Depression is not a one-size-fits-all condition. Mental health care professionals have long recognized that patients tend to display reasonably distinct clusters of symptoms, and they increasingly regard such clusters as subtypes of depression.
The bounds between subtypes in many cases are fuzzy, with some overlap of symptoms, and never every depression expert agrees around the classification system. But clinical studies suggest that parsing depression into subtypes is effective in guiding treatment as well as in gauging the long-term outcome for patients.
Anxious depression covers the large gray area where signs of depression and anxiety co-exist or overlap. Patients routinely have feelings of worthlessness and pessimism, excessive worrying and guilt, and are struggling to enjoy things. The disorder is expressed physically in diminished appetite, poor sleep with frequent awakenings, and restlessness and psychomotor agitation.
The disorder may have its origins early in life among children of a definite temperament type that are frightened by novelty. Both anxiety and depression could be the upshot of abnormaly high amounts of hormones driving your body's stress response system.
br> Anxious depression typically poses a therapy dilemma for doctors. Many attempt to use antidepressants who have sedating properties, although it is not clear that they must, said Dr. Fava. Research has shown that all of the antidepressants work equally efficiently against this kind of depression, although high doses may be required. Still, used physicians often prescribe a combination of drugs for such patients, normally a tranquilizer along with an antidepressant.
Melancholic depression is usually a synonym for severe depression, and it is far more common some of those hospitalized for depression than some of those in the neighborhood. Affected persons lack pleasure in virtually all activities and never react to pleasurable stimulation. They could experience extreme slowness of motion or agitation. Their depression is frequently worse each day and is also accompanied by not enough appetite and weight loss.
Melancholic depressives could also ruminate on the same thoughts and experiences, and feel excessive guilt. Their depression takes on a life of its very own: the harder episodes they have, the more autonomous such episodes seem, less likely to be tripped by stressful events. And patients usually do not reply to psychotherapy, at least not before successful drug treatment, reported J. Craig Nelson, M.D., of Yale.
Studies he yet others have conducted reveal that one of the most helpful drugs because of this type of disorder usually are not the SSRIs but agents that block the reuptake of norepinephrine in addition to of serotonin. "Some drugs," he was quoted saying, discussing dual-action agents like venlafaxine and mirtazapine, "may treat more symptoms."
Psychotic depression once was another term for severe depression, however the more refined the tools scientists apply to dissect the disorder, the greater distinctive this variety appears, especially biologically. Besides this being kind of depression severe, life-impairing and marked by suicide attempts, it's accompanied by delusions that reflect the depressed mood and guilt patients feel.
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