Depression is a medical condition characterized by long-lasting feelings of intense sadness and hopelessness associated with additional mental and physical changes, such as weight loss or gain, fatigue, or difficulty sleeping.
First visit to the doctor
To determine whether you have depression, your doctor will ask you about your symptoms, when they started, and how they are affecting your life and your ability to function. Your doctor will also ask you questions about your medical and family history. Many people with depression can be cared for by their family doctor, but in some cases your doctor may refer you to a psychiatrist or psychotherapist.
There are a number of tests that your doctor may perform or order, such as:
- depression questionnaires
- physical exam
- thyroid function tests (to rule out a thyroid problem)
The main goals of treatment are to:
- reduce symptoms of depression (such as feelings of sadness, loss of interest or pleasure, or hopelessness)
- improve your ability to function at home and at work
- reduce the risk of suicide
- prevent depression from returning
The main treatments for depression are medications, psychotherapy, or a combination of both. Living an active lifestyle and having the support of family and friends can also make it easier to cope with depression. The choice of medication will be influenced by whether you have other medical conditions or medications, your tolerance for side effects, medications you have responded to in the past, cost, and your own preferences. Some people may need more than one medication to manage their depression.
Follow-up and monitoring
If you are taking a medication, your doctor will probably schedule follow-up appointments every 1 to 2 weeks to start with, and then decrease this to every 2 to 4 weeks once the medication starts working.
You should also see your doctor if:
- your medication doesn't seem to be helping (keep in mind that depression medications take about 4 to 6 weeks to work)
- you think you may be having side effects from your medication
- you're not sure how to use your medication
Get help right away if you are having thoughts of harming yourself.
Depression usually responds to treatment with medications and/or psychotherapy. However, you won't see results right away: depression medications take about 4 to 6 weeks to work, and you and your doctor may need to try more than one medication before you find the one that gives you the best results with the fewest side effects. If you are taking medications, you will need to continue them for as long as your doctor recommends. Don't try to stop them yourself, even if you feel better. If psychotherapy is part of your treatment, you will need to attend regular sessions.
For most people who are having depression for the first time, medications will need to be taken for 6 to 12 months after you are no longer depressed in order to reduce the risk that symptoms could return. When it is time to stop the medication, it will need to be stopped gradually over a number of weeks and supervised by your doctor.
If you have had depression before, your doctor may recommend a longer course of treatment to reduce the risk that it will come back. People who suffer from frequent episodes of depression may need to be on lifelong treatment.