Major Depressive Disorder Treatments
About Depression
Depression, or major depressive disorder, is an ever-varying disease that may present itself in a number of ways. While everyone experiences depression differently, the illness generally manifests itself through persistent mood changes, as well as behavioral changes.Â
- Feeling sad or having a depressed mood
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite — weight loss or gain unrelated to dieting
- Trouble sleeping or sleeping too much
- Loss of energy or increased fatigue
- Increase in purposeless physical activity (e.g., handwringing or pacing) or slowed movements and speech (actions observable by others)
- Feeling worthless or guilty
- Difficulty thinking, concentrating or making decisions
- Thoughts of death or suicide
There are different categories of depression and understanding what they are will help you in navigating the best course of treatment for your symptoms.Â
is characterized by the presence of five or more of the above symptoms during the same two-week period, representing a change from previous functioning; at least one of the symptoms is either depressed mood or loss of interest or pleasure.
is defined as a sub-category of MDD. People with TRD have depressive symptoms that persist despite adequate trials of antidepressant medication or psychotherapy. There isn’t a universally accepted definition of TRD, but commonly used criteria include:Â
- Failure to respond to at least two different antidepressant medications of adequate dose and duration.Â
- Failure to respond to a course of psychotherapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT).Â
- Persistence of clinically significant depressive symptoms despite treatment.Â
It’s important to note that the definition of TRD can vary among clinicians and researchers. Some may require a specific duration of failed treatment trials, while others may consider additional factors such as severity of symptoms or comorbid conditions.Â
also known as anxious distress, is a specifier used in the diagnosis of major depressive disorder (MDD) to describe a subtype of depression characterized by the presence of specific symptoms of anxiety. These symptoms often co-occur with depressive symptoms and may influence the course and treatment of depression.Â
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), includes anxious distress as a specifier for depressive disorders. According to the DSM-5, a diagnosis of major depressive disorder with anxious distress is made when at least two of the following symptoms are present during most days of a major depressive episode:Â
- Feeling tense, restless, or keyed up.Â
- Feeling unusually apprehensive or fearful.Â
- Having difficulty concentrating because of worry.Â
- Fear that something awful may happen.Â
Anxious depression can manifest with a variety of symptoms, including excessive worry, irritability, difficulty concentrating, and physical symptoms such as muscle tension or sleep disturbances. It’s important to recognize anxious distress in individuals with depression, as it may impact treatment decisions and response to antidepressant medications.Â
How Hopemark Treats Depression
At Hopemark, we use a comprehensive and integrated approach to treatment that involves testing, medication management, psychotherapy, as well as other necessary treatments, all overseen by board-certified psychiatrists and psychiatric medical providers. We pride ourselves in treating patients holistically, versus focusing only on one problem or one solution. Â
It is important to have an individual plan for each patient, therefore we begin our process with a comprehensive psychiatric evaluation. If needed, we will conduct pharmacogenetic and/or cognitive testing. Â
Once we have learned more about you as a patient through these tests, a multifactorial treatment plan is recommended. There are many possible treatment solutions for depression including IV Ketamine Therapy, Spravato, dTMS, psychotherapy and medication management. Your provider will go through all these options with you during your evaluation.Â
Our treatment plans are created with more than just your current symptoms in mind, the goal is to get to the root cause of your symptoms and support you in your psychological growth.Â