Depression


Do patients with mild depression need to be hospitalized?
Patients with mild depression can choose inpatient treatment or outpatient treatment. The main decision depends on the communication between the patient, their family, and medical professionals. Patients with mild depression have relatively mild depressive symptoms, so psychological therapy is primarily used, with pharmacotherapy and physical therapy serving as supplementary treatments. Psychological therapy mainly employs cognitive-behavioral therapy to improve the patient’s unreasonable beliefs and alleviate emotional stress. This includes identifying automatic thoughts, recognizing the irrationality of cognition, and employing reality testing, ultimately aiming to improve the patient's symptoms. Pharmacological treatment primarily uses serotonin reuptake inhibitors, and patients can adhere to a regular medication schedule at home during outpatient treatment periods. Physical therapy consists mainly of transcranial magnetic stimulation, which can be administered either as an outpatient or inpatient treatment. The final treatment choice should involve comprehensive communication with the patient's family and physicians to make an informed decision.


Will mild depression get better?
Mild depression can achieve good therapeutic effects. Patients with mild depression may experience low mood, slow thinking, and decreased volition, but its severity is relatively mild. These patients primarily show lack of concentration, or slightly lower self-evaluation, and abnormalities in diet and sleep. Generally, the overall mental state of the patients is still relatively good. Therefore, in clinical practice, the main treatment for patients with mild depression is psychotherapy, especially cognitive behavioral therapy, to improve the patients' distorted and unreasonable cognition, ultimately leading to cognitive reconstruction and achieving good therapeutic effects. Antidepressant drugs can also be used for systematic treatment, such as serotonin reuptake inhibitors, which have an effective cure rate of over 85%.


Dietary Cautions for Geriatric Depression
Patients with geriatric depression currently find antidepressant medications and electroconvulsive therapy to be quite effective. However, due to lack of appetite and poor mental responsiveness in these patients, their nutritional status often remains unfulfilled. Therefore, we should enhance the dietary nutrition of elderly patients with depression. The focus should be on protein-rich foods such as eggs, shrimp, fish, chicken, and duck. Additionally, attention should be given to including roughage in the diet, ensuring daily fruit intake and vegetables in every meal.


Can mild depression recur?
Patients with mild depression also have the possibility of relapse. Clinical research investigations have found that systematic antidepressant treatment can lead to clinical recovery in 85% of patients. However, even with persistent and standardized treatment, nearly one-fifth of patients still experience relapse. This signifies that some patients may have a relapse rate exceeding 70% if they cease treatment. For those who recover, there is still a one-fifth chance of relapse within six months, and nearly half might relapse within two years after the initial episode. Therefore, relapse is a significant challenge for depression patients. Thus, treatment should be systematic and standard, including pharmacotherapy. Additionally, psychotherapy plays a crucial role in treating depression by improving patients' irrational cognitive patterns and adjusting their cognitive reconstruction systems, ultimately achieving a healed state.


Symptoms of depression
Patients with symptoms of depression often experience a persistent low mood throughout most of the day, along with a loss or decrease in interests and pleasure. They commonly experience fatigue, an increase in feelings of exhaustion, and more. Additionally, these patients may have poor concentration, low self-esteem, decreased self-confidence, a sense of worthlessness, self-blame, and a bleak outlook on life with no perceived future, including suicidal thoughts. There are also significant changes in their sleeping and eating habits. Therefore, if these symptoms persist for more than two weeks and adversely impact the patient’s work, studies, lifestyle, or social abilities, it should be considered indicative of depression. Thus, once diagnosed, systematic and standardized treatment should be administered to prevent the worsening of the condition.


How long does it take for depression to get better?
The treatment of depression is generally divided into three stages: acute phase treatment, continuation phase treatment, and maintenance phase treatment. The complete recovery from depression depends on the individual characteristics of the patient. The acute phase treatment usually lasts one to three months, mainly focusing on controlling the symptoms related to depression. Additionally, during the continuation phase treatment, the medication period generally lasts four to nine months, and its main goal is to maintain the stability of the patient's condition and prevent relapse of the disease. As for the maintenance phase treatment, the duration of treatment is to be determined. Typically, the duration is one to two years after the first onset, three to five years after the second onset, and for patients who have had more than three episodes, it is recommended to maintain a low-dose medication treatment to prevent recurrence of the disease.


How to Cure Geriatric Depression
For geriatric depression, the treatment includes several aspects. Firstly, it is important to strengthen the patient's diet and nutrition supplementation. Secondly, certain psychological therapies should be provided to the depressed patients. The aim is mainly to alleviate or relieve symptoms, improve patients’ compliance with medication, prevent relapse, and reduce or eliminate the adverse consequences caused by the disease. The third aspect is to provide certain medication treatments, such as the currently used selective serotonin reuptake inhibitors (SSRIs), and selective norepinephrine reuptake inhibitors (SNRIs). These types of medications have been widely used in patients with geriatric depression disorders. Among them, SSRIs are quite effective for geriatric depression disorders and can effectively counteract cholinergic and have milder adverse reactions on the cardiovascular system, making it easy for elderly patients to accept and maintain long-term treatment. The fourth aspect is the improvement of electroconvulsive therapy, which can significantly improve depression when combined with comprehensive treatment. However, since depression has a high recurrence rate, full-course treatment is recommended.


Where to get a diagnosis for depression?
The diagnosis of depression often recommends consulting with a psychiatry or psychology department for confirmation. Clinically, depression is categorized as a mental and psychological disorder, primarily characterized by low mood, slow thinking, and reduced willpower. Patients usually lack interest and pleasure, feel fatigued, self-blame, valuelessness, incapability, have low self-esteem, and poor concentration. They often feel that life is meaningless, harboring thoughts or behaviors of self-harm and suicide. They view the future as bleak, sad, helpless, and hopeless. Patients generally exhibit poor eating and sleeping habits, and there is a noticeable decline in sexual function. Therefore, in clinical settings, if the aforementioned symptoms persist for over two weeks and interfere with work, study, daily life, social, and occupational functions, a clear diagnosis is required to develop a treatment plan involving medication, psychotherapy, and physical therapy.


How to self-rescue from depression
Patients with depression can self-help through self-adjustment or seek help from a doctor. Clinically, the method of self-adjustment mainly involves exercise, which is also called behavioral activation training in psychology. Exercise can relax the muscles throughout the body. Additionally, exercise can stimulate the brain to release the "happiness element" endorphins, which have a significant improving effect on depression and anxiety. Other methods include venting and shifting attention. Venting typically involves expressing feelings through spoken or written words to others, especially close friends and family. By expressing these feelings, depressive emotions can also be articulated. Shifting attention, clinically, involves engaging in personal interests such as painting, fishing, or listening to music, which can increase pleasure and enhance motivation. Alternatively, seeking help from a doctor usually involves psychotherapy and medication, which often yield good results.


How to manage mild depression
Mild depression is primarily treated clinically through self-adjustment, psychotherapy, or physical therapy. Self-adjustment often involves exercise, which can stimulate the brain to release endorphins, playing an anti-depressive role. Additionally, exercise is an effective relaxation training that can divert attention and stimulate feelings of control and pleasure. Furthermore, psychotherapy is also used in clinical settings, particularly cognitive behavioral therapy, which is crucial in helping patients identify thoughts, correct irrational cognitive patterns, and rebuild their cognitive systems. Effective training in social and other activities is also necessary to enhance social or occupational functioning. In terms of physical therapy, repetitive Transcranial Magnetic Stimulation (rTMS) is the main treatment method.