People often believe that, like the mood depression, the disease depression should always be amendable by force of personal will alone. This is not true. Depression is a disease — not a personal failing or character flaw. Managing and treating depression, the disease depression, requires the help of primary care providers and specialized medical professionals.

Detection

Certain risk factors can increase your likelihood of developing depression. These risk factors include:

  • Family history
  • Medical comorbidity
  • Recent childbirth
  • Substance abuse
  • Bereavement
  • Prior episodes or suicide attempts
  • Female gender

If you have any of the above risk factors, and have had any if the following symptoms for a prolonged time, you may want to talk to your primary care physician about the possibility of depression.

  • Sleep
  • Interest
  • Guilt
  • Energy
  • Concentration
  • Appetite
  • Affect/mood
  • Psychomotor retardation/agitation
  • Suicidality

Use the acronym SIG "E" CAAPS to remember the symptoms of depression.

Treatment

Antidepressants are considered the first-line of treatment for depression of any severity. Other methods for managing and treating depression include:

Psychotherapy

Psychotherapy treats depression by helping patients identify, address, and solve life problems that contribute to their depression. It can also help patients identify and improve negative or distorted thinking patterns and explore other learned thoughts and behaviors that create problems and contribute to depression. 

Combining psychotherapy with medication has a demonstrated advantage for patients with recurrent depression or a history of poor adherence to treatment plans. Psychotherapy is best administered by a therapist who practices cognitive behavior therapy (CBT) or interpersonal therapy (IPT).

Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT) is often considered for those with treatment-resistant depression. ECT has the highest rates of response and remission of any depression treatment; 70% to 90% of patients treated with ECT show improvement. 

Along with treating patients who do not respond to medication, ECT can be used on those who 1) are suicidal or nutritionally compromised, 2) have medical conditions that preclude the use of antidepressants, and 3) are pregnant.

Self-management plan

Self-management plans, also known as self-care plans, are integral to managing and treating depression. These plans encourage patients to set goals in the following areas:

  • Adhering to treatment plans.
  • Maintaining or building fulfilling relationships.
  • Ensuring good nutrition and getting regular exercise.
  • Scheduling enjoyable or relaxing activities daily.
  • Developing realistic, rather than negative, perceptions of self.
  • Dividing problems into smaller components and identifying ways to address them.

A copy of Intermountain Healthcare's self-management/self-care plan can be found by clicking on the link found above right. More information about managing and treating depression can be found using the other links listed above right.