When Does Depression Require Medical Intervention?

Depression is a mental health condition noted for a persistent feeling of sadness, hopelessness, and loss of interest in daily activities. It’s not the same thing as “the blues,” temporary mood fluctuations that most people experience as part of normal life.

Depression is the primary cause of disability worldwide, affecting some 3.8% of the global population. Fortunately, there are treatments that can help you feel better and regain your quality of life.

At Primecare Family Practice, board-certified family practitioners Maryline Ongangi, APRN, FNP-C and Lewis Nyantika, APRN, FNP-C offer mental health treatment for their patients in the Arlington, Texas, area who are living with depression. But how can you tell if you’re just “down in the dumps” and will snap out of it on your own, or if you’re clinically depressed and require medical intervention? Here’s what the experts have to say.

What causes depression?

Depression is a biochemical disorder resulting from a complex interaction of biological, social, and psychological factors. It’s more likely to occur if you’ve gone through grief or trauma; on the other hand, being depressed can increase your stress level and worsen dysfunction.

Depression and physical health are closely linked. For example, having cardiovascular disease or diabetes can lead to depression, but being depressed about your condition can aggravate it as well.

Other factors that contribute to depression include:

• Genetics: you’re more likely to develop depression if a close relative has it
• Changes in brain neurotransmitter levels, especially serotonin, norepinephrine, and glutamate
• Other physical or mental conditions, including bipolar disorder and anxiety

Each person is unique, so the contributing factors vary from case to case. However, data show that women are twice as likely as men to develop the condition.

Depression symptoms

As with causes, symptoms of depression can vary from individual to individual. They may include any or all of the following:

• Decreased interest in hobbies, sports, or social gatherings
• Loss of libido
• Changes in appetite
• Unintentional weight loss or gain
• Sleeping too much or too little
• Overwhelming fatigue
• Feelings of worthlessness, hopelessness, or guilt
• Difficulty thinking, focusing, or making decisions

When depressive episodes become recurrent or moderate-to-severe in intensity, depression can become a serious health condition, leading to isolation and detachment, poor performance at work or school, recurrent thoughts of death or suicide, and even suicide attempts. If this describes you, you need medical help.

When does depression require medical intervention?

If you’re not able to improve your mood with quality sleep, exercise, and a healthy diet, and if you’re becoming detached with thoughts of self-harm, you need medical help.

When you come into Primecare Family Practice for depression, we take a complete medical history, including length and severity of symptoms and lifestyle factors. Then, we draw up a personalized treatment plan that may include:

Medications

Medications fall into a number of categories:

• Selective serotonin reuptake inhibitors (SSRIs): often the first-line treatment; examples include Lexapro, Prozac, and Zoloft
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): include duloxetine (Cymbalta), venlafaxine (Effexor XR), and desvenlafaxine (Pristiq, Khedezla) 
• Tricyclic antidepressants: tend to have more severe side effects, so only used if SSRIs aren't effective; examples include Tofranil, nortriptyline, amitriptyline, and doxepin
• Other medications: add-ons such as mood stabilizers and antipsychotics or stimulant medications for short-term use to boost antidepressant effects

Medications can take up to three months to reach a therapeutic level, so it’s important to be patient while they go to work.

Psychotherapy

Also known as “talk therapy,” psychotherapy comes in different forms. One of the most effective is cognitive behavioral therapy (CBT), which teaches you to respond to triggers and solve problems in healthy ways so you become more positive and productive.

If you’re struggling with the symptoms of depression, don’t despair. Primecare Family Practice can help. To get started, call us at 817-873-3710, or book online with us today.