Too many misinformed opinions about this topic out there leads to tragedy or poor quality of life for too many people.
Clinical depression is a mood disorder category. It is not a character or personal weakness. Within that category there are the Depressive Disorders. The Depressive Disorders include Major Depressive Disorder (MDD) and Dysthymic Disorder (DD). MDD includes single, recurrent, melancholic, atypical or seasonal subcategories. DD includes early or late onset categories.
Dysthymia is a less severe, chronic form of depression. It is often referred to as mild depression. It usually has an early onset before adulthood, however late onsets do occur. This form of depression does require treatment because if left untreated it can develop into a double depression which would include a major depressive episode. Psychotherapy and low dose antidepressant medication, along with lifestyle changes can help resolve the symptoms and bring on remission.
MDD, also known as major depression, is a much more severe form of clinical depression that also requires psychotherapy and usually antidepressant medications with higher doses. Diet, lifestyle and environmental changes can also provide relief of symptoms and remission along with clinical treatment.
Clinical depression can be caused by medical problems. It is always best to rule out this possibility by having a health examination performed to check for nutritional problems, thyroid problems, or other medical conditions. If there are no medical issues found, then the depression is likely caused by a combination of biological and environmental conditions (Preston & Johnson, 2012).
Symptoms of clinical depression include negative rumination, irritability, loss of feelings of pleasure, inappropriate feelings of guilt, extreme sadness and a profound sense of emptiness, among others. Antidepressant medication and cognitive behavior therapy used together has shown to be an effective treatment for clinical depression. The medication helps relieve the symptoms so that the talk therapy can be effective.
There is still too much unfounded and learned stigma associated with antidepressants as well as with psychotherapy. As people become better educated about these medications and therapies, it becomes less of a stigma. The more that people understand that clinical depression is based on neuroscience, and therefore its treatment is more effective most of the times when approached from a combination of a psychological and medical perspective, the less stigma will play a role in diagnoses and treatment. It is important to note that physiological symptoms of clinical depression must be present in order to consider medication as part of the treatment. Some of these symptoms include unexplained weight loss or gain, fatigue, insomnia or oversleeping. Substance use and abuse must also be eliminated as a possible cause of the depression.
Although the medication typically takes between two to four weeks to take effect, it is important to remain on the medication for at least six months in order to ensure recovery and prevent relapse. Dysthymia does not always present with the acute symptoms that major depressive disorder does, but it can be just as debilitating in time. People who live with Dysthymia continue with their day to day life, unlike major depression which can be debilitating and cause individuals to isolate, shut down and withdraw completely from society. However, life can still feel difficult to someone with symptoms of Dysthymia.
Preston, J. & Johnson, J. (2012). Clinical psychopharmacology made ridiculously simple (7th edition). Miami, FL: MedMaster, Inc.
Schatzberg, A.F., Cole, J.O., & DeBattista, C. (2010). Manual of clinical psychopharmacology (7th ed.). Washington, DC: American Psychiatric Publishing, Inc.
Medscape References by WedMD (2012). Retrieved March 22, 2012 from http://emedicine.medscape.com.
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Xiomara A. Sosa, NCC, LPC-I (application pending), is a National Certified Counselor, a Licensed Professional Counselor-Intern (application pending), a Clinical Mental Health – Forensic Counselor and a freelance writer based out of the Charleston, SC and Miami, FL metropolitan areas. Xiomara is passionate about integrative mental healthcare and holistic wellness and social change advocacy. Xiomara holds a Bachelor of Science in psychology from the University of Phoenix and a Master of Science in clinical mental health counseling with a specialization in forensic counseling from Walden University (CACREP accredited). She is currently a doctoral/PhD student for human services with a specialization in public health at Walden University. Xiomara is committed to helping people lead healthy lives. She is the founder and principal of her private practice, XAS Consulting, LLC, where she practices a progressive, innovative path to integrative mental healthcare and holistic wellness by combining psychological health, mental health, forensics, physical health, social services and public health. She is also the founder of The Get-Right! Organization, Inc., a social change advocacy nonprofit organization, whose mission is to educate families, teach children, and support communities about mental health and physical health. She is also the founder, president and CEO of You Are Strong! Center on Veterans Health and Human Services, Inc., a social change advocacy nonprofit organization, whose mission is to combat stigma and provide information about health and human services to veterans and their families.