Depression Diagnosis and Treatment
Depression is a serious mental health disorder that can have extreme impacts on a person’s day-to-day life. Learn more here.
Table of Contents
What is Depression?
According to the American Psychiatric Association, major depressive disorder is “a common and serious medical illness that negatively affects how you feel, the way you think and how you act.”1 There are multiple kinds of depression, and symptoms can vary among people.
Most people associate depression with sad or lonely feelings or losing interest in activities that one used to enjoy.1 sadness can lead to serious issues and other medical troubles. It is important to not confuse depression with things such as grief or a general sad feeling in response to a situation.
There are also multiple different kinds of sadness. Each type could have similar side effects, but the causes could be very different. It is important to talk to your doctor specifically about the side effects that you are dealing with day in and day out. Read on to learn about the different variations of sadness.
Types of Depression
Major Depression
Major depressive disorder is the name given when a person struggles with depression most of the time. A person with major sadness will struggle with a loss of interest in activities, weight fluctuation, restlessness or sluggishness either mentally or physically, irregular sleep schedule and tendencies, a sense of being worthless or feeling guilty, suicidal thoughts or ideation, and difficulties with concentrating or making decisions.2
Persistent Depressive Disorder
Persistent depressive disorder is when a person has depression that lasts longer than two years. A person that has persistent depressive disorder might experience abnormal sleep patterns, chronic fatigue, change in appetite, struggles with low self-esteem, difficulties with focusing or planning, or feelings of hopelessness.2 Normally, this kind of sadness is treated with medication and therapy.
Manic Depression
Manic depression is another term for bipolar disorder. Manic depression occurs when a person goes through a range of emotional extremes, going from extreme highs to extreme lows. These extremes can last for long periods and normally do not fluctuate within the day.
When a person is going through a low episode, they will experience very similar symptoms to major depressive disorder.2 When they go through stages of mania, they might experience high amounts of energy and show signs of recklessness.
Seasonal Affective Disorder (SAD)
Seasonal affective disorder is a form of depression that tends to correlate to a lack of sunlight, normally affecting people in the winter months. A person who struggles with seasonal depression will see an improvement in symptoms during the spring. The symptoms most reflect that of major depressive disorder. 2
Psychotic Depression
A person that struggles with psychotic depression will have things such as delusions, paranoia, and hallucinations on top of regular major sadness symptoms. Normally, doctors will prescribe multiple medications to combat this type of sadness. 2
Peripartum (Postpartum) Depression
Postpartum depression occurs shortly after childbirth primarily in women but can happen in men as well (10%). Symptoms will normally occur within a few weeks or months after the child is born. Normally, doctors will treat this kind of sadness the same way they would treat major depressive disorder. 2
Situational Depression
Atypical Depression
Atypical depression is when positive news or an event can improve your mood for a short period. However, the person will still struggle with regular sadness symptoms most of the time. A person that struggles with atypical sadness may experience symptoms such as sleeping more, being sensitive to critique or criticism, or having an increase in appetite. 2
Treatment-Resistant Depression
Nearly 33% of people that seek out treatment for depression try multiple different methods without finding one that works. This issue is what is known as treatment-resistant sadness.
When a person struggles with this, a doctor might suggest “less conventional treatment options” in hope that something might work.2 It is not known why sadness in some people remains treatment-resistant, but other conditions can play a factor.
Risk Factors for Depression
Biochemistry
One of the most believed causes of depression is a chemical imbalance that impacts the neurotransmitters that regulate one’s mood. sadness may occur when a person has fewer neurotransmitters including serotonin, dopamine, and norepinephrine.3
However, even though biochemistry is believed to have an impact, there is little data that proves it, and many researchers believe that it’s not the only factor. Hormone fluctuations can also have a big impact on rates of sadness, especially for women.3
Genetics
Studies also show that “depression is approximately 40% determined by genetics.” If a person has a parent/grandparent that battles with depression, they are twice as likely to also get sadness.3
Scientists are not sure which specific gene or genes increase the risk for depression, but research is being done to isolate those genes to increase the effectiveness of treatments. It is a nature and nurture disorder, so it is important not to attribute sadness to one thing.
Personality
According to one study, neuroticism, extraversion, and conscientious personality traits are linked to higher rates of depression. Although there is more research needed, personality traits tend to show up in children very early on. Personality traits cannot predict if a person will struggle with depression, but they very much should be considered a risk factor.4
Environmental Factors
Factors such as rough home life, poverty, poor working conditions, poor nutrition, drug usage, or even not getting enough sunlight can have an impact on whether someone develops depression. There is no one cause of sadness, but environmental factors play a significant role. Higher stress levels can also lead to sadness and anxiety .5
Depression Diagnosis
Depression can be difficult to diagnose. Aspects like blood tests or scans cannot identify depression. Because of this difficulty, a diagnosis normally comes about after talking to a patient in depth over multiple sessions.
How Does a Doctor Make a Depression Diagnosis?
It is recommended that doctors screen a patient for depression regularly. Normally, this screening is through a series of questions during the checking-in period. During these screenings, doctors will try to find specific signs of sadness that are listed inside of the DSM 5.6
Signs and Symptoms of Depression
Symptoms for depression can vary depending on the type and the person. Moreover, certain symptoms might be more prevalent for one person and less prevalent for another.
Feeling Sad or Anxious
One of the most common symptoms of depression is a feeling of being sad or anxious. Many times, these issues can lead to a constant feeling of being tired or having a lack of energy. They go beyond a slight feeling of disappointment but tend to be chronic symptoms.7
Feeling Hopeless, Worthless, and Pessimistic
People with sadness may struggle with losing hope, feeling worthless, or becoming pessimistic. Many people who struggle with depression might also experience suicidal thoughts or ideation, which is the extreme of these symptoms. Because of this issue, it is very important to seek help from a health care professional.7
Angry Outbursts, Irritability, or Frustration
Another sign of depression is irritability at small things or frustration with others, oneself, and tasks. A person with depression might notice that they have outbursts towards roommates or family members, leading to further feelings of guilt or shame.7
Sleep Disturbances, Including Insomnia
A person struggling with depression might also struggle with inconsistent sleep patterns. Normally, this issue leads to waking up throughout the night or trouble falling asleep. In addition, it might lead to excessive fatigue and tiredness throughout the day, making it difficult to do things.7
Loss of Interest in Hobbies and Other Activities
Appetite or Weight Changes
Finally, a person might struggle with weight fluctuation and changes in appetite. For some people battling depression, they might experience a feeling like they do not want to eat, which can lead to weight loss.
For others, this disorder might lead to issues such as binge-eating or eating an excess of calories each day, leading to weight gain.7 If you or a loved one are experiencing several of these symptoms, please reach out to a health care professional.
Misdiagnosis of Depression
Due to several factors, there is always a chance of accidentally being misdiagnosed with depression. Depression is one of the most difficult medical issues to diagnose because there is not a consistent test, and the symptoms overlap with several other mental health disorders.
Because of this issue, it is very important to take every precaution and try to be as honest as possible when speaking with a health care provider about your symptoms. 8
How Often Do Doctors Make Mistakes?
Misdiagnoses are infrequent today since symptoms normally present themselves at the same time. Just in case, it is wise to get a second opinion to make sure that you are treating the right thing. Other undiagnosed health issues can also cause depression or present similar symptoms, so extra testing to rule out other possible factors is a good idea.8
Symptoms That Overlap With Other Mental Illnesses
With many mental health disorders, there are overlapping symptoms that can make diagnosis challenging. One study found there are even similar genetic variations among five of the most major mental health disorders.9 Some of these symptoms include fatigue, anxious feelings, irritability, a loss of interest in things a person used to like, and feelings of hopelessness.
Consequences of Misdiagnosis
How to Avoid Misdiagnosis
One of the best ways to avoid misdiagnosis is by getting a second opinion. Doing thorough testing to rule out other factors and exploring your family’s history with depression are two other steps that can help in narrowing down the issue.
Because many mental health issues overlap with one another, it is crucial to be as honest as possible when speaking to your doctor. One of the best ways to do this is by giving concrete examples of what you are feeling/experiencing throughout your day.
Treatment for Depression
Medications
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
The second kind of depression medication is serotonin and norepinephrine reuptake inhibitors. SNRIs increase serotonin and norepinephrine inside of your brain.10
Tricyclic and Tetracyclic Antidepressants
Tricyclic and tetracyclic antidepressants also increase serotonin and norepinephrine inside of your brain. These are not as commonly prescribed because they can cause more side effects than the previous two. 10
Atypical Antidepressants
Psychotherapy
Cognitive-Behavioral Therapy (CBT)
Dialectical Behavior Therapy (DBT)
Psychodynamic Therapy
Light Therapy
During light therapy, a person will be exposed to white light to try and regulate their emotions. Light therapy is used consistently with seasonal depression. This is normally a temporary treatment or one that is used only at specific times.
Electroconvulsive Therapy (ECT)
Alternative Therapies
Some people will choose different methods to try and help with their depression, which can go alongside regular therapy and medication.
- Meditation: Meditation has been proven to help with the symptoms caused by sadness. By practicing meditation, a person can rewire their brain to better respond to certain triggers such as anxiety and stress.
- Acupuncture: Another alternate treatment plan is acupuncture. It can ease some symptoms of sadness. Some studies have shown that it can help alongside other treatments.
JFHI Concierge Approach to Diagnosis and Treatment
Our team at J. Flowers Health Institute aims to address all facets of any disorder that someone is struggling with. We take a holistic, concierge approach to diagnosis and treatment.
Depression Diagnosis
At JFHI, we ensure that each client receives an accurate diagnosis through multiple sessions and tests. Not only can this type of testing rule out other causes, but it can find co-existing conditions that could be impacting a person’s depression.
Concierge Medical Services for Treatment
Benefits of Concierge Medical Services
Why You Need Concierge Care For Depression
A person battling sadness needs concierge care because it allows them to receive quick access to a doctor that personally knows what they are dealing with. One significant benefit is the decrease in suicide and self-harm.
Because a person can reach out right away for care, it provides them a place to go when they are battling suicidal ideation. Moreover, due to the varying symptoms of sadness, it is necessary to find a solution that allows the doctor to care specifically for the patient. Concierge care does just that. For more information, reach out to our team at J. Flowers Health Institute.
Resources
- https://www.psychiatry.org/patients-families/depression/what-is-depression
- https://www.webmd.com/depression/guide/depression-types
- https://www.verywellmind.com/common-causes-of-depression-1066772
- https://www.verywellmind.com/personality-trait-versus-mood-state-1067551
- https://www.verywellmind.com/how-your-environment-affects-your-mental-health-5093687
- https://www.webmd.com/depression/guide/depression-diagnosis#091e9c5e80010b7a-1-2
- https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
- https://www.everydayhealth.com/depression/could-you-have-been-misdiagnosed-with-depression.aspx
- https://www.webmd.com/mental-health/news/20130811/genetic-overlap-seen-in-five-mental-disorders
- https://www.healthline.com/health/depression#treatment
