We all have periods when we feel blue or “down in the dumps,” but when dark, sad moods become the norm, for us, or for a loved one, then depression may be the cause.
What is depression? It is a debilitating illness that can significantly compromise a person’s ability to enjoy their life and the companionship of others. It can reduce their capacity to be productive at school or at work. It can happen to anyone—young or old, male or female, and from any walk of life. While it is sometimes triggered by a significant event or a biological cause, it can also occur for no obvious reason, and in rare cases, be caused by medication.
Know the Signs
How do you know if you or a loved one is being affected by depression?
The classic symptoms include a persistently sad mood, irritability, an inability to enjoy activities that are usually a source of pleasure, fatigue, lack of energy, poor sleep (or increased sleep), guilt, excessive worrying, and a decline in what doctors call cognitive functioning– meaning memory, concentration, decision-making, and thinking clearly. A decline in sex drive, appetite, and interest in social interaction can also occur. Sometimes thoughts of suicide are also present, and this is obviously of significant concern.
If you, or a loved one, have a combination of these symptoms, a psychiatric evaluation is recommended.
What Happens During a Psychiatric Evaluation?
A psychiatric evaluation consists of a thorough review of a person’s history. The psychiatrist will ask about the current episode of depression and when those feelings began, as well as explore possible past episodes. Further areas of exploration include past psychiatric history, family psychiatric history, substance abuse history, trauma history, medical history, social history, and educational history (particularly important with children and adolescents). Stress factors that may be contributing to the depression are reviewed. Symptoms need to be clearly defined so they can be targeted and treated. We make sure to clearly identify the target areas so we can measure improvement.
Types of Treatment
Treatment for depression can take several forms. A number of types of psychotherapy can be used. Psychotherapy is a way of healing a mental disorder by psychological rather then medical means. I will provide referrals for psychotherapy if it is indicated and the patient does not presently have a therapist. As a psychiatrist (who is a medical doctor and can prescribe medications), I feel it is extremely important for anyone suffering from depression to become aware of the medication options that may be useful for treatment. I discuss these options thoroughly with my patients, including their pros and cons, along with the option for psychotherapy. This way, patients, or their family members, can make informed decisions as to what course of treatment may work best. Sometimes the choice is medication, sometimes therapy, and sometimes a combination is used. 
