Depression: Signs, Treatment, And How to Help
October is National Depression and Mental Health Screening Month. During this month, Pennsylvania Psychiatric Institute (PPI) hopes to bring more awareness to this disorder, and with the help of one of their psychiatrists, educate on the symptoms, treatment and how family members can help.
Ankit Jain, MD, is an outpatient psychiatrist at PPI, and regularly treats patients with depression among various other mental health problems. “Depression is a common term, but medically, it’s known as major depressive disorder, or MDD” clarifies Dr. Jain.
Symptoms
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook widely used by clinicians and psychiatrists in the United States to diagnose psychiatric illnesses. According to the DSM-5, some of the symptoms include:
- A period of sad or depressed mood
- Loss of interest or pleasure in activities
- Sleeping too little or too much
- Variation in appetite
- Variation in weight
- Moving too slow or fast
- Having little energy/easily feeling fatigued
- Poor focus or concentration
- Feeling unworthy of good things in life
- Extremely hopeless
- Feeling guilty or self-critical
- Repeating/fleeting suicidal thoughts
Dr. Jain notes: “Some or all these symptoms are required for diagnosis. The World Health Organization estimates that MDD is the 11th greatest cause of disability and mortality in the world, meaning that there are over 265 million that suffer from depression worldwide. In the US especially, it is extremely common – almost at epidemic levels – affecting 1 in 10 Americans. Depression also greatly increases the risk of suicide, at a rate 27 times more likely than the general population.”
“We see the highest rates in individuals 18-25, with women being twice as likely than men to have depression. Depression also has a genetic component, meaning those with a family history are more at risk. If you have a family history, it’s important to be aware of the symptoms of depression and seek the help of a mental health provider if you think you might be depressed.”
Diagnosis and Treatment
When discussing how he treats patients with depression, Dr. Jain states, “I first give them an assessment and psychiatric evaluation, before recommending psychotherapeutic techniques. Then I look at their medical conditions, if they’re taking any medications and if they might need adjusted. I mostly see patients in an office setting, though sometimes if any of their conditions are so severe that functionality becomes limited, or they pose a danger to themselves or others, I’ll refer them to impatient care for appropriate treatment.”
In addition to mental status examinations, Dr. Jain also does physical exams and medical evaluations, and will refer patients to other providers if he finds other conditions that need treatment. “Depression is a common comorbidity, meaning a medical condition that is also present with one or more other conditions in a patient. Common comorbid conditions are diabetes, high blood pressure, cancer, stroke, rheumatological diseases and chronic illness like lupus and MS. Unfortunately, when associated with another condition, outcomes are worse than having that condition alone.”
Depression can be experienced at different stages. “There are three levels – mild, moderate and severe. For mild to moderate depression, we typically treat with psychotherapy, individual counseling, cognitive behavioral therapy (CBT), interpersonal therapy and/or psychodynamic psychotherapy. For moderate to severe cases, in addition to therapy, we also use medication. Common medications include anti-depressants like selective serotonin reuptake inhibitors (SSRIs), SNRIs, atypical antidepressants, mood stabilizers, anti-psychotics, stimulant and non-stimulant medications.
“No matter the severity, I always recommend lifestyle changes like exercise, maintaining a healthy diet, socialization and avoiding substances. These behavioral modifications are an important part of any treatment plan.”
Helping a Friend or Loved One
If you have a friend or family member who has depression, know that there are things you can do to help their recovery. With a 50% chance that a patient’s depression will reoccur, having supportive friends and family can help prevent recurrence.
Dr. Jain explains, “Knowing the symptoms is important. Feeling sad off and on is different from feeling heavy and experiencing changes in appetite or sleep. You can help a loved one by talking with and supporting them, taking them to their mental health professional for assessment and by asking them if they have any thoughts of self-harm.”
“Those with depression can be hypersensitive, so being more sensitive to their emotions and offering support and encouragement can go a long way. MDD causes poor psychosocial relations so they may have problems with personal relationships or issues dealing with their employment. If you notice them isolate or withdrawal, encourage them to socialize. Other things to look out for are any worsening symptoms, like not sleeping or eating. If you notice worsening symptoms, increase your encouragement for them to get evaluated.”
The median time to recovery is 20 weeks and though sometimes episodes can resolve more quickly, it can be a long process. Support groups are available for family members who may need help and support as well.
Pandemic Impact
“Many are now aware that COVID-19 had a huge impact on mental health. There are lots of studies showing how it worsened anxiety and depression symptoms in patients. In a study I wrote during Covid, those who already had MDD experienced worsening conditions due to its unexpected nature, not having enough information initially, the reduction of services and institutes running at lower capacities.”
Read more from Dr. Jain’s article linked below.
Impact on mental health by “Impact on mental health by “Living in Isolation and Quarantine” during COVID 19 pandemic
Dr. Jain has authored numerous other studies and papers in renowned journals and has written book chapters related to psychiatric and neurological conditions. He is also an Assistant Professor of Psychiatry and Behavioral health at Penn State College of Medicine and an Attending Psychiatrist at Penn State Health where he routinely teaches medical students, PA students and Psychiatry residents.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
If you would like to speak to someone about better managing your stress and anxiety, or to make an appointment, please call (717) 782-6493 for more information.