Depression a Growing Illness that seems to touch us all in some manner

Whether each of us, as individuals, experience from time to time symptoms of depression or we know of some one that suffers from this condition that in many cases goes untreated, we all are affected by this growing phenomena.

Symptoms of Depression

Certain symptoms, which are present nearly every day, all day, for at least two weeks, are associated with depression and include at least one of the following:

• Loss of interest in things one used to enjoy
• Feeling sad, blue or down in the dumps
• Feeling irritable

In addition, at least three of the following symptoms may also be present:

• Loss of energy or feeling tired all of the time
• Feeling restless or unable to sit still
• Feeling worthless or guilty
• Increase or decrease in appetite or weight
• Thoughts of death or suicide
• Problems concentrating, thinking, remembering, making decisions
• Problems with sleep

Physical or psychological symptoms often associated with depression include:

• H eadaches
• Digestive problems
• Sexual problems
• Feeling pessimistic or hopeless
• Being anxious or worried
• Various aches and pains

Background

M ajor depressive disorder, also referred to as depression, affects 11 million Americans annually. Depression is not occasionally feeling sad, “blue”, “down in the dumps” or the feeling of intense grief after a loss. Depression is an illness just like asthma, diabetes, high blood pressure or heart disease, and is treatable just like these other illnesses.

Causes of Depression

Depression may be caused by many things including:

• Family history of depression
• Genetics affecting the body chemical serotonin
• Social Stressors
• Certain medications
• Drugs or alcohol
• Other psychiatric conditions
• Other general medical conditions

Seeking Help

H ealth care professionals are available to help you. Depression may be identified by your Primary Physician who may take several actions such as:

• Determining if there is a physical cause for your depression
• Treating your depression
• Referring you to a behavioral health specialist for further evaluation and treatment

The HELPING Professionals  

• General Behavioral Health Care Professionals
• Physician-medical health care provider who has some training in treating psychiatric disorders.
• Nurse Practitioner-a registered nurse with additional training, including training in treating psychiatric disorders.
• Physician Assistant-a health care provider with medical training and additional training in treating psychiatric disorders.
• Behavioral Health Specialists

Psychiatrist - physician who specializes in the diagnosis and treatment of psychiatric disorders and psychological problems associated with medical disorders. Psychiatrists may also prescribe medications or psychotherapy as part of treatment.

Psychologist - licensed health care provider with a Doctorate or Master’s degree in psychology and training in counseling, psychotherapy and psychological testing. Psychologists work in a variety of settings with individuals, groups or families to resolve problems.

Psychiatrist Nurse Specialist - registered nurse with at least a master’s degree in psychiatric nursing who specializes in the areas related to prevention, treatment and rehabilitation of psychiatrist.

Social Worker - health care provider with a degree in social work. A social worker with master’s degree usually has specialized training in counseling.

Behavioral Health Counselor - health care provider who has earned a master’s degree and is nationally board certified to provide professional counseling services, which include psychotherapy, human development, learning theory, and group dynamics to help individuals, couples and families.

Care Manager and Outreach Worker - health care professionals who assist individuals with severe psychiatric illness in obtaining needed services in the community. Care managers may be nurses, social workers or behavioral health workers and may be associated with behavioral health centers, psychosocial rehabilitation programs or other agencies.

Types of Treatment

M ajor treatments for depression include:

• Psychotherapy
• Antidepressant medications
• Antidepressant medications combined with psychotherapy
• Adjunctive treatment

Psychotherapy

Psychotherapy is a form of treatment where you work in a close partnership with a qualified behavioral health specialist known as a therapist. This therapist listens, talks and helps patients with problem solving. The course of treatment for psychotherapy is usually of short duration. There are several types of psychotherapy such as:

• Cognitive Therapy focuses on thoughts and beliefs. The goal of this therapy is the identification and correction of thinking patterns that can lead to troublesome feelings and behaviors. This therapy may be combined with behavioral therapy to improve effectiveness.
  
  
• Interpersonal Therapy focuses on your current life and relationships regarding family, social and work environments. Through this therapy, the therapist helps you understand your illness, feelings and how interpersonal problems and conflicts relate to depression. Patients are encouraged to identify and better understand these problems and develop more adaptive ways of relating to others.
  
  
• Behavioral Therapy focuses on current behaviors and uses learning principles. The goal of this therapy involves using these learning principles in an attempt to change troublesome thinking patterns and behaviors in a systematic manner. This therapy may also include stress management, biofeedback and relaxation training.
  
  
• Brief Psychodynamic Psychotherapy examines important relationships and experiences from early childhood to the present. This type of therapy attempts to analyze and change behaviors, which may be unsettling or destructive, and to resolve emotional problems.
  
  
• Adjunctive Therapy occurs under the guidance of a therapist and may be used alone or in combination with other therapies. Examples of adjunctive therapy include group therapy, couple therapy or family therapy. In group therapy, small groups of people with similar problems discuss individual issues in an attempt to help each other solve problems. Couple therapy involves discussions with the couple in an attempt to gain understanding about individual conflicts. The goal of this form of therapy is to develop a rewarding relationship for the couple while minimizing the problems in the relationship. Family therapy involves discussion and problem solving sessions that may involve the entire family or individual members of the family. Occupational, recreational or creative therapies may also be combined with adjunctive therapies. A behavioral health provider can help determine the need for these other therapies and make the appropriate referral.

Medication

M edication can be very helpful in reducing the symptoms of depression. Medication may be combined with psychotherapy. Some of the more commonly used groups of medications include:

Selective Serotonin Reuptake Inhibitors (SSRIs)

• Tricyclic antidepressants
• M onoamine Oxidase Inhibitors ( MAOs)

It is believed the medications correct chemical imbalances in the brain that contribute to depression. A Primary Care Physician or Psychiatrist can prescribe medications. Other health care providers may be aware of the medications but would need to refer you to the appropriate physician to obtain a prescription. A physician will carefully discuss the medication which is most appropriate for you. It is important to take the medication as ordered and continue taking the medication as you begin to feel better. Any unusual side effects should also be reported to your physician.

Choosing a Treatment

Individuals with symptoms need to be frank with their health care provider and should discuss their feelings openly. If a diagnosis of depression is made it is important the effects of depression be discussed (lost time from work, toll on personal relationships, etc.) benefits, risks and expense of the treatment being suggested. Since depression is a treatable illness, you and your health care provider should work together to determine which treatment is best for you.

Determining the Effectiveness of Treatment

M edication

If an antidepressant medication is prescribed, it is important to remember

that the medication does not take effect right away. Antidepressants may need to be taken 2-4 weeks for a noticeable effect. Because of this, it is important to take medication as prescribed and continue to take it even if the patient is feeling better. Within the initial 12 weeks, at least three follow-up visits with the doctor who prescribed the medication are needed to measure progress while on the medication.

Therapy

At the beginning of psychotherapy, one should establish clear goals with their therapist. Depending on the amount of time spent in psychotherapy, these goals may need to be adjusted. Honest, open communications and establishment of good rapport between the patient and their therapist are very important. Periodically, the patient and their therapist should review their progress or concerns if there seems to be a lack of making progress. Indications of progress with psychotherapy include reaching goals, experiencing relief from emotional distress and beginning to lead a more productive and fulfilling life.

Nova Southeastern University ’s Health Centers are Available to Help

Nova Southeastern Health Centers have qualified providers to help patients that may be experiencing symptoms of depression.

Medical Centers at the Davie and North Miami Beach campuses

Psychology Services Center in the Maltz building on the Davie campus

Family Therapy Center through the Graduate College of Humanities and Social Science in the Maltz Building on the Davie Campus

Student Counselling Center in the Parker Building on the Davie Campus for students only

For further information or referral regarding any of our services you may call (954) NSU- CARE (678-2273)