Diagnosis and Treatment

Making a proper diagnosis of major depression involves the doctor asking you many questions, performing a physical exam, and possibly running some tests. Doctors may use standardized depression questionnaires to gather information.

The doctor will ask you questions about the history of your depression symptoms, including when they started, how long they have lasted, how severe they are, whether they have occurred before, and if so, how they were treated. He or she will also ask about life stresses and whether any family members have been diagnosed with depression. The doctor will review any medications you are taking to determine if a medication may be affecting your mood.

A physical examination and blood tests can be performed to rule out other conditions that cause symptoms similar to depression, like thyroid disease, anemia or kidney disease. Treating these conditions can often relieve the depression symptoms.

Common Medications for Depression

Major depressive disorder is typically treated with antidepressant medications and/or counseling. Antidepressant medications work by changing the balance of certain chemicals in the brain, which helps improve mood. These are the most common medications used to treat depression:

  • Selective serotonin reuptake inhibitors (SSRIs): These drugs work by blocking a receptor in the brain that absorbs serotonin, a brain chemical known to influence mood.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs): These drugs work by blocking the absorption of serotonin and norepinephrine (another brain chemical that affects mood) in the brain.
  • Bupropion: This drug works by acting on the chemical dopamine in the brain. It does not fit into any specific drug category.
  • Monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and tetracyclic antidepressants: These older classes of antidepressants are prescribed less often than SSRIs, SNRIs, and bupropion. They typically cause more side effects; however they do work well for some people.

Therapies for Depression

  • Psychotherapy (also called counseling or talk therapy): This therapy involves talking about your depressive moods, attitudes, and life stresses or problems with a professional therapist. The therapist helps you develop new ways to think about and deal with difficult situations and develop ways to cope with your feelings. Therapy gives people tools to help fight feelings of depression, low self-esteem, anger, fear, anxiety, shyness or panic.
  • Electroconvulsive therapy (ECT): This treatment may be recommended for severe depression that does not respond to medication or therapy. ECT involves delivering an electrical shock to the brain for 1-2 seconds in an attempt to alter the release of brain chemicals involved in depression.
  • Alternative therapies:Some studies suggest that St. John’s wort may relieve symptoms of milder depression, but it has not been shown effective for treating major depression. It is important to talk to your doctor before taking any herbal supplements, particularly St. John’s wort, because it can interact with some medications.

In addition to standard depression therapies, the following habits may help manage depression symptoms:

  • Eating a nutritious diet
  • Exercising on a regular basis
  • Avoiding alcohol and recreational drugs
  • Avoiding caffeine

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