Depression
Although the mood is often sad/depressed it does not have to be. Mood can be irritable, anxious or apathetic. Other symptoms often include:
Psychotic depression includes at least one of the following in addition to the above:
- Sleep disturbance (insomnia or sleeping too much)
- Change in appetite and/or weight (loss of appetite but more commonly “stress eating”)
- Impaired cognitive functioning (trouble concentrating, remembering and/or making decisions)
- Change in energy level (fatigue or agitation)
- Feeling overwhelmed and as if everything is harder than it should be
- Loss of interest in normally enjoyable activities (avoiding people or situations or just “going through the motions”)
- Low self-esteem
- Excessive guilt
- Hopelessness
- Feeling helpless to change the situation or oneself
- Pessimism
- Thoughts of escape or death (suicidal thoughts or a wish something would happen to end the suffering)
Psychotic depression includes at least one of the following in addition to the above:
- Hallucinations (seeing visions, hearing voices)
- Delusions (beliefs out of touch with reality such as paranoia—not simply excessive self-consciousness)
Treatment for Depression
Goal — Resolve the current episode and prevent (as much as possible) another from developing.
Steps
Steps
- Calm down the acute symptoms with nonaddictive antidepressant medication if indicated.
- Regulate hormonal status if needed.
- Assess the stressors—either those causing the symptoms or resulting from the depression (i.e. job loss, relationship disruptions, etc.)
- Teach ways to undo the current problems and/or symptoms and prevent their development in the future through helping the patient acquire new skills for managing emotions.
- Incorporate the four cornerstones of health into every day life (good diet, exercise, proper sleep, socialization)
- Develop a strategy for early identification of depressive symptoms in the future and preventative measures to be taken.