Managing Depressive Disorder

Managing Depressive Disorder

Dr.Selvizhi Subramanian profile Authored by Dr.Selvizhi Subramanian on 11 Sep 2014 - 13:43.

Major depressive disorder, also known as depression or clinical depression, is a serious disorder of mood that cause persistent feeling of sadness affecting thoughts, behavior, feelings and physical health. It is also known as unipolar disorder that indicates the presence of one extreme mood unlike bipolar disorder which is characterized by mania in addition to depression. It is a long term condition in which periods of wellness alternate with recurrence of sad mood.

Some people believe that depression is not worth bothering. However, the severity and frequency of the condition tend to increase if treatment is overlooked. According to statistics, about half of the patients who have had an episode of depression do not experience it for the second time in their life but for the rest, it can be experienced many a time.

Biological issues which are related to depression are genetic and family history. If somebody who has history of depression, those types of patients are easily susceptible for depression even with very little psycho-social issues. But if somebody who doesn't have any family history can also be affected when there are more severe psycho-social issues such as financial, housing issues, poor social support, etc.

So various biological and pyscho-social issues that causes depression ultimately lead to an imbalance in the mind, where there is a deficiency of neurochemicals in the mind and how these neurotransmitters interact with neurons, finally affecting the communication between the neurons that are mainly involved and control the emotions.

Symptoms may include:

  • Feeling of sadness/unhappiness
  • Angry outburst
  • Sleep disturbance (difficulty in sleeping or excess sleep)
  • Excessive tiredness
  • Feelings of helplessness and hopelessness
  • Loss or gain of weight
  • Difficulty in concentration
  • Loss of appetite
  • Physical pains
  • Loss of sex drive
  • Suicidal thoughts
  • Self harm

When to see a doctor?

Consult a psychiatrist if you are experiencing these symptoms for more than 15 days or earlier if there are suicidal thoughts or if you don't eat or drink. The sooner you see a doctor, the sooner you can be recovered.

There are no specific tests for the diagnosis of Depression. Your psychiatrist may ask you a few questions related to your health, behavior, symptoms and daily lifestyle to understand your condition. Psychiatrists follow the criteria of Diagnostic and Statistical Mental Disorders or International classification of diseases to confirm the diagnosis. You may also need to give a sample of blood to test for other parameters such as thyroid levels to rule out other conditions.

All age groups irrespective of their race and socioeconomic status may experience Depression. However, people in the range of 25-44 years and geriatric population above 65 years of age are more susceptible to the condition. Further, women are at twice the risk of men in adulthood. Other factors may include:

  • Alcohol/drug abuse
  • Anxiety disorder
  • Chronic illnesses like cancer,, diabetes and heart diseases


Treatment of Depression should be started as soon as possible, if not it might lead to:

  • Suicidal attempts or suicide
  • Alcohol abuse
  • Poor quality of life.

With right treatment and support, a majority of the patients do recover. Either Medications or psychotherapy or both are recommended as treatment based on the severity of the condition.

Types of antidepressants that can be used are:

  • Selective Serotonin Reuptake Inhibitors (SSRIs): fluoxetine, sertraline, paroxetine, citalopram and escitalopram.
  • Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs): duloxetine, venlafaxine and desvenlafaxine.
  • Tricyclic antidepressants: imipramine and nortriptyline. (rarely prescribed due to its severe side effects)
  • Monoamine Oxidase Inhibitors (MAOIs): tranylcypromine and phenelzine (severe side effects and strict diet requirements limit its usage)
  • Atypical antidepressants: trazodone and mirtazapine.


Non-drug therapy:

  • Talking treatment such as cognitive behavioral therapy and counseling can treat mild to moderate depression.
  •  Reach out to a friend or loved one if you experience suicidal thoughts.
  • Consider physical exercises as it increases the levels of endorphins and the neurotransmitters serotonin, dopamine, and norepinephrine, thereby improving the symptoms.
  • Social interaction can keep symptoms away.
  • Talk your feelings to a friend or join a self-help group.
  • Get plenty of sleep to maintain physical and mental well-being.
  • Do not skip medications or psychotherapy session unless advised by your psychiatrist.
  • Protein rich food may boost your alertness.

Other therapies:

  • Electroconvulsive therapy: Electric currents are passed through your brain to improve your mood when other therapies fail to relieve depressive symptoms.
  • Transcranial magnetic stimulation: Rapid pulses of magnetic field are applied to the head for anti-depressant effect.

We cannot completely prevent depression, but these strategies can help in reducing the risk of developing the condition:

  • Learn ways to control stress
  • Get treatment at the earliest if you think you are suffering from depression
  • Do not stay alone in times of crisis
  • If you already have experienced depression, you may have to consider long term treatment to prevent relapse. 
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.