Major Depressive Disorder Treatments, Medication Treatment for Major Depressive Disorder & Major Depressive Disorder Therapies.

Diagnosis and Treatment for Major Depressive Disorder

Diagnosing major depressive disorder involves a comprehensive assessment by a qualified healthcare professional, typically a psychiatrist or a psychologist. The diagnostic process typically includes the following components:

Clinical Interview for Major Depressive Treatment

The healthcare professional will conduct a thorough interview to gather information about the individual’s symptoms, medical history, and psychosocial factors. They will inquire about the duration, frequency, and intensity of depressive symptoms, such as the following:

• Persistent feelings of sadness, emptiness, or hopelessness.
• Loss of interest or enjoyment in activities once enjoyed.
• Significant changes in appetite or weight.
• Insomnia or excessive sleeping.
• Fatigue or loss of energy.
• Feelings of worthlessness or extreme guilt.
• Difficulty concentrating, making decisions, or remembering things.
• Restlessness or slowed movements and speech.
• Recurrent thoughts of death or suicide.
• Physical signs and symptoms include headaches, digestive problems, or chronic pain.

They may also explore any potential underlying medical conditions or medications that could contribute to the symptoms.

Diagnostic Criteria for Major Depressive Disorder

The healthcare professional will refer to established diagnostic criteria, such as the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), published and prepared by the American Psychiatric Association. MDD is characterized by specific symptoms and their impact on daily functioning. According to the DSM-5 criteria, the symptoms should be present for at least two weeks and significantly impair social, occupational, or other important areas of functioning.

Screening Tools for Major Depression Treatments

Various screening tools and questionnaires may be used to aid in the diagnostic process. These tools assess the severity of depressive symptoms and help gauge the individual’s level of impairment. Examples include the Beck Depression Inventory (BDI), the Patient Health Questionnaire-9 (PHQ-9), and the Hamilton Rating Scale for Depression (HAM-D).

Differential Major Depressive Disorder Diagnosis

It is essential to differentiate MDD from other psychiatric disorders that may present with similar symptoms. The healthcare professional will consider alternative explanations and rule out other conditions, such as the following:

• Bipolar disorder.
• Persistent depressive disorder (Dysthymia).
• Adjustment disorder with depressed mood.
• Seasonal affective disorder (SAD).
• Anxiety disorders.
• Substance use disorders.

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• Can You Go To Rehab for Depression? What To Expect
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7.5%

It is estimated that MDD accounted for 7.5% of all years lived with disability in the US in 2017.

Source: NCBI

25.9%

The lifetime risk of developing MDD is estimated to be around 16.2% for men and 25.9% for women in the US.

Source: JAMA Psychiatry

Individuals with treatment-resistant depression often struggle to find effective treatment options that can help alleviate their symptoms. In such cases, healthcare professionals may explore alternative approaches, such as the following:

• Augmenting therapies (adding additional medications or treatments).
• Switching to different classes of antidepressants.
• Considering more specialized interventions like electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS).

The management of treatment-resistant depression requires close collaboration between the individual and their healthcare team to explore various strategies and find the most suitable treatment approach to improve their quality of life.

• CBT Therapy: Cognitive-behavioral therapy focuses on identifying and modifying negative thought patterns and behaviors contributing to depression. It helps individuals develop healthier coping strategies, challenge negative beliefs, and learn new skills to manage depressive symptoms effectively.
• Interpersonal Therapy (IPT): IPT focuses on improving interpersonal relationships and addressing social conflicts that may exacerbate depressive symptoms. It aims to enhance communication skills, resolve interpersonal difficulties, and support rebuilding social connections.
• Psychodynamic Therapy: Psychodynamic therapy explores unconscious processes and unresolved conflicts that may contribute to major depressive signs and symptoms. It involves examining past experiences, childhood relationships, and emotional patterns to gain insight into underlying issues and promote healing.
• Mindfulness-Based Therapies: One example is the (MBCT) or mindfulness-based cognitive therapy or (ACT) acceptance and commitment therapy, which incorporates mindfulness techniques to help individuals develop greater awareness and acceptance of their thoughts and emotions. These therapies can assist in reducing rumination and increasing resilience to depressive symptoms.

Psychotherapy for MDD typically involves regular sessions over a specified period. The specific type and duration of therapy may vary depending on the individual’s needs, preferences, and the therapist’s expertise. Working collaboratively with a mental health professional is crucial to examine and determine the most suitable psychotherapeutic approach for treating major depressive disorder.

Adjunctive Treatment of Major Depressive Disorder 

About half of patients who receive treatment with antidepressant drugs for major depressive disorder (MDD) do not achieve complete remission of symptoms. Despite treating depression effectively with short-term antidepressant drugs, the problem of relapse/recurrence remains. Treatment of depression by pharmacological means will likely leave residual symptoms in most patients. Such symptoms produce impairment and are important risk factors for relapse.

Researchers continue to seek complementary treatments that may improve residual symptoms of depression safely and sustain remission. Physical exercise may be a helpful resource. According to the National Center for Biotechnology Information (NCBI), exercise is one potential treatment for MDD in which there are positive research findings. The use of exercise in the treatment of MDD has gained support, as evidenced by the inclusion of exercise treatment in the American Psychiatric Association’s most recent treatment guidelines.

Depressive symptoms are temporarily reduced immediately following acute bouts of aerobic exercise. Patients may experience improvements in depressive symptoms in as little as four weeks; however, continued exercise for at least 10–12 weeks is necessary for the most excellent antidepressant effect. Psychosocial strategies should be implemented to promote adherence to the exercise program. Aerobic exercise can include walking/running outside, cycling, using a treadmill, or using an elliptical machine.

Biological Treatment for Major Depressive Disorder

Compared with the earlier generation of antidepressants exemplified by the tricyclics, selective serotonin reuptake inhibitors (SSRIs) have comparatively few side effects and lower cardiotoxicity, making them safer in overdose. The combination of safety, tolerability because of low side effects, and efficacy has undoubtedly contributed to a steadily rising number of SSRI prescriptions in recent years.

The SSRIs include fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, and escitalopram (the active enantiomer of citalopram). As a class, they are nonsedative (apart from fluvoxamine) and are not associated with an increased appetite or weight gain. Indeed, they can have an appetite-suppressing effect, and nausea and vomiting may be provoked, particularly at high doses.

An activating effect with restlessness in the first week or two and increased anxiety may be reported, but this does not usually persist. More controversially, SSRIs, in general, and fluoxetine and paroxetine, in particular, have been associated with increased suicidal ideation and an increased risk of suicide. As with restlessness and anxiety, suicidal ideation and behavior occur most commonly in the early stages of treatment.

• Intensive Treatment Setting: Residential rehab for MDD offers a highly structured and supportive environment where individuals can receive round-the-clock care from a multidisciplinary team of mental health professionals. This setting allows for close monitoring of symptoms, medication management, and a focused approach to treatment.
• Comprehensive Treatment Approach: Residential rehab programs for MDD typically offer a range of therapeutic interventions, including individual therapy, group therapy, family therapy, and various evidence-based treatments. The goal is to provide a comprehensive treatment approach that addresses the underlying factors contributing to depression and equips individuals with coping skills to manage their symptoms.
• Supportive Environment: Residential rehab provides a supportive community of peers who can relate to the challenges of living with MDD. Being surrounded by individuals going through similar experiences can offer a sense of validation, understanding, and connection. Moreover, a structured routine, away from the stressors of daily life, can create a safe and focused environment for individuals to engage in their recovery fully.

The decision to pursue residential rehab should be made in collaboration with a mental health treatment professional who can assess the individual’s needs and determine sufficient care. If you don’t know where to start or are looking for treatment options, connect with We Level Up mental health treatment center today.