Self-Help and Coping

Psychotherapy, or “talk therapy,” is sometimes used alone to treat mild depression; for moderate to severe depression, psychotherapy is often used in conjunction with antidepressants. Cognitive-behavioral therapy (CBT) has been found to be effective in treating depression. CBT is a form of therapy focused on problem-solving in the present. CBT helps a person recognize distorted/negative thinking with the goal of changing thoughts and behaviors to respond to challenges in a more positive manner.

Psychotherapy can involve just an individual, but it can also involve others. For example, family therapy or couples therapy can help address issues in these close relationships. Group therapy brings together people with similar conditions in a supportive environment and can help participants learn how others cope in similar situations.

Depending on the severity of depression, treatment can last for several weeks or much longer. In many cases, significant improvement can be achieved within 10 to 15 sessions.

Electroconvulsive therapy (ECT)

ECT is a medical treatment most often reserved for patients with severe major depression who haven’t responded to other treatments. It involves brief electrical stimulation of the brain while the patient is under anesthesia. The patient typically receives ECT two to three times a week for a total of six to 12 treatments. It is usually administered by a team of trained medical professionals including a psychiatrist, an anesthesiologist, and a nurse or physician assistant. ECT has been used since the 1940s, and many years of research have led to significant improvements and recognition of its effectiveness as mainstream rather than a “last resort” treatment.

There are several things people can do to help alleviate depression symptoms. For many, regular exercise aids in creating a positive sense and improving mood.

Getting sufficient quality sleep, maintaining a healthy diet, and avoiding alcohol (a depressant) can also help reduce depression symptoms.

Depression is a real illness and help is available. With proper diagnosis and treatment, the majority of people with depression will overcome it. If you’re experiencing symptoms of depression, the first step is to visit a family doctor or psychiatrist. Discuss your concerns and seek a thorough assessment. This is the beginning of addressing your mental health needs.

Premenstrual Dysphoric Disorder (PMDD)

PMDD was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. A woman with PMDD experiences severe symptoms of depression, irritability, and tension about a week before the onset of menstruation.

Common symptoms include mood swings, irritability or anger, depressed mood, and pronounced anxiety or tension. Other symptoms can include decreased interest in usual activities, difficulty concentrating, lack of energy or fatigue, changes in appetite with specific food cravings, problems sleeping or sleeping too much, or feeling overwhelmed or out of control. Physical symptoms may include breast tenderness or swelling, joint or muscle pain, bloating, or weight gain.

These symptoms start a week to 10 days before menstruation and improve or cease around the start of menstruation. Symptoms cause significant distress and impairment in regular functioning or social interactions.

For a PMDD diagnosis, symptoms must be present in most menstrual cycles over the past year and must have a negative impact on work or social functioning.

Premenstrual dysphoric disorder is estimated to affect between 1.8% and 5.8% of menstruating women each year.

PMDD can be treated with antidepressants, birth control pills, or nutritional supplements. Diet and lifestyle changes, such as cutting back on caffeine and alcohol, getting enough sleep and exercise, and practicing relaxation techniques can help.

Premenstrual Syndrome (PMS) is similar to PMDD in that symptoms occur seven to 10 days before menstruation in women. However, PMS includes milder and less severe symptoms compared to PMDD.

Disruptive Mood Dysregulation Disorder

Disruptive Mood Dysregulation Disorder is a condition occurring in children and adolescents aged 6 to 18 years. It involves chronic and severe irritability leading to frequent and severe temper outbursts. These outbursts can be verbal or involve behaviors such as physical aggression toward people or property. The outbursts are significantly out of proportion to the situation and not consistent with the child’s developmental age. They must occur frequently (on average, three or more times a week) and usually in response to frustration. Between outbursts, the child’s mood is persistently irritable or angry for most of the day, almost every day. This mood is noticeable to others, such as parents, teachers, and peers.

To diagnose Disruptive Mood Dysregulation Disorder, symptoms must be present for at least one year in at least two settings (such as home, school, with peers) and the condition must start before age 10 . Disruptive Mood Dysregulation Disorder is much more common in males than females. It can co-occur with other disorders, including major depression, attention-deficit/hyperactivity disorder, anxiety, and conduct disorder.

Disruptive Mood Dysregulation Disorder can significantly impact a child’s ability to function and have a substantial effect on the family. Chronic, severe irritability and temper outbursts can disrupt family life, make it difficult for a child to establish or maintain friendships, and create difficulties at school.

Treatment typically includes psychotherapy (cognitive-behavioral therapy) and/or medications.

Persistent Depressive Disorder

A person with Persistent Depressive Disorder (previously known as Dysthymic Disorder) has a depressed mood for most of the day. In children and adolescents, the mood can be irritable or depressed and must last for at least one year.

In addition to the depressed mood, symptoms include:

• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy or fatigue
• Low self-esteem
• Poor concentration or difficulty making decisions
• Feelings of hopelessness

Persistent Depressive Disorder often begins in childhood, adolescence, or early adulthood and affects about 0.5% of adults. Individuals with persistent depressive disorder often describe their mood as sad or “in the dumps.” Since these symptoms have become a part of their everyday experience, they may not seek help, assuming that they have “always been like this.”

Symptoms cause significant distress or impairment in work, social activities, or other important areas of functioning. While the impact of persistent depressive disorder on work, relationships, and daily life can vary widely, its effects can be significant or even greater than those of major depressive disorder.
A major depressive episode may precede the onset of persistent depressive disorder, but it can also occur during (and be an extension of) previous persistent depressive disorder diagnoses.