What to do about insomnia caused by mild depression?

Written by Pang Ji Cheng
Psychiatry and Psychology
Updated on September 05, 2024
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Patients with mild depression who experience insomnia symptoms can partly manage this through self-adjustment. For example, they can improve insomnia through exercise, especially two hours before bedtime, with medium intensity exercises to expend excess energy and ultimately achieve comprehensive muscle relaxation, leading to good sleeping habits. Additionally, in the treatment of mild depression, sedative antidepressants such as paroxetine, fluvoxamine, mirtazapine, and trazodone can be used, sometimes including tricyclic antidepressants like amitriptyline, which have been very satisfactory in their effects. Therefore, clinically, for insomnia in mild depression, both pharmacological treatment and self-adjustment methods can be adopted.

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Written by Pang Ji Cheng
Psychiatry and Psychology
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Can depression recur?

Relapse in patients with depression is a relatively common issue in clinical practice. Large-scale studies have found that even with systematic, standardized treatment with sufficient dosage and duration of antidepressant medications, still 15% of patients do not achieve clinical recovery. Even with persistent standardized treatment, the relapse rate remains at 20%. If treatment is discontinued, the relapse rate can rise to as high as 85%. For patients who have recovered, there is still a 20% chance of relapse within six months. 50% of patients relapse within two years after their first episode. Therefore, the relapse rate is higher in patients over the age of 45. Thus, depression is characterized by a high rate of relapse, yet it is also highly treatable. Therefore, during the course of pharmacological treatment, psychological and physical therapies should be concurrently employed as adjunctive treatments to improve cure rates and reduce the likelihood of relapse.

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Written by Pang Ji Cheng
Psychiatry and Psychology
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Do patients with mild depression need to be hospitalized?

Patients with mild depression can choose inpatient treatment or outpatient treatment. The main decision depends on the communication between the patient, their family, and medical professionals. Patients with mild depression have relatively mild depressive symptoms, so psychological therapy is primarily used, with pharmacotherapy and physical therapy serving as supplementary treatments. Psychological therapy mainly employs cognitive-behavioral therapy to improve the patient’s unreasonable beliefs and alleviate emotional stress. This includes identifying automatic thoughts, recognizing the irrationality of cognition, and employing reality testing, ultimately aiming to improve the patient's symptoms. Pharmacological treatment primarily uses serotonin reuptake inhibitors, and patients can adhere to a regular medication schedule at home during outpatient treatment periods. Physical therapy consists mainly of transcranial magnetic stimulation, which can be administered either as an outpatient or inpatient treatment. The final treatment choice should involve comprehensive communication with the patient's family and physicians to make an informed decision.

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Written by Pang Ji Cheng
Psychiatry and Psychology
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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.)

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Written by Du Rui Xia
Obstetrics
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What is postpartum depression?

Postpartum depression is a psychological disorder affecting emotions, psychology, and the body, caused by a decline in physical constitution and poor mental state due to societal perspectives and excessive stress after childbirth. Mothers may experience anxiety, sadness, emotional indifference, weakness, a tendency to cry easily, and a loss of confidence and interest in life. These symptoms generally persist throughout the entire postpartum period. Mild cases of postpartum depression can be alleviated through daily life adjustments. More severe cases, however, require treatment at a formal medical institution, and it is crucial for family members to pay attention to psychological communication with the patient.

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Written by Pang Ji Cheng
Psychiatry and Psychology
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How to diagnose mild depression?

For the clinical examination of mild depression, it is first necessary to thoroughly understand the patient’s onset, development, evolution, and treatment of depression. Furthermore, detailed communication must be conducted with the patient concerning consciousness, sensations, perceptions, thinking, attention, emotional willpower, self-control, and other aspects. It is important to comprehend the patient's overall mental and psychological condition, then combine this with the results of corresponding scales or exclude other conditions through diagnostic auxiliary examinations to make a comprehensive judgment. Particularly, the content of the psychiatric examination for the patient is an important aspect in determining mild depression. By integrating the aforementioned information, it is often possible to clearly diagnose the symptoms of mild depression, which is very meaningful for the subsequent treatment.