What are the three major signs of depression?

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression: Persistent sad, anxious, or “empty” mood. Feelings of hopelessness, or pessimism. Feelings of irritability, frustration, or restlessness.

nimh.nih.gov - NIMH » Depression - National Institute of Mental Health

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Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore. Quick Tip: No two people are affected the same way by depression and there is no "one-size-fits-all" for treatment. It may take some trial and error to find the treatment that works best for you.

Medications

Antidepressants are medicines commonly used to treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered. Antidepressants take time – usually 4 to 8 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before deciding whether it works. If you begin taking antidepressants, do not stop taking them without talking to your health care provider. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your health care provider have decided it is time to stop the medication, usually after a course of 6 to 12 months, the health care provider will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms. Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment. If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding, talk to your health care provider about any increased health risks to you or your unborn or nursing child. To find the latest information about antidepressants, talk to your health care provider and visit the FDA website.

Psychotherapies

Several types of psychotherapy (also called “talk therapy” or "counseling") can help people with depression by teaching new ways of thinking and behaving and how to change habits that contribute to depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). More information on psychotherapy is available on the NIMH Psychotherapies webpage.

Brain Stimulation Therapies

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If medications do not reduce the symptoms of depression, electroconvulsive therapy (ECT) may be an option to explore. Based on the latest research: ECT can provide relief for people with severe depression who have not been able to feel better with other treatments. Electroconvulsive therapy can be an effective treatment for depression. In some severe cases where a rapid response is necessary or medications cannot be used safely, ECT can even be a first-line intervention. Once strictly an inpatient procedure, today ECT is often performed on an outpatient basis. The treatment consists of a series of sessions, typically three times a week, for two to four weeks. ECT may cause some side effects, including confusion, disorientation, and memory loss. Usually these side effects are short-term, but sometimes memory problems can linger, especially for the months around the time of the treatment course. Advances in ECT devices and methods have made modern ECT safe and effective for most patients. Talk to your doctor and make sure you understand the potential benefits and risks of the treatment before giving your informed consent to undergoing ECT. ECT is not painful, and you cannot feel the electrical impulses. Before ECT begins, a patient is put under brief anesthesia and given a muscle relaxant. Within one hour after the treatment session, which takes only a few minutes, the patient is awake and alert. Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). Other types of brain stimulation treatments are under study. You can learn more about these therapies on the NIMH Brain Stimulation Therapies webpage. Natural Products FDA has not approved any natural products for depression. While research is ongoing, some people find natural products, including vitamin D and the herbal dietary supplement St. John’s wort, to help depression. Do not use St. John’s wort or other dietary supplements for depression before talking to your provider. For more information, visit the National Center for Complementary and Integrative Health website.

How can I find help?

If you think you may have depression, start by making an appointment to see your health care provider. This could be your primary care practitioner or a health provider who specializes in diagnosing and treating mental health conditions. Visit the NIMH Find Help for Mental Illnesses webpage if you are unsure of where to start.

Beyond Treatment: Things You Can Do

Once you begin treatment, you should gradually start to feel better. Here are other tips that may help you or a loved one during treatment for depression:

nimh.nih.gov - NIMH » Depression - National Institute of Mental Health

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