Depression is a mental disorder characterized by persistently low mood and a loss of interest in activities. It can lead to a wide range of emotional and physical problems. It is usually treated with medication, psychological therapy, or a combination of both.
The World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (ICD) is the standard diagnostic tool for mental, behavioral, and neurodevelopmental disorders.
Symptoms of Depression
As per ICD criteria, the diagnosis of a depressive disorder is made when these symptoms are present:
- reduced concentration
- diminished self-confidence and self-esteem
- feelings of unworthiness and guilt
- pessimistic views
- disturbed sleep
- suicidal thoughts or acts/thoughts of self-harm
- reduced appetite
The categories of depression vary based on whether the symptoms are mild, moderate, or severe.
A mild depressive disorder diagnosis is made when these symptoms are present:
- depressed mood,
- loss of enjoyment and interest
Alternatively, at least two out of these three, in addition to any two symptoms from the ICD criteria list, will also qualify for a mild depression diagnosis.
Moderate depressive disorder
For this diagnosis, two of the three mild depressive symptoms in addition to three (or four) symptoms listed in the ICD classification need to be present.
Severe depressive disorder
The sufferer has all the three symptoms described under the mild depression classification in addition to four or more symptoms from the ICD classification list.
The prominent symptoms are likely to be agitation, feelings of uselessness, and suicidal ideation. Psychotic symptoms such as depressive stupor, hallucinations, and delusions may also be present in some cases.
For a diagnosis of depressive disorder to be made, these symptoms have to be present for at least two weeks. However, if symptoms are of rapid onset and are unusually severe, shorter periods may also qualify for a depression diagnosis.
Ketamine is a medication that is used for depression. It is an anesthetic that was first used in the 1960s. It works by blocking certain receptors in the brain. Ketamine is used to treat depression that has not responded to other medications.
How is depression treated?
Milder forms of depression can be treated with psychotherapy or ‘talk therapy.’ A licensed mental health professional administers the therapy in a group or one-on-one setting. The professional may use techniques such as Interpersonal Therapy (IPT) and/or Cognitive Behavioral Therapy (CBT) to help individuals learn new ways of behaving and thinking.
For moderate to severe forms of depression, antidepressants are used that help improve symptoms such as concentration, mood, appetite, and sleep. The most commonly used medications – SSRIs or selective serotonin reuptake inhibitors can take up to six weeks to exert their effect.
In some cases, treatment-resistant depression can occur where the individual does not find relief even after trying two or more antidepressants.