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Symptoms
of Depression
Sometimes
depression is not recognized because patients
don’t feel depressed. The onset of
the first episode of major depression may
not be obvious if it is gradual or mild.
The symptoms of major depression characteristically
represent a significant change from how a
person functioned before the illness. The
symptoms of depression include:
-
Profoundly
sad or irritable mood.
-
Pronounced changes
in sleep, appetite, and energy.
-
Difficulty
thinking, concentrating, and remembering.
-
Physical slowing or agitation.
-
Lack of
interest in or pleasure from activities
that were once enjoyed.
-
Feelings
of guilt, worthlessness, hopelessness,
and emptiness.
-
Recurrent thoughts of
death or suicide.
-
Persistent physical
symptoms that do not respond to treatment,
such
as headaches, digestive disorders, and chronic pain.
When several symptoms of depression co-occur
with chemical dependency for longer than
two weeks and interfere with ordinary functioning,
professional dual diagnosis treatment is
needed for depression and chemical dependency.
Facts about Depression
Major depression is a serious medical illness
affecting 9.9 million American adults,
or approximately 5 percent of the adult
population in a given year. Unlike normal
emotional experiences of sadness, loss,
or passing mood states, major depression
is persistent and can significantly interfere
with an individual's thoughts, behavior,
mood, activity, and physical health. Major
depression is the leading cause of disability
in the U.S. and many other developed countries.
Nearly twice as many women (6.7 million)
as men (3.2 million) suffer from major depressive
disorder. Major depression can occur at any
age including childhood, the teenage years
and adulthood. All ethnic, racial and socioeconomic
groups suffer from depression. More than
half of those who experience a first episode
of depression will have at least one other
episode in their lives. Some individuals
may have several episodes in the course of
a year. If untreated, episodes commonly last
anywhere from six months to a year. Left
untreated, depression can lead to suicide.
Major depression is also known as clinical
depression or unipolar depression. Other
depressive disorders include dysthymia (chronic
less severe depression) and bipolar disorder
(manic depression). People who have bipolar
disorder experience both depression and mania.
Mania involves abnormally and persistently
elevated mood or irritability, elevated self-esteem,
and excessive energy, thoughts, and talking.
Causes of Major Depression
There is no single cause of major depression.
Psychological, biological, and environmental
factors may all contribute to its development.
Whatever the specific causes of depression,
scientific research has firmly established
that major depression is a biological brain
disorder.
Norepinephrine, serotonin, and dopamine
are three neurotransmitters (chemical messengers
that transmit electrical signals between
brain cells) thought to be involved with
major depression. Scientists believe that
if there is a chemical imbalance in these
neurotransmitters, then clinical states of
depression result. Antidepressant medications
work by increasing the availability of neurotransmitters
or by changing the sensitivity of the receptors
for these chemical messengers.
Scientists have also found evidence of a
genetic predisposition to major depression.
There is an increased risk for developing
depression when there is a family history
of the illness. Not everyone with a genetic
predisposition develops depression, but some
people probably have a biological make-up
that leaves them particularly vulnerable
to developing depression. Life events, such
as the death of a loved one, a major loss
or change, chronic stress, and drug and alcohol
abuse may trigger episodes of depression.
Some illnesses and some medications may also
trigger depressive episodes. It is also important
to note that many depressive episodes occur
spontaneously and are not triggered by a
life crisis, physical illness, drug and alcohol
abuse, or other risks.
Treatment of Depression and Chemical Dependency
Transitions Recovery employs a holistic approach
to help each individual with dual diagnosis
depression and chemical dependency. The
treatment of depression is not limited
to medication. There are a number of ways
to treat depression, including individual
therapy, group therapy, family therapy,
cognitive therapy, and medications if indicated.
Patients are assessed as to their individual
needs, and appropriate recommendations
are made. In most cases, a combination
of therapeutic interventions effectively
relieves the symptoms.
Although
major depression can be a devastating illness,
it is highly treatable. Between
80 and 90 percent of those suffering from
serious depression can be effectively treated
and return to their normal daily activities
and feelings. Many types of treatment are
available, and the type chosen depends on
the individual and the severity and patterns
of his or her illness. There are three basic
types of treatment for depression: medications,
psychotherapy, and group therapy. They may
be used singly or together during dual diagnosis
treatment.
Medication
The first antidepressant medications were
introduced in the 1950s. Research has shown
that imbalances in neurotransmitters like
serotonin, dopamine, and norepinephrine
can be corrected with antidepressants.
Four groups of antidepressant medications
are most often prescribed for depression.
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Tricyclic antidepressants
(TCAs)
Still widely used for severe depression.
TCAs elevate mood and activate behavior,
but it often takes three to four weeks
for an individual to respond. These medications
include amitriptyline (Amititril, Elavil),
desipramine (Norpramine), doxepine (Sinequan),
imipramine (Antipress, Imavate, Tofranil),
nortriptyline (Aventyl, Pamelor), and protriptyline
(Vivactyl).
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Monoamine oxidase
inhibitors (MAOIs)
Often effective in individuals who do not
respond to other medications or who have
atypical depressions with marked anxiety,
excessive sleeping, irritability, hypochondria,
or phobic characteristics. These medications
include phenelzine (Nardil) and tranylcypromine
sulfate (Parnate).
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Selective serotonin
reuptake inhibitors (SSRIs)
These act specifically on the neurotransmitter
serotonin. In general, SSRIs cause fewer
side effects than TCAs and MAOIs. These medications
include fluoxetine (Prozac), sertraline (Zoloft),
and paroxetine (Paxil).
-
Serotonin and
norepinephrine reuptake inhibitors (SNRIs)
Useful as first-line treatments in people
taking an antidepressant for the first time
and for people who have not responded to
other medications. In general, SNRIs cause
fewer side effects than TCAs and MAOIs. These
medications include Venlafaxine (Effexor).
-
Bupropion (Wellbutrin)
This newer antidepressant medication classified
as a dopamine reuptake blocking compound.
It acts on the neurotransmitters dopamine
and norepinephrine. In general, bupropion
causes fewer side effects than TCAs and
MAOIs.
Consumers and their families must be cautious
during the early stages of treatment when
energy levels and the ability to take action
return before mood improves. At this time
- when decisions are easier to make, but
depression is still severe - the risk of
suicide may temporarily increase.
Psychotherapy
There are several types of psychotherapy
that have been shown to be effective for
depression, including cognitive-behavioral
therapy (CBT) and interpersonal therapy
(IPT). Research has shown that mild to
moderate depression can often be treated
successfully with either of these therapies.
However, severe depression appears more
likely to respond to a combination of psychotherapy
and medication.
-
Cognitive-behavioral
therapy (CBT)
Helps to change the negative thinking and
behavior associated with depression while
teaching how to unlearn the behavioral
patterns that contribute to the illness.
-
Interpersonal
therapy (IPT)
Focuses on improving disturbed personal relationships
that may worsen depression.
Dual
Diagnosis – Depression
and Chemical Dependency
Our comprehensive approach to depression
and drug and alcohol addiction treatment
begins immediately with medical, psychiatric
and psychological evaluations. Each patient
benefits from a dual diagnosis treatment
program that is tailored to their specific
needs for depression and chemical dependency.
Our highly
regarded staff is trained and experienced
in recognizing
and treating depression and chemical dependency.
Our psychiatrist assesses patients who may
be struggling with psychiatric or emotional
disorders or who may already be on psychotropic
medication.
Our psychiatrist can prescribe appropriate
non-addictive psychotropic medication to
ease the affects of these disorders, giving
the patient an opportunity to successfully
participate in the dual diagnosis treatment
process. The psychiatrist will provide periodic
medication reviews to make sure that prescribed
medications and therapies are having the
desired effects.
To determine if you or a loved one may require
dual diagnosis for treatment of depression
and chemical dependency, call 800-626-1980
now to talk to us.
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