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Depression
How long does it take for depression to get better?
The treatment of depression is generally divided into three stages: acute phase treatment, continuation phase treatment, and maintenance phase treatment. The complete recovery from depression depends on the individual characteristics of the patient. The acute phase treatment usually lasts one to three months, mainly focusing on controlling the symptoms related to depression. Additionally, during the continuation phase treatment, the medication period generally lasts four to nine months, and its main goal is to maintain the stability of the patient's condition and prevent relapse of the disease. As for the maintenance phase treatment, the duration of treatment is to be determined. Typically, the duration is one to two years after the first onset, three to five years after the second onset, and for patients who have had more than three episodes, it is recommended to maintain a low-dose medication treatment to prevent recurrence of the disease.
How to Cure Geriatric Depression
For geriatric depression, the treatment includes several aspects. Firstly, it is important to strengthen the patient's diet and nutrition supplementation. Secondly, certain psychological therapies should be provided to the depressed patients. The aim is mainly to alleviate or relieve symptoms, improve patients’ compliance with medication, prevent relapse, and reduce or eliminate the adverse consequences caused by the disease. The third aspect is to provide certain medication treatments, such as the currently used selective serotonin reuptake inhibitors (SSRIs), and selective norepinephrine reuptake inhibitors (SNRIs). These types of medications have been widely used in patients with geriatric depression disorders. Among them, SSRIs are quite effective for geriatric depression disorders and can effectively counteract cholinergic and have milder adverse reactions on the cardiovascular system, making it easy for elderly patients to accept and maintain long-term treatment. The fourth aspect is the improvement of electroconvulsive therapy, which can significantly improve depression when combined with comprehensive treatment. However, since depression has a high recurrence rate, full-course treatment is recommended.
Where to get a diagnosis for depression?
The diagnosis of depression often recommends consulting with a psychiatry or psychology department for confirmation. Clinically, depression is categorized as a mental and psychological disorder, primarily characterized by low mood, slow thinking, and reduced willpower. Patients usually lack interest and pleasure, feel fatigued, self-blame, valuelessness, incapability, have low self-esteem, and poor concentration. They often feel that life is meaningless, harboring thoughts or behaviors of self-harm and suicide. They view the future as bleak, sad, helpless, and hopeless. Patients generally exhibit poor eating and sleeping habits, and there is a noticeable decline in sexual function. Therefore, in clinical settings, if the aforementioned symptoms persist for over two weeks and interfere with work, study, daily life, social, and occupational functions, a clear diagnosis is required to develop a treatment plan involving medication, psychotherapy, and physical therapy.
How to self-rescue from depression
Patients with depression can self-help through self-adjustment or seek help from a doctor. Clinically, the method of self-adjustment mainly involves exercise, which is also called behavioral activation training in psychology. Exercise can relax the muscles throughout the body. Additionally, exercise can stimulate the brain to release the "happiness element" endorphins, which have a significant improving effect on depression and anxiety. Other methods include venting and shifting attention. Venting typically involves expressing feelings through spoken or written words to others, especially close friends and family. By expressing these feelings, depressive emotions can also be articulated. Shifting attention, clinically, involves engaging in personal interests such as painting, fishing, or listening to music, which can increase pleasure and enhance motivation. Alternatively, seeking help from a doctor usually involves psychotherapy and medication, which often yield good results.
How to manage mild depression
Mild depression is primarily treated clinically through self-adjustment, psychotherapy, or physical therapy. Self-adjustment often involves exercise, which can stimulate the brain to release endorphins, playing an anti-depressive role. Additionally, exercise is an effective relaxation training that can divert attention and stimulate feelings of control and pleasure. Furthermore, psychotherapy is also used in clinical settings, particularly cognitive behavioral therapy, which is crucial in helping patients identify thoughts, correct irrational cognitive patterns, and rebuild their cognitive systems. Effective training in social and other activities is also necessary to enhance social or occupational functioning. In terms of physical therapy, repetitive Transcranial Magnetic Stimulation (rTMS) is the main treatment method.
What are the signs of mild depression?
Signs of mild depression may also include a gloomy mood, an inability to feel joy, a sorrowful facial expression, and often downturned corners of the mouth. The head may be tilted forward with a downward gaze, and there might be fewer changes in posture. Patients may experience sleep disturbances, commonly having trouble falling asleep, waking repeatedly at night, and still being in the sleep process when waking up in the morning. Appetite reduction may not be very noticeable. Mood variations occur during the day, often with a worse mood in the evening compared to the morning. There is no significant slowing down of movement, but the emotional state of the patient is often poor. Some patients may experience symptoms of autonomic nervous system dysfunction, such as dizziness, headaches, and bodily discomfort, which are indicative of mild depression.
Is depression hereditary?
Depression has a certain hereditary tendency. Studies involving large samples have found that if first-degree relatives of patients with depression have the disorder, the incidence of the disease in their offspring is significantly higher than in the general population. Additionally, studies on twins have shown that the concordance rate of depression in monozygotic twins is significantly higher than in dizygotic twins. Research in genetic studies has revealed that depression is a polygenic disorder. Therefore, it is possible for offspring of parents with depression not to inherit the disease. The onset of depression is often influenced by genetic factors, biochemical factors, and various social and psychological factors. Thus, the genetic probability of developing depression is generally higher than in the general population.
What medication is used for depression?
The medications commonly used for depression in clinical settings are selective serotonin reuptake inhibitors, primarily used to increase serotonin levels in the patient's brain to improve depressive symptoms. Representative drugs in clinical use include paroxetine, sertraline, fluoxetine, fluvoxamine, citalopram, and escitalopram. There are also medications that inhibit the reuptake of both serotonin and norepinephrine, such as venlafaxine and duloxetine. Additionally, there's a type of antidepressant that acts on norepinephrine and is specifically serotonergic, with mirtazapine being the main drug. These medications are considered modern antidepressants and have a relatively significant clinical efficacy. Of course, there are also traditional tricyclic and tetracyclic antidepressants, which are not recommended as first-line treatments in clinical settings due to their more adverse reactions. (Please follow a doctor's guidance regarding the use of specific medications.)
Can mild depression cause dizziness?
Patients with mild depression may also experience symptoms of dizziness. These patients often come to see a doctor primarily for physical symptoms, manifesting discomforts such as dizziness, headaches, nausea, palpitations, chest tightness, heart palpitations, vomiting, sweating, and difficulty breathing, among other related symptoms. These are also symptoms of autonomic dysfunction, which are relatively common. Thus, the emotional and cognitive symptoms in these patients are often mild, while the physical symptoms are comparatively severe. Particularly, disturbances in sleep, fatigue, and diminished appetite are amongst the more prominently severe symptoms. When patients seek medical help, they often present with the aforementioned symptoms as their main complaints, and if not carefully questioned, misdiagnosis can easily occur. Therefore, for physical symptoms of depression, it is important to observe carefully as the physical manifestations are closely related to emotional changes. Attention should be given to observe and administer antidepressant therapy, which can achieve good therapeutic effects.
Treatment of Depression
The treatment of depression in clinical settings primarily utilizes pharmacotherapy, psychotherapy, and physical therapy. Pharmacotherapy, as the first-line treatment for depression, mainly relies on selective serotonin reuptake inhibitors such as paroxetine, fluoxetine, sertraline, escitalopram, venlafaxine, and duloxetine. Adequate dosages and treatment duration with a systematic approach are essential when using pharmacotherapy. Secondly, psychotherapy. The main psychotherapeutic approaches include cognitive-behavioral therapy, psychoanalytic therapy, and interpersonal therapy, which aim to improve the patient's irrational cognitions and rebuild their cognitive framework. Thirdly, physical therapy. In clinical practice, physical therapy mainly encompasses electroconvulsive therapy and transcranial magnetic stimulation, both of which can yield significant therapeutic outcomes. (Specific medications should be used under the guidance of a physician.)