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Symptoms

Depressed mood for much of the day

Decrease in interest or pleasure

Changes in appetite and/or weight

Changes in sleep patterns

Fatigue

Psychomotor agitation or retardation (i.e., being agitated or slowed down)

Feelings of worthlessness or excessive or inappropriate guilt

Diminished ability to think, concentrate or make decisions

Thoughts of suicide or death

Statistics

Up to one in four women, and one in eight men, will suffer from depression at some point in their life.

Treatment

Changing thoughts: When people are depressed, they view themselves, the world, and their future, in a very negative light. These biases can be corrected with cognitive re-structuring techniques, such that negative thoughts (e.g., “I’ve wasted my life ”) can be replaced with more realistic ones (e.g., “I have achieved some of my goals and not others”).

Changing behaviors: When people are depressed, they tend to be less active, physically and socially, and to engage in fewer of the activities that gave them pleasure before becoming depressed (e.g., watching movies), and in fewer of the activities that can lead to a sense of mastery (e.g., cleaning, ordering papers, etc).
Behavioral activation simply refers to engaging in more activities.

Optional additional treatment strategies

Better identification of needs: getting in touch with one’s own values, for meaning and pleasure.

Setting personal goals based on these values.

Improved communication with others: building upon or strengthening a good social support system.

Better problem-solving, including how problems are perceived (as a welcomed opportunity for personal growth instead of as aversive insurmountable obstacles)

Mindfulness and Acceptance: Learning to be in the here and now, and to suspend judgment (i.e., instead of labeling experiences as “good” or “bad”, accepting them the way they are).

Medication: SSRIs (Selective Serotonin Reuptake Inhibitors), like Paxil, Celexa, Lexapro, Luvox, Prozac, Zoloft, are most often used, as are SNRIs (Selective Serotonin Norepinephrine Reuptake Inhibitors) like Effexor. There are also Tricyclic antidepressants (e.g., Anafranil, Sinequan, Tofranil, Norpramin, and Amixapine), Tetracyclic antidepressants (e.g., Remeron) and MAO-inhibitors (Monoamine oxidase-inhibitors), like Nardil or Parnate.

Dysthymia

Dysthymia is a milder but more chronic form of depression. In dysthymia, the depressed mood and associated symptoms have been present for at least 2 years. Treatment is similar to that for depression.

Selected Book References

Feeling Good.
David Burns, M.D. (1999).
Penguin Books Ltd., ISBN 0-452-28132-6

Mind over Mood: Change how you feel by changing the way you think.
Dennis Greenberger, Ph.D. & Christine Padesky, Ph.D. (1995).
The Guilford Press. ISBN 0-89862-128-3


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