Depression usually exist in phases, ie, they may be limited in time and quite often sound from even unattended. A depressive episode ("Episode") takes around six to eight months when not treated. major depressive disorder treatments
The course of a depressive disorder differs considerably from person to person. A depressive disorder can be completely cured for most people. In some patients, however, remains of depressive symptoms persist. Some depressive disorders also develop chronic, ie, periods of depression which can be regularly repeated, or there is a dysthymic disorder in which the symptoms usually are not as pronounced like a classical depression, but constantly (over a couple of years) remain.
In depressive disorders there is a high probability that they do not remain an illness episode. Over half of patients develop disease after a first depressive episode to another. The likelihood of developing again increases after two disease at 70 percent, and after the third episode even at 90 %.
A detailed ("differential diagnostic") is essential conversation: Beyond the assessment of the current complaints is definitely a collection of all mental patient discomfort over its entire lifetime required. Furthermore, can the therapist living and genealogy and current stresses and problems portray.
The severity of depression is measured through the number, intensity superiority depressive symptoms. Clinical diagnostic interviews, z. B. CIDI (Composite International Diagnostic Interview) or DIPS (Diagnostic interview for psychiatric disorders), ask the diagnostic criteria in accordance with the classification of the World Health Organization from (ICD-10). Standardized questionnaires and external assessment scales help assess the severity of the sickness. Here are the right choice PHQ-D (Patient Health Questionnaire depression), BDI (Beck Depression Inventory) or HDRS (Hamilton Depression Rating Scale). Ahead of initiation of therapy, careful and neurological examination to rule out physical causes is helpful, as such, for example, metabolic disorders (eg. As diabetes), or certain medications (antihypertensives, steroid hormones) can be physical causes of depressive symptoms.
The recommendations for the treatment depend on whether a depression occurs the very first time or repeated and exactly how hard the patient's disease. Treatment should be based on the recommendations which might be in the National Care Guideline "Unipolar Depression".
Not every depression needs to be treated immediately with psychotherapy or medications:
In mild depressive disorder, the patient may first seek guidance and advice, as he is better at coping with depressed emotional states. However, this is the differential diagnostic investigation, which excludes an extreme course of the disease. If within two weeks without improvement, specific treatment ought to be agreed with the patient. In such cases, psychotherapy is preferable to a pharmaceutical Kobe plot.
In moderate depressive disorders the patient psychotherapy or treatment with drugs needs to be offered as treatment alternatives.
In severe and chronic depressive disorders, a combination of psychotherapy and medicine is necessary.
When depression following psychotherapies are occupied with regards to effectiveness: behavioral therapy, psychodynamic psychotherapy, interpersonal psychotherapy, psychotherapy and systemic therapy. For medications of depressive disorders different classes of antidepressants are particularly permitted.
Probability of recovery
The time period of a depressive illness may be significantly reduced by treatment - around 16 weeks. Effective treatments lessen the relapse rate significantly. A certain strength of psychotherapy is it acts consistently and long run, particularly if it continues even after resolution of acute symptoms as maintenance therapy. The recurrence rate can be significantly reduced via a psychotherapeutic treatment. Patients with the increased risk of relapse, z. B. if depression just isn't completely subsides, a longer-term stabilizing psychotherapy is usually recommended. Antidepressants reduce the risk of relapse. You should also be taken after complete disappearance of depressive symptoms on. The use of intake depends especially on the specific probability of relapse of patients.