Medication
This tool is designed to support primary care providers in the treatment of adult patients (≥ 18 years) who have major depressive disorder (MDD). MDD is the most prevalent depressive disorder, and approximately 7% of Canadians meet the diagnostic criteria every year. 1,2 The treatment of MDD involves psychotherapy and/or pharmacotherapy.
Therapy
Adult Treatment Planner Contents Anger Management Intermittent explosive disorder Personality change due to medical disorder Posttraumatic stress disorder Antisocial Behavior Adjustment disorder with disturbance of conduct
Self-care
Effective treatments for major depressive disorder are available in your area. The earlier that you begin treatment, the greater likelihood of a better outcome. For confidential and anonymous help finding a specialty program near you, visit SAMHSA’s Early Serious Mental Illness Treatment Locator.
How is major depressive disorder (MDD) treated?
Major depressive disorder is a treatable mental health condition that should be taken seriously by the person with the disorder and their loved ones. Clinical depression treatment is most effective when it begins shortly after diagnosis, but it is never too late to receive medical help for a mental illness.
What is an adult treatment planner?
Where can I find treatment for major depressive disorder?
Is there a cure for major depressive disorder?
What DSM category is major depressive disorder?
Table 9DSM-IV to DSM-5 Major Depressive Episode/Disorder ComparisonCriteria1DSM-IVDSM-52Class: Depressive Disorders✓Five or more of the following A Criteria (at least one includes A1 or A2)✓✓A1 Depressed mood—indicated by subjective report or observation by others (in children and adolescents, can be irritable mood).✓✓15 more rows
What is the first treatment for major depressive disorder?
SSRIs, which include fluoxetine, sertraline, paroxetine, citalopram, escitalopram, and fluvoxamine, have become the first-line treatment for major depression.
What therapy is used for MDD?
Psychotherapy. Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health professional. Psychotherapy is also known as talk therapy or psychological therapy.
What are the depressive disorders in the DSM-5?
The American Psychiatric Association's Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies the depressive disorders as disruptive mood dysregulation disorder, major depressive disorder (including major depressive episode), persistent depressive disorder (dysthymia), premenstrual ...
What are the psychotherapeutic treatment for adults with major depression disorder on the basis of evidence?
Psychotherapies that meet criteria as evidence-based treatments for geriatric depression include CBT, behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and reminiscence therapy.
What are 3 phases in treatment and recovery from major depression?
Treatment consists of three phases: Acute Phase – Remission is induced (minimum 6 – 8 weeks in duration). Continuation Phase – Remission is preserved and relapse prevented (usually 16 – 20 weeks in duration).
What are the 2 types of treatment for major depressive disorder?
There are several treatment methods for major depression disorder. These approaches include psychotherapy, antidepressant medications, electroconvulsive treatment (ECT), and other somatic therapies. However, ECT is generally avoided, except in extreme circumstances, in favor of both psychotherapy and antidepressants.
Which of the following is a characteristic of major depressive disorder?
Feelings of sadness, tearfulness, emptiness or hopelessness. Angry outbursts, irritability or frustration, even over small matters. Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports. Sleep disturbances, including insomnia or sleeping too much.
What is major depressive disorder with anxious distress?
MDD patients with Anxious Distress are not only down and out. They're tormented by inner restlessness and anticipating worst-case scenarios that compound the negative thinking already present from the depression. Unfortunately, it seems like anxious distress is more common than meets the eye.
What disorders are listed in the DSM-5?
Download fact sheets that cover changes to disorders in the DSM–5.Attention-Deficit/Hyperactivity Disorder (ADHD)Autism Spectrum Disorder.Conduct Disorder.Disruptive Mood Dysregulation Disorder.Eating Disorders.Gender Dysphoria.Intellectual Disability.Internet Gaming Disorder.More items...
What is Section 3 of the DSM-5?
Section III introduces emerging measures and models to assist clinicians in their evaluation of patients. This area of the manual includes assessment measures, guidance on cul- tural formulation, an alternative model for diagnosing personality disorders, and conditions for further study.
When was major depressive disorder first added to the DSM?
The diagnostic concept of major depressive disorder (MDD) was adopted in the DSM-III1 in 1980 and subsequently refined in the DSM-III-R2 and the DSM-IV. Since then, MDD has been described as the most frequent mood disorder, with rates up to 16%, and as highly comorbid with anxiety and substance use disorders (SUDs).
What is the treatment of major depressive disorder?
1,2 The treatment of MDD involves psychotherapy and/or pharmacotherapy. Providers should work with patients to create a treatment plan together using providers’ clinical expertise and keeping in mind the patient’s preferences, as well as the practicality, feasibility, availability and affordability of treatment.
What is late life depression?
Late-life depression (LLD) can be defined as MDD occuring in adults 60 years and older. It is important to differentiate early adult-onset (MDD) depression recurring in late life from late-onset depression. 21
How to avoid cognitive distortions?
Use understandable language for cognitive distortions (e.g. “assumption” which covers many cognitive distortions, “thought trap” instead of rumination). Use positive language, and maintain a focus on your patient’s strengths. Avoid stigmatizing labels (e.g. “abnormal”, “unusual”). Talk about symptoms instead of disorders/diagnoses.
How should providers work with patients to create a treatment plan together?
Providers should work with patients to create a treatment plan together using providers’ clinical expertise and keeping in mind the patient’s preferences, as well as the practicality, feasibility, availability and affordability of treatment.
What are the causes of secondary MDD?
Rule out causes of secondary MDD by considering testing for B-12 deficiency, CBC, folic acid deficiency, corticosteroid medication, hypothyroidism and syphilis. If necessary, treat the cause of secondary MDD and other disorders.
How long does it take to recover from depression?
17 After achieving symptom remission, treatment is recommended to be maintained for 6-9 months. Use clinical expertise and consider patient’s life events before determining tapering and/or stopping treatments. Unless there are clinical reasons otherwise, it is recommended to slowly taper patients off antidepressants over several weeks to avoid discontinuation syndrome. It is helpful to explain to patients what to watch out for once they have discontinued antidepressants (e.g. flu-like symptoms, insomnia, nausea and imbalance). If symptoms persist or are worrisome the patient should contact their providers.
When selecting a specific type of psychotherapy, what should you consider?
When selecting a specific type of psychotherapy consider the patient’s treatment goals and preferences (e.g. group or individual therapy), whether the patient has had a prior positive response to psychotherapy treatment and if providers skilled in the preferred psychotherapy approach are available.
Definitions
Major depression is one of the most common mental disorders in the United States. For some individuals, major depression can result in severe impairments that interfere with or limit one’s ability to carry out major life activities.
Prevalence of Major Depressive Episode Among Adults
Figure 1 shows the past year prevalence of major depressive episode among U.S. adults aged 18 or older in 2019. An estimated 19.4 million adults in the United States had at least one major depressive episode. This number represented 7.8% of all U.S.
Major Depressive Episode with Impairment Among Adults
In 2019, an estimated 13.1 million U.S. adults aged 18 or older had at least one major depressive episode with severe impairment in the past year. This number represented 5.3% of all U.S. adults.
Treatment of Major Depressive Episode Among Adults
In 2019, an estimated 66.3% U.S. adults aged 18 or older with major depressive episode received treatment in the past year.
Prevalence of Major Depressive Episode Among Adolescents
Figure 2 shows the past year prevalence of major depressive episode among U.S. adolescents in 2019. An estimated 3.8 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. This number represented 15.7% of the U.S.
Major Depressive Episode with Impairment Among Adolescents
In 2019, an estimated 2.7 million adolescents aged 12 to 17 in the United States had at least one major depressive episode with severe impairment in the past year. This number represented 11.1% of the U.S. population aged 12 to 17.
Treatment of Major Depressive Episode Among Adolescents
In 2019, an estimated 43.3% of U.S. adolescents with major depressive episode received treatment in the past year.
How to prevent relapses in depression?
Self-management programs may be helpful to prevent relapses. 3. Psychotherapy. Recommend psychotherapy in the acute phase of mild to moderate depression and/or maintenance phase of depression treatment to prevent relapse.
What is self management for depression?
Recommend self-management for all patients with depression. When appropriate, use education and self-management resources (see Associated Document: Resource Guide: Information Sources for Physicians [PDF, 145KB] ), including available community resources and self-help agencies. Self-management programs may be helpful to prevent relapses.
How many Canadians have MDD?
Approximately 11% of Canadians meet criteria for MDD at some point in their lives and approximately 4% of Canadians suffer from MDD within any given year. 1 About 2% of people with depression commit suicide, and 50% of these individuals will have been in contact with their general practitioner in the month preceding the suicide. 2
How long do you have to take antidepressants after remission?
Several non-pharmacological and pharmacological interventions are available in the short, medium and long term. Antidepressants are continued for at least 6 months after remission.
What is the treatment for major depressive disorder?
Treatment options for major depressive disorder include psychotherapy, psychotropic medication and electroconvulsive therapy. A mental health professional may recommend a combination of psychotherapy and antidepressant medication to treat the disorder in children, adolescents and adults. Electroconvulsive therapy induces seizures and is a valid ...
What is the best treatment for depression?
Psychotherapy, or traditional talk therapy , is an effective treatment for major depressive disorder. Psychotherapy may not be enough on its own to treat clinical depression but one can use it in conjunction with medication or other types of therapies. Psychotherapy can assist an individual to identify the triggers for their depression in addition ...
Why do people with major depressive disorder have low serotonin levels?
Individuals with a major depressive disorder diagnosis have inadequate levels of serotonin, possibly caused by consistent substance use and a reliance on these substances to produce the chemical.
Why is it important to treat a dual diagnosis?
It is important to treat an individual with a dual diagnosis for both struggles so that a mental health practitioner can address both major depressive disorder and co-occurring conditions and provide a strong foundation for recovery. Substance abuse is a highly common co-occurring disorder to depression.
How long does it take for antidepressants to work?
Antidepressants take four to six weeks to take full effect and often sleep, attentiveness and appetite improve before mood does.
What is interpersonal therapy?
Interpersonal therapy is a type of treatment that concentrates on how relationships with others impact depression. This specific therapy approach focuses on the individual and their relationships and assumes that personal relationships are at the core of all emotional issues.
How does cognitive behavioral therapy help with depression?
Cognitive behavioral therapy also assists people in understanding how their cognition and behavior can impact depression. Cognitive behavior therapy has been especially effective in the treatment of clinical depression in children and adolescents.
What is the meaning of "major depressive disorder"?
Major depressive disorder is a serious mental illness that affects how people feel, think, and go about their everyday tasks. The condition can also impact a person’s sleep habits, appetite, and ability to enjoy life. Major depressive disorder isn’t something that eventually “passes.”.
How to manage depression?
These healthy lifestyle habits, along with professional treatment, can help you manage the symptoms of major depression: Focus on self-care. Control stress with activities such as meditation or tai chi. Eat healthy, exercise, and get enough sleep. Most adults need 7-9 hours of sleep per night.
How long does depression last?
Major depressive disorder isn’t something that eventually “passes.”. While most people feel sad at times in their lives, major depression is when a person is in a depressed mood most of the day, nearly every day, for at least two weeks.
How does postpartum depression affect women?
Postpartum Depression affects women after having a baby. It causes intense, long-lasting feelings of anxiety, sadness, and fatigue, making it difficult for mothers to care for themselves and/or their babies, as well as handle daily responsibilities.
What is a form of depression with psychosis?
Psychotic Depression is a form of depression with psychosis, such as delusions (false beliefs) and/or hallucinations (hearing or seeing things that are not there). Seasonal Affective Disorder is triggered by changes in seasons.
How long does it take to get diagnosed with major depression?
To receive a diagnosis of major depressive disorder, some of these signs and symptoms must be present for at least two weeks. Anyone who has questions should consult their doctor. Continued feelings of sadness, hopelessness, pessimism, emptiness.
How to treat depression and anxiety?
Set realistic goals to build confidence and motivation. A goal at the beginning of treatment may be to make your bed, have lunch with a friend, or take a walk.
What is the most common mental disorder?
Convergent evidence from international studies indicates that Major Depressive Disorder (MDD) is one of the most common mental disorders affecting adult populations.
Does MDD have neuroprogressive processes?
Emerging evidence indicates that, in some cases, MDD exhibits a neuroprogressive process as evidenced by changes in brain structure, volume, and connectivity as a function of illness duration and episode frequency.
Is MDD a risk factor for other diseases?
In addition to being a highly disabling disorder, MDD is also a risk factor for several other NCDs (e.g., cardiovascular disease) and has been demonstrated to complicate health outcomes from conditions ranging from cardiovascular disease and diabetes to obesity.
When was the 3rd edition of Major Depression published?
Based on Practice Guideline for the Treatment of Patients With MajorDepressive Disorder, Third Edition, originally published in October2010. A guideline watch, summarizing significant developments inthe scientific literature since publication of this guideline, may beavailable.
What is a QRG for treating major depressive disorder?
Treating Major Depressive Disorder: A Quick Reference Guide is asynopsis of the American Psychiatric Association’s Practice Guidelinefor the Treatment of Patients With Major Depressive Disorder, ThirdEdition, Part A of which was originally published in The American Jour-nal of Psychiatry in October 2010 and is available through AmericanPsychiatric Publishing, Inc. The psychiatrist using this Quick Refer-ence Guide (QRG) should be familiar with the full-text practice guide-line on which it is based. The QRG is not designed to stand on its ownand should be used in conjunction with the full-text practice guide-line. For clarification of a recommendation or for a review of the ev-idence supporting a particular strategy, the psychiatrist will find ithelpful to return to the full-text practice guideline.
Treatment
Clinical Trials
Lifestyle and Home Remedies
Alternative Medicine
Specialist to consult
Coping and Support
- Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professi…
Preparing For Your Appointment
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Recommendations and Topics
- Depression generally isn't a disorder that you can treat on your own. But in addition to professional treatment, these self-care steps can help: 1. Stick to your treatment plan.Don't skip psychotherapy sessions or appointments. Even if you're feeling well, don't skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-lik…
Scope
- Alternative medicine is the use of a nonconventional approach instead of conventional medicine. Complementary medicine is a nonconventional approach used along with conventional medicine — sometimes called integrative medicine. Make sure you understand the risks as well as possible benefits if you pursue alternative or complementary therapy. Don't replace conventional medical …
Key Recommendations
- Talk with your doctor or therapist about improving your coping skills, and try these tips: 1. Simplify your life.Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down. 2. Write in a journal.Journaling, as part of your treatment, may improve mood by allowing you to express pain, anger, fear or other emotions. 3. …
Epidemiology
- You may see your primary care doctor, or your doctor may refer you to a mental health professional. Here's some information to help you get ready for your appointment.
Diagnosis
Management
Resources
- Screen for MDD with ‘two quick question’ method.
- Use the Patient Health Questionnaire-9 (PHQ-9) to aid in diagnosing and monitoring patients.
- Assess suicide risk in all depressed patients.
- Several non-pharmacological and pharmacological interventions are available in the short, medium and long term.