking, they often exhibit feelings of worthlessness, pessimism, guilt, uselessness, or despair. Behaviorally, they often show psychomotor retardation, meaning they walk and act slowly, think sluggishly, cannot relax, and sometimes exhibit symptoms of restlessness.