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General principles of depression treatment


Assessing and correctly identifying any underlying cause is critical

-is it an illness, medication side effect, other personal or environmental factor

Clarify if it is unipolar or bipolar, are there manic episodes.

Psychotherapy and drug therapy are both effective and often used together




Major depressive disorder

Characterized by recurrent major depressive episodes

minimum 2 week periods, involving 4 of the criteria, one of which must be depressed mood or anhedonia.

(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
(4) insomnia or hypersomnia nearly every day
(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
(6) fatigue or loss of energy nearly every day
(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide


Pyschotherapy treatments


Psychoeducation - give information concerning the symptoms and natural course of the illness, and the advantages, side effects, temporal and financial concomitants of the possible treatments

Amending negative thoughts with cognitive therapy

Identifying and increasing positive experiences
Keep a diary of positive events and goals met