Management of depression

Management of depression is the treatment of depression that may involve a number of different therapies: medications, behavior therapy, psychotherapy, and medical devices.

Depression is a symptom of some physical diseases; a side effect of some drugs and medical treatments; and a symptom of some mood disorders such as major depressive disorder or dysthymia.[1] Physical causes are ruled out with a clinical assessment of depression that measures vitamins, minerals, electrolytes, and hormones.[2][3][4]

Though psychiatric medication is the most frequently prescribed therapy for major depression,[5] psychotherapy may be effective, either alone or in combination with medication.[6] Combining psychotherapy and antidepressants may provide a "slight advantage", but antidepressants alone or psychotherapy alone are not significantly different from other treatments, like "active intervention controls". ( e.g., sham acupuncture[clarification needed]) Given an accurate diagnosis of major depressive disorder, in general the type of treatment (psychotherapy and/or antidepressants, alternate or other treatments, or active intervention) is "less important than getting depressed patients involved in an active therapeutic program."[7]

Psychotherapy is the treatment of choice in those under the age of 18, with medication offered only in conjunction with the former and generally not as a first line agent. The possibility of depression, substance misuse or other mental health problems in the parents should be considered and, if present and if it may help the child, the parent should be treated in parallel with the child.[8]

  1. ^ Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition (DSM-5) ed.). American Psychiatric Association. 2013.
  2. ^ Parker GB, Brotchie H, Graham RK (January 2017). "Vitamin D and depression". Journal of Affective Disorders. 208: 56–61. doi:10.1016/j.jad.2016.08.082. PMID 27750060.
  3. ^ Orengo CA, Fullerton G, Tan R (October 2004). "Male depression: a review of gender concerns and testosterone therapy". Geriatrics. 59 (10): 24–30. PMID 15508552.
  4. ^ Dale J, Sorour E, Milner G (2008). "Do psychiatrists perform appropriate physical investigations for their patients? A review of current practices in a general psychiatric inpatient and outpatient setting". Journal of Mental Health. 17 (3): 293–98. doi:10.1080/09638230701498325. S2CID 72755878.
  5. ^ Carson VB (2000). Mental health nursing: the nurse-patient journey. W.B. Saunders. p. 423. ISBN 978-0-7216-8053-8. Archived from the original on 2023-01-11. Retrieved 2016-09-24.
  6. ^ "Psychotherapy". The Merck Manual of Diagnosis and Therapy. Archived from the original on 2011-11-09. Retrieved 2011-11-09.
  7. ^ Khan A, Faucett J, Lichtenberg P, Kirsch I, Brown WA (July 30, 2012). "A systematic review of comparative efficacy of treatments and controls for depression". PLOS ONE. 7 (7): e41778. Bibcode:2012PLoSO...741778K. doi:10.1371/journal.pone.0041778. PMC 3408478. PMID 22860015.
  8. ^ NICE (2005). NICE Guidelines:depression in children and adolescents. London: NICE. p. 5. ISBN 978-1-84629-074-9. Archived from the original on 2008-09-24. Retrieved 2008-08-16.