Depressive / Mood Disorders
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Depressive disorders, also known as mood disorders, are a group of mental health conditions characterised by persistent feelings of sadness, emptiness, and hopelessness, as well as a range of physical and cognitive symptoms that can impact a person's ability to function in daily life. The most common types of depressive disorders include major depressive disorder, dysthymia (persistent depressive disorder), and bipolar disorder.
Major depressive disorder is the most common type of depressive disorder, and it is characterised by episodes of intense sadness, loss of interest in activities, feelings of worthlessness or guilt, and changes in appetite, sleep, and energy levels. Dysthymia is a milder form of depression that involves long-term, persistent feelings of sadness and hopelessness, while bipolar disorder involves cycles of manic and depressive episodes.
In Australia, depressive disorders are very common, with an estimated one in five people experiencing symptoms of depression at some point in their lives. According to the Australian Bureau of Statistics, around 4.8% of the population had experienced major depressive disorder in the 12 months prior to a 2017-2018 survey. Women are more likely than men to experience depressive disorders, and the condition is more common among people who have experienced adverse life events, such as trauma or loss, or who have a family history of depression.
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Depression is often comorbid with other mental health conditions or physical illnesses. Some of the most common conditions that co-occur with depression include:
Anxiety disorders: Anxiety disorders, such as generalised anxiety disorder, panic disorder, and social anxiety disorder, often co-occur with depression. In fact, it is estimated that up to 60% of people with depression also have an anxiety disorder.
Substance abuse: Depression is also commonly comorbid with substance use disorders, such as alcohol or drug abuse. People with depression may use substances as a way to cope with their symptoms, which can worsen the depression and lead to substance dependence.
Eating disorders: Eating disorders, such as anorexia nervosa, bulimia nervosa, and binge-eating disorder, often co-occur with depression. People with depression may use food as a way to cope with their symptoms, which can lead to disordered eating patterns.
Chronic pain: Depression is also frequently comorbid with chronic pain conditions, such as fibromyalgia, arthritis, or back pain. The experience of chronic pain can contribute to the development of depression, and vice versa.
Other physical illnesses: Depression can also be comorbid with other physical health conditions, such as heart disease, diabetes, or cancer. These conditions can cause stress and lead to depression, or depression can worsen the physical symptoms and outcomes of these illnesses.
Treatment of depression may therefore involve treating other conditions simultaneously.
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There are several evidence-based treatments for depression that have been proven effective through clinical research studies. It is important to note that not everyone is going to respond to each type of treatment the same. It is important to consult with a professional to determine what approach is best for you.
Some treatments include:
Cognitive Behavioral Therapy (CBT): This form of therapy aims to identify and change negative thought patterns and behaviors that contribute to depression. CBT typically involves weekly sessions with a trained therapist over a period of several months.
Intensive Short Term Dynamic Psychotherapy (ISTDP): Intensive Short-Term Dynamic Psychotherapy (ISTDP) is a psychodynamic approach that focuses on helping individuals identify and address unconscious emotions that may be causing emotional difficulties. There is some evidence to support the use of ISTDP in the treatment of depression.
One study published in the Journal of Psychiatric Research found that ISTDP was effective in reducing symptoms of depression in a group of patients with major depressive disorder. The study followed patients over a 12-week period and found that those who received ISTDP had significant improvements in their depression symptoms compared to a control group.
Another study published in the Journal of Affective Disorders found that ISTDP was effective in reducing symptoms of depression and anxiety in patients with both disorders. The study followed patients over a 24-week period and found that those who received ISTDP had significant improvements in their depression and anxiety symptoms compared to a control group.
Antidepressant medication: Several classes of medications, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs), have been shown to be effective in treating depression. These medications can be prescribed by a psychiatrist or GP.
Transcranial Magnetic Stimulation (TMS): TMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. TMS is an emerging treatment of major depressive disorder that has not responded to traditional antidepressant medication. Here is some information about the effectiveness of TMS in treating depression:
Several studies have found that TMS can be an effective treatment for depression. A meta-analysis published in JAMA Psychiatry in 2018, which included data from 81 randomized clinical trials involving a total of 4,520 patients, found that TMS was significantly more effective than sham (placebo) treatment in reducing symptoms of depression. The study also found that TMS was generally well-tolerated, with few serious side effects.
Another meta-analysis published in the Journal of Clinical Psychiatry in 2019, which included data from 68 randomized clinical trials involving a total of 2,489 patients, found that TMS was effective in reducing symptoms of depression, regardless of whether it was used as a first-line or second-line treatment.
A review of the long-term effects of TMS published in the Journal of Affective Disorders in 2020 found that TMS produced sustained improvements in depression symptoms for up to 12 months after treatment.
It is important to note, however, that not all patients respond to TMS and that the degree of response varies among individuals. Some individuals may require several sessions of TMS before they notice any improvement in their symptoms, while others may not respond at all. Additionally, TMS is generally considered safe, but there are some risks associated with the procedure, such as headaches, scalp discomfort, and rare instances of seizure. Therefore, it is important to discuss the potential risks and benefits of TMS with a qualified healthcare provider before starting treatment. NOTE: SEC Psychology does not provide TMS treatment but we do work with clients currently undergoing TMS treatment.
Exercise: Regular physical exercise has been shown to be an effective treatment for depression, and may be used in combination with other treatments.
Mindfulness-based therapies: These therapies, such as mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR), aim to cultivate mindfulness and acceptance as a way to alleviate symptoms of depression.
It's important to note that the best treatment for depression may vary from person to person, and a combination of different treatments may be necessary for some individuals. It's also important to work with a trained healthcare provider to develop a personalised treatment plan.
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