Depressive Disorders

Depressive disorder is also known as clinical depression, a mood disorder that causes sadness or distressing feelings. It can lead to stress and dysfunction, interfering with your daily life. You may even lose interest in activities that you once enjoyed. It can happen because of physical conditions, neurochemistry, and traumatic events. Other causes are genetic factors and disrupted neurotransmitter and neuroendocrine function.  

What is a depressive episode? 

 A depressive episode can be described as a period when one feels low mood and loses interest in activities for two weeks or more. He/she may feel intense sadness, emptiness, or hopelessness that may interfere with normal daily functioning. The period may last for months if not properly treated.

A depressive episode can be described as a period of sustained low mood and loss of interest in activities, which lasts at least two weeks or more. It is a defining feature of major depressive disorder (MDD). However, it can be experienced in other mental disorders such as bipolar disorder.

Some of the things that people may experience during a depressive episode include persistent sadness, emptiness, or irritability most of the days of the week. Anhedonia is also a typical feature of a depressive episode. This happens when a person loses interest in the activities he once enjoyed. 

Cognitively, a person during a depressive episode suffers from problems with concentration. Decisions become hard to make. Negative thoughts characterize depressive episodes, and people feel guilty and worthless.

Physiologically, a person suffering from depressive episodes experiences tiredness, changes in sleeping patterns (insomnia or hypersomnia), changes in appetite, weight changes, and psychomotor slowing/agitation. They make functioning at work, at school, and socially difficult. The person tends to withdraw socially and becomes less productive.

The episodes are divided into mild, moderate, and severe according to symptom severity and consequences. In the case of severe episodes, there is a risk of suicidal thoughts/attempts and a need for immediate help. There are several risk factors, such as genetic vulnerability, chronic illnesses, trauma, and substance abuse.

Treatment

If untreated, episodes tend to recur and intensify. Psychotherapy (cognitive behavioral therapy, interpersonal therapy), medications (antidepressants), and changes in lifestyle (exercise, good sleep habits, stress reduction) constitute evidence-based approaches to treating depression.

Thus, a depressive episode is not just feeling sad but a complex disorder that influences the person’s mood, thought process, and physical state.

What is Major Depressive Disorder and Symptoms?

Major depressive disorder is defined by having one or more depressive episodes in one’s life. Neither an episode nor a disorder is completely curable, but doctors can effectively manage and treat both conditions. Therefore, it is advisable to seek medical help from medical professionals at HealthMedsGuide in case of distress instead of avoiding symptoms. 

MDD is characterized as a clinical mood disorder with mood swings, sadness, low self-esteem, and lack of enjoyment in favorite activities for more than two weeks.  It can be cured with antidepressants and psychotherapy. 

Symptoms 

  • Self-hatred and emptiness: It is a symptom of widespread negative evaluation of oneself and emotional anesthesia, which is accompanied by feelings of being worthless and long-lasting mood dysphoria.
  • Self-harm behavior and negative ideas: Suicidal ideation and behaviors appear in severe episodes, triggered by hopelessness and ineffective coping mechanisms.
  • Anhedonia: This symptom is one of the key diagnostic criteria, meaning that a person cannot experience joy because of the altered functioning of the brain’s reward system.
  • Social disengagement and withdrawal: Social withdrawal takes place due to lack of motivation and difficulties in communication.
  • Difficulty focusing, irritability, and sleep disorders: Cognitive impairment and insomnia are characteristic neuropsychological symptoms.
  • Delusions and hallucinations: Mood-congruent delusions and hallucinations may take place in psychotic depression, implying a serious psychiatric disorder.
  • Appetite dysregulation: It results in weight loss and malnutrition.
  • Weakness and headaches: Complaints about the body’s functioning represent fatigue and increased pain sensitivity in depressed people.
  • Abdominal discomfort: Such somatic complaints are caused by stress physiology and altered serotonin metabolism.
  • Lethargy and poor functioning: This symptom includes psychomotor retardation and poor performance at work and in studies.

Other Types of Depressive Disorders 

  1. Persistent Depressive Disorder 

Persistent depressive disorder is also called dysthymia. It is similar to MDD but more long-lasting and less intense. It is more chronic in nature, as people experience it consistently for even two years. The difference is that MDD is characterized by episodes, while PDD is experienced for longer periods. It can even start at an early point in life, and many victims tend to be embarrassed to even approach diagnosis. They tend to accept this as a normal way of life.  

As guessed, diagnosis can be difficult because the experience can be subtle and hidden. Antidepressant medication can be very helpful for such people, such as SNRIs and SSRIs like sertraline. 

  • Low self-esteem
  • Poor concentration
  • Lack of appetite or insomnia
  • Hypersomnia or overeating 
  • Avoidance for fear of failure and withdrawal 

What is double depression? 

The term “double depression” refers to the overlap of major depressive disorder with persistent depressive disorder, which used to be called dysthymia. When a victim suffers from a depressive episode while having persistent depressive disorder, they are diagnosed with double depression. 

Patients suffering from double depression experience more severe symptoms compared to patients with single disorders, such as suicidal thoughts, hopelessness, and inability to function normally. Unlike people suffering from major depression, patients with double depression do not remember the period of time when they felt normal. 

Recovery takes much effort since people with double depression tend to relapse. In addition, people with double depression recover very slowly. The treatment is based on taking antidepressants and undergoing psychotherapy, especially cognitive behavioral therapy, to change the way people think. In addition, people can improve their state through engaging in physical exercise, sleeping better, and managing stress. 

  1. Bipolar Disorder 

Unlike MDD and PDD, bipolar disorder is characterized by episodes of depression and mania or hypomania. In depressive episodes, patients show signs of feeling depressed, hopeless, and fatigued, just like MDD patients. 

Manic episodes make people feel happy, energized, impulsive, or grandiose, leading them to engage in risky behavior. Bipolar I consists of one or more episodes of manic states, whereas Bipolar II entails episodes of hypomania and major depression without manic states. 

Cyclothymia is another mild case of bipolar disorder with fluctuating moods of hypomania and mild depression. It can cause major disruptions in people’s relationships, finances, and daily life. Lithium, anticonvulsants, antipsychotics, and psychotherapy are among the treatment options for bipolar disorder, which has a high genetic predisposition and affects men and women equally.

  1. Seasonal Affective Disorder 

Seasonal Affective Disorder (SAD) is a type of depression that occurs every year during a specific season. It usually occurs during winter because of decreased sunlight exposure. 

  • Fatigue
  • Excessive sleeping 
  • Carb cravings
  • Weight gain
  • Hopelessness
  • Social withdrawal

As the symptoms occur annually, SAD is predictable, yet disruptive. Among treatment options, there are bright lamps imitating sunlight used for light therapy, antidepressant treatment, and CBT. The disorder is most common among younger adults, women, and those living far from the equator. 

  1. Postpartum Depression

PPD arises after pregnancy, within days, weeks, or months following childbirth. It is more serious than the “baby blues,” an instance where women have fleeting mood swings in the early days of motherhood. 

PPD manifests through feelings of extreme sadness, guilt, irritability, fatigue, inability to bond with the infant, and suicidal ideation. 

In some instances, a more severe condition known as postpartum psychosis may arise, involving hallucinations and/or delusions, necessitating urgent medical attention. This mental illness affects the bonding between the mother and her newborn, as well as the entire family dynamics. The treatment options include antidepressant medications safe for breastfeeding, psychotherapy, and good social support.

  1. Premenstrual Dysphoric Disorder 

This is also commonly known as Premenstrual Syndrome (PMS), which encompasses routine and functional impairment due to the severity of common symptoms. Such symptoms are usually experienced one to two weeks before the menstrual bleeding begins, which is the luteal phase of the cycle. However, victims of PMDD have heightened symptoms, inflammation, and hormonal changes compared to other women. It is also critical to distinguish between PMDD and normal premenstrual syndrome, heightened mood disorders, and other conditions that have similar symptoms.

The victim tends to demonstrate higher sensitivity to hormonal fluctuations. FDA-approved hormonal contraceptives like Yaz can help with premenstrual dysphoric disorder. Other treatment types include oral contraceptives, psychotherapy like CBT, and antidepressants like SNRIs

  • Depression and hopelessness
  • Tension, anger, and irritability 
  • Lethargy and inactivity 
  • Lack of interest and rapid mood swings, also known as emotional lability 
  • Changes in appetite and sleep issues
  • Headaches, bloating, muscular pain 
  • Feeling out of control and joint pain 

Treatment and Diagnosis at HealthMedsGuide

Depression is confirmed after psychiatric assessment, laboratory testing to rule out organic causes, and meeting DSM-5 criteria, while treatment options involve psychotherapy, pharmacotherapy, and procedures such as ECT or TMS.

HealthMedsGuide Protocol

  • Physical examination: To rule out physical conditions (thyroid malfunction, anemia, neuropathic disease).
  • Laboratory investigations: CBC, thyroid profile, vitamin B12, folic acid, and metabolic panels.
  • Psychiatric evaluation: A structured interview to test mood, cognitive functioning, sleep and appetite, and suicidality.
  • DSM-5 criteria: Two or more weeks of depressed mood or anhedonia along with 4 or more other symptoms.
  • Rating scales: PHQ-9 and Beck Depression Inventory to assess severity level.
  • Differential diagnosis: Bipolar disorder, cyclothymia, substance-induced mood disorder, and various diseases.

Psychotherapy

  • Cognitive Behavioral Therapy: Corrects distorted, catastrophic, and negative thinking. 
  • Interpersonal Psychotherapy: Deals with interpersonal problems.
  • Behavioral Activation: Encourages involvement in pleasant activities.

Pharmacotherapy

  • Selective Serotonin Reuptake Inhibitors (SSRIs): Fluoxetine and sertraline (first-line due to safety).
  • Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Venlafaxine, Duloxetine (for pain-related disorders).
  • Tricyclics and MAOIs: Used in refractory cases.
  • Adverse effects: Sexual dysfunction, weight gain, and serotonin syndrome.
  • Electroconvulsive Therapy (ECT): Used in severe, psychotic, and suicidal depression.
  • Transcranial Magnetic Stimulation (TMS): A non-invasive neuromodulation technique for moderate and severe depression.
  • Ketamine/Esketamine: Rapid-acting therapy for refractory depression.

This medical procedure is done under strict monitoring and evaluation by licensed mental health professionals and psychiatrists. 

Empathetic Care at HealthMedsGuide 

HealthMedsGuide recognizes that most of the depressive disorders ignore or are unaware of their condition, which delays or rules out diagnosis. That is why we follow evidence- and research-based medical treatments under strict health protocols. 

What is even more important is that the patient opens up psychologically to be able to receive treatment of the highest medical standard. Our approach is to understand and justify human mental health experiences without judgment. We have records of improved mental health and patient satisfaction with this unique and engaging approach. 

Cognitive Behavioral Therapy 

In practice, CBT is delivered as a medical procedure where the therapist recognizes the distortions and catastrophes in thoughts in the same precise way in which the surgeon does when he recognizes the diseased tissues. 

The patients are trained by therapists on how to challenge their irrational thinking and substitute it with rational thoughts backed by evidence. This process brings about a reduction in emotional disturbances and improved behavioral functioning. 

CBT is delivered in 12–20 sessions and has measurable outcomes measured by standardized scales. The progress of the treatment is monitored as the doctor does through vital signs. Therefore, CBT is used as a first-line, evidence-based procedure in depressive disorders.

Interpersonal Psychotherapy 

Like surgery, which is aimed at dealing with an infection in the body, IPT is a medical procedure where the therapist assesses the interpersonal world of the patient to identify the issues causing depressive symptoms such as interpersonal disputes, role transitions, and complicated grief.

IPT in HealthMedsGuide is carried out in sessions to improve communication skills, to solve disputes, and to increase the patient’s social support system. It takes 12–16 weeks and aims to achieve a set goal.

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HealthMedsGuide is proactively treating patients with accessible and empathetic medical support. Our treatment plans are affordable and involve holistic psychological care. Call us back today at +1 307 998 2348, and feel free to talk to our expert team of mental health professionals!