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Treating depression usually starts with a visit to doctor's office and a physical examination by a physician. Medications and some medical conditions such as a viral infection may cause the same symptoms as depression. The physician should be able to distinguish between possible causes by conducting an interview, using lab tests and by examining the patient. If physical causes are not the reason for the depression, a psychological evaluation may be performed by the physician or the patient may be referred to a psychologist or a psychiatrist.
A diagnostic evaluation will include a complete history of symptoms to determine when they began, the length of time they last, their severity and if they are recurrent symptoms. The doctor should ask about alcohol and drug use, and if the patient has suicidal thoughts or thoughts about dying. The history should also include questions about whether the patient or other family members have had a depressive disorder and what treatments were found to be effective.
The evaluation should also include a mental status examination to see if speech or thought patterns or memory have been affected in any way. Patients should also realize that a second opinion from another doctor or qualified medical practitioner and exploring all of your options can be helpful. Make sure that you work with a physician in determining an approach that you are comfortable with and investigate any claims made by alternative medicine before using them.
Treating the depression will depend on the outcome of the evaluation. Antidepressant medications and psychotherapies are generally used to treat depressive disorders. Most studies find that the best way is to combine treatments using medication to for relieving symptoms and psychotherapy to learn how to better deal with problems and thoughts that cause symptoms. In some other medical studies, treating depression with certain medications has proven to be no more effective than a placebo.
Electroconvulsive therapy (ECT) is used when one's depression is considered to be severe or life threatening or for those who cannot take antidepressants. A muscle relaxant is given before the treatment, which is done under brief anesthesia. Electrodes are then put at precise locations on the head to deliver electrical impulses. The stimulation causes a brief (about 30 seconds) seizure within the brain. The person receiving ECT does not consciously experience the electrical stimulus. Several sessions of ECT, usually three time a week, are generally recommended.
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