Major Depressive Disorder Diagnosis
Major depressive disorder may be diagnosed when a person sees his or her doctor with complaints about mood, changes in appetite or sleeping problems, and different symptoms recognized as signs of depression. Sometimes some people with depression try to discuss their problems with their friends and relatives, the latter in their turn strive to help them.
The diagnosis of major depressive disorder involves a group of symptoms in addition to depressed low mood. Firstly, the doctor takes into consideration the history of the patient, then he asks the patient about his or her sleep, appetite, sex drive, and mood, after all, the doctor gives the person with depression a physical examination to find out other possible causes of the symptoms.
Some disorders may resemble MDD, including cognitive dysfunction caused by the direct effects of a substance (drug abuse, medication, or toxic chemical); various medical conditions (i.e., an underactive thyroid gland; strokes; or early stages of dementia ), or other mental disorders. Such terrible stressful life events as normal bereavement may also produce behaviors similar to those associated with MDD; while a person may seem to have many of the signs of MDD, the disorder would not be diagnosed unless the symptoms lasted for more than two months. As an essential part of the diagnostics, the doctor may give the patient a brief screening form, in order to receive a precise interpretation of the symptoms. In addition to interviewing the person with MDD, the doctor may talk with family members or others who can provide information that the sufferer may forget, deny, or consider unimportant.
The diagnosis of major depressive disorder is complex by the fact that people with major depressive disorder frequently suffer from other mental disorders at the same time, including anxiety disorders, alcohol or drug abuse problems, and personality disorders. Each person with MDD may have “individual” symptoms according to age, sex, stage of the illness, it is believed that MDD may be a combination of disorders, thus, sometimes it is difficult to reach an accurate diagnosis in a short period.
The diagnosis of a person with depression may comprise certain determinants:
- the severity and chronicity of the disorder;
- the existence of psychotic signs (delusions or hallucinations) or catatonia (motionless for a long period of time, and other features of posture, movement, speech);
- melancholia (extra low mood that is worse in the morning);
- very early morning awakening;
- psychomotor retardation or agitation;
- significant weight loss, or inappropriate guilt feeling;
- any data about postnatal status.
If MDD is currently in remission, this fact is also highlighted as a diagnostic determinant.
Major Depressive Disorder Treatment
MDD can have a destructive impact on a person’s life, the importance of effective treatment cannot be overestimated. Treatment of major depressive disorder usually includes medication, talking therapy (psychotherapy), or both together. Antidepressants are used in the treatment of severe forms of depression, such as MDD.
Talking therapy is based on the belief that depressed people perceive themselves and the world in unrealistically negative ways. It has been found that depressed people pay more attention to negative events than to positive ones, people get stuck in a negative way of thinking, thus, depression is getting worse. Therapists help patients identify the automatic thoughts that lead them to anticipate poor outcomes or to interpret neutral events in negative ways. The patient is also encouraged to challenge negative thoughts by comparing his or her expectations of events with actual outcomes.
It was proved that bad interpersonal relationships may boost vulnerability to depression plus depressed adults and children tend to provoke negative reactions from other people, it was decided to use social skills training as a form of treatment. In this type of therapy, people learn to recognize actions and attitudes that irritate others and to change behaviors with more appropriate ones. This type of training may be helpful to people with depression who strive to avoid any kind of relationships and you are not able to build healthy relations. This method is suggested that depression is likely to vanish when a person finds new friends and receives some social support.
Psychodynamic psychotherapy is often effective in treating patients with MDD whose depression is related to unresolved issues from the past, particularly abuse or other inconceivable and painful childhood experiences. When a person shares his personal feelings and fears with others, he receives enormous relief from emotional pain.
Support groups are extremely helpful to people to cope with depression. Talking therapy is effective in combination with other treatments, such as medication.
The use of medications in the treatment of depression began in the late 1950s with the successful introduction of tricyclic antidepressants and MAO inhibitors. Treatment of depression with medications has extremely increased since the introduction of selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and sertraline (Zoloft). The significant advantage of these medications is that they have fewer side effects and are much safer for patients who may tend to overdose. Choosing the optimal antidepressant medication is not always an easy process, however, and the patient may have to try out different drugs for a period of weeks or months before finding one that is effective to him or her. In addition, while the SSRIs have few side effects, such concerns as loss of sexual interest or functioning, nervousness, headaches, gastrointestinal complaints, drowsiness, and insomnia can be significant obstacles to the patient’s taking the medication as directed.
Other well-known approaches
The use of electroconvulsive therapy (ECT), initially began to use in the 1930s, was actually banished as a treatment for MDD for many years, as a result of the effectiveness and convenience of psychotropic medications. Since the 1980s, interest in this method has renewed; in 1990 new instructions for the use of ECT were published. While it is believed a cruel method of treatment that causes pain, in actuality the patient is given a sedative and the electrical stimulation is calibrated precisely to produce the maximum therapeutic effects. ECT may be the first line of treatment when a patient resists to common medications or is at high risk of harming themselves.
The use of phototherapy (light therapy) has become the treatment of choice for patients diagnosed with the seasonal affective disorder (SAD). Although the reasons for the effectiveness of phototherapy are not yet precise, treatment involves exposing the eyes to bright light for several minutes a day. Nowadays, however, there is little evidence to suggest that phototherapy is helpful in the treatment of other types of major depressive disorder.
Alternative and additional treatments
Alternative and additional treatments include acupuncture, meditation, and a therapeutic diet designed to be free of caffeine and refined sugar, are likely to reduce symptoms of mild forms of depression. However, such types of treatment turned to be less effective for severe forms of depression including major depressive disorder. Before using alternative methods of treatment, the person with depression should consult the doctor since the combination of alternative methods of treatment and certain medications can lead to complications.
Herbal medicine is a common alternative method of treatment for depression. The most important caution is that persons who are using herbal remedies, whether to beat depression or other conditions, should always inform their doctors what they are taking, how much, and how often. This warning is extremely important because some herbal remedies that are safe in themselves can interact with prescription medications. In particular, Saint-John’s-wort causes interactions with fluoxetine (Prozac).
Some additional approaches seem to be helpful to persons with depression because they are supposed to bring pleasurable experiences for the senses or lift the person’s spirit. These include aromatherapy, music therapy, pet therapy, humor, therapeutic massage, and yoga.