Depression: Diagnosis and Treatment

When diagnosing depression, generalized anxiety disorder, or social anxiety disorder, your doctor may:

     
  • Perform a complete physical examination  
  • Run some tests to see if you have other underlying medical conditions that might be causing your symptoms  
  • Ask how you are feeling  
  • Ask you to complete a questionnaire to help determine if your memory or any speech or thought patterns have been affected by your condition

Depending on the outcome of these evaluations, your doctor may select a treatment that may include one or a combination of the following treatments: medications, talk therapy, or other treatments.

When working with your doctor, it is important to tell him or her about any symptoms you are experiencing. For example, are you low on energy? Do you have trouble concentrating? Also tell your doctor about how you are feeling emotionally and if you are not motivated to do the things you once looked forward to doing. This will help him or her determine the best treatment for your condition and track your progress. After all, the goal is to reduce or virtually eliminate your symptoms and get back to your life again.

Medications

Several types of antidepressant medications are used to treat depression. Some of these are also used to treat generalized anxiety disorder and social anxiety disorder, including the following. Make sure to ask your doctor which is right for you.

     
  • Monoamine oxidase inhibitors (MAOIs)  
  • Tricyclic antidepressants (TCAs)  
  • Selective serotonin reuptake inhibitors (SSRIs) such as Paxil CR™*, Prozacreg;*, Lexaproreg;*, and Zoloftreg;*  
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Effexor® XR (venlafaxine HCl). Effexor XR is known as an SNRI (serotonin and norepinephrine reuptake inhibitor) and is believed to help treat depression and the associated symptoms of anxiety by affecting the levels of two chemicals in the brain - serotonin and norepinephrine. These two chemicals are thought to play a key role in depression. Correcting the imbalance of these two chemicals may help relieve depression symptoms - which can be the first step toward getting your life back. Click here to learn more about the benefits of Effexor XR. Talk Therapy Talk therapy (psychotherapy) helps you work toward changing the way you view the world around you and how you react to it. The addition of counseling or talk therapy to your medication may help you to interact with others again. Talking with a psychiatrist or another qualified health professional can help you explore your relationships, feelings, and experiences in a meaningful way. This kind of therapy could be helpful in learning more about depression and how to cope with events in the future. The following are three possible types of psychotherapy used for depression, generalized anxiety disorder, and social anxiety disorder:
       
    • Cognitive behavioral therapy (CBT) - helps a person to recognize his or her own negative thought patterns and behaviors and replace them with positive ones. CBT can quickly bring important changes to a person’s daily life and outlook for the future.  
    • Interpersonal therapy (IPT) - focuses on working through troubled personal and social relationships that may contribute to depression. By learning how to deal with others more effectively, a depressed person may be able to reduce conflict in daily life and gain support from family and friends.  
    • Psychodynamic therapy - helps a person look inside himself or herself to uncover and understand emotional conflicts that may be contributing to depression. Because unresolved problems from childhood may be the cause, it could take some time to work out problems using this type of therapy.

    Many people benefit from a combination of antidepressants and some form of psychotherapy. According to the National Institute of Mental Health, more than 80% of patients with depression show at least some improvement when they receive appropriate treatment with medication, talk therapy, or both. Talk to your doctor to determine a treatment plan that works best for you.
    Other Treatments

    In the treatment of depression, various stress reduction techniques are also often recommended, such as biofeedback, exercise, and meditation. In some cases, electroconvulsive therapy (ECT) can be very helpful.

    Unlike diseases that can occur only once in a lifetime, depression can return. If you have had an episode of depression, you face a 50% chance that it will recur sometime within 5 years. Left untreated, the disease can become chronic (lasting for a long time), with each episode increasing the risk for another bout with the disease. After 3 episodes, the odds are 90% that depression will return again.

    Therefore, it is important to work with your doctor to find the right treatment for you. With treatment, it is possible to reduce or virtually eliminate symptoms of depression and get your life back again.

    Important Product Information

    Before starting Effexorreg; XR (venlafaxine HCl), tell your doctor about any medicines you’re taking, including over-the-counter drugs and herbal supplements. People taking MAOIs should not take Effexor XR. Patients taking antidepressants should be watched closely for signs that their condition is getting worse or that they are becoming suicidal, especially when they first start therapy, or when their dose is increased or decreased. Patients should also be watched for becoming agitated, irritable, hostile, impulsive, or restless. Such symptoms should be reported to the patient’s doctor right away. Effexor XR may raise blood pressure in some patients, so blood pressure should be monitored regularly. When people suddenly stop using or quickly lower their daily dose of Effexor XR, discontinuation symptoms may occur. Talk to your doctor before discontinuing or reducing your dose of Effexor XR. Pregnant or nursing women shouldn’t take any antidepressant without consulting their doctor. Until you see how Effexor XR affects you, be careful doing such activities as driving a car or operating machinery. Avoid drinking alcohol while taking Effexor XR. Common side effects with Effexor XR include anorexia, constipation, dizziness, dry mouth, insomnia, nausea, nervousness, sexual side effects, sleepiness, sweating, and weakness. Effexor XR is for adults 18 and over. Ask your doctor if Effexor XR is right for you. Click here for full Prescribing Information.

    Provided by ArmMed Media
    Revision date: June 18, 2011
    Last revised: by Jorge P. Ribeiro, MD