Self-Management of Depression

When one is feeling low, it doesn’t necessarily mean that one is going through the throes of clinical depression, i.e., major depressive disorder. There are several conditions that may mimic clinical depression but don’t reach the severity or pervasiveness of the former condition or are symptomatically distinct. It is important to recognize these so that one may not unnecessarily get prescribed medications or started on psychotherapy as some of these conditions are time limited or may remit on their own. At the same time, some of these conditions such as complicated grief may need specialized therapy. Conditions that resemble depression but are not depression include the following: Sadness: Depression is more than the normal pangs of sadness one gets when experiencing a stressful situation. Depression is a more pervasive and persistent change in your mood along with changes in your physiological functions such as sleep, appetite, and energy level. Although stress can trig...

With strategies such as Transcranial Magnetic Stimulation (TMS), Ketamine, and psychedelics becoming more prevalent for treatment-resistant depression, it is helpful to take a look at what this entity really means. Not everyone who is being referred for either TMS or treatment with Ketamine may have "true" treatment-resistant depression, and then there is what is called "pseudo-resistance." In simple terms, treatment-resistant depression implies that depression has not reached sufficient remission after adequate treatment. Remission is defined as clinical improvement with few signs of depression still remaining and a lower likelihood of subsequent exacerbations. About 15% of people with depression may eventually develop treatment-resistant depression (Berlim & Turecki, 2007). Treatment-resistant depression has been variously defined, but the most commonly accepted definition is as follows (Souery et al., 2007): A person with depression is considered ...

Bipolar depression is a depressive episode occurring in context of bipolar disorder. When diagnosing depression, it is imperative to first exclude an underlying bipolar disorder. This is because the medication treatment for bipolar depression differs from that for   “unipolar”  depression. People with bipolar disorder have   manic  or  hypomanic  episodes. These are periods of persistently elevated or irritable mood along with feelings of grandiosity, decreased need for sleep, talkativeness, racing thoughts, increase in sexual drive, increased goal-directed activity, or excessive involvement in risky or impulsive activities. Individuals with bipolar disorder spend around 40% of the symptomatic time being depressed (Judd et al., 2002). Moreover, people with bipolar disorder are more likely to seek help when they are depressed. Therefore, it is not uncommon for bipolar depression to be   misdiagnosed   as unipolar depression or majo...