Diagnosing and Treating Depression Online
Sadness is a very common emotion and will typically pass with time. If it seems to be lasting longer than a couple of weeks, it could be depression. Depression is often referred to by doctors as "major depressive disorder" or "clinical depression" and is by no means a reflection of someone’s personality traits or character. It is, however, something to take seriously — most people need treatment to get better.
Causes and Risk Factors
Depression is often caused by a combination of factors including:
- Biological traits: Those who suffer from depression have physical differences in their brains.
- Brain chemistry: Neurotransmitters, which are naturally occurring chemicals in the brain, may impact mood stability and have a role in depression.
- Hormones: The body has a natural balance of hormones, which can sometimes cause or trigger depression.
- Inherited traits: Genetics plays a key role in depression — it is more common among those who have blood relatives with the same condition.
- Environmental factors: Stressful or adverse life events can be precipitants to depressive episodes.
The key risk factors for depression include:
- Family history: Those who have blood relatives with a history of depression, bipolar disorder, alcoholism, or suicide are at risk of suffering from depression themselves.
- Trauma or stress: This may include physical or sexual abuse, the loss of a loved one, difficult relationships, or financial obstacles.
- Medical history: A history of other mental disorders such as an anxiety disorder or post-traumatic stress disorder (PTSD) can lead to depression.
- Medications: The most common types of medications that might put someone at a higher risk of depression include high blood pressure and sleep disorder medications.
Medical Issues Related to Depression
If left untreated, depression can lead to physical obstacles and more serious emotional concerns. It can also interfere with a person’s ability to function in everyday life. This is why it’s important to reach out for help and support.
- Risk of heart attack: Those who suffer from depression are more at risk of dying from a heart attack.
- Weight fluctuations: Depression can cause over or under eating and a general tendency to use food as a coping mechanism. This can lead to obesity, stomachaches, and/or nutritional deficiencies.
- Risk of cardiovascular disease: Depression can cause blood vessels to constrict, which may ultimately lead to certain kinds of heart disease.
- Increased pain sensitivity: Depression may heighten head and body aches and make it difficult to manage pain in general.
- Fatigue: Depression can take a toll on a person’s energy levels, leaving them feeling lethargic during the daytime.
- Reduced sex drive: Untreated depression causes a loss of interest in many activities, which can include sex.
- Weakened immune system: Depression reduces the ability to fight off diseases as benign as the common cold and as serious as cardiovascular disease.
- Feelings of sadness or emptiness: Depression can lead to long-lasting negative emotions.
- Insomnia: Difficulty falling or staying asleep at night due to a restless body and/or mind is typical for cases of untreated depression.
- Cognitive difficulties: Trouble with memory, decision making, and/or concentration are especially common for adults with depression.
- Thoughts of self harm: Depression can lead to increased risk of self-harm and suicide.
Types of Depression
The five main types identified by the National Mental Health Institute include:
- Persistent depressive disorder, also known as dysthymia, which lasts two or more years and can be mild or severe. This kind of depression isn’t as extreme as major depressive disorder, though it can still be characterized as an inability to enjoy day-to-day activities for an extended period of time.
- Postpartum depression, (PPD) which involves feelings of extreme sadness, anxiety, and exhaustion following the birth of a child. It is different from the “baby blues” mainly because of its severity. A person diagnosed with PPD may have difficulty bonding with their baby, fear of inadequacy as a mother, struggle to care for themselves and their baby, and thoughts of harming themselves and/or their baby. If left untreated, PPD can last for several months or longer.
- Psychotic depression, which is a kind of schizophrenic disorder and occurs when someone experiences depression alongside delusions and hallucinations. The delusions can sometimes be related to guilt, poverty, or illness.
- Seasonal Affective Disorder (SAD), which typically occurs at the beginning of winter and is caused by the decrease in sunlight. The symptoms of SAD can vary based on the season. During the fall and winter, a person suffering from SAD may oversleep and gain weight; during the spring and summer they could have trouble sleeping and lose weight. Because SAD is dependent on seasons, it is important to take into account a person’s geographic location and whether they may be getting too much or too little sunlight in a given day.
- Bipolar disorder, which usually involves low moods followed by emotional highs. The dramatic fluctuation between major depression (lows) and mania (highs) can be very disruptive to a person’s life — impacting their job, relationships, and overall happiness.
Symptoms of depression can also vary by age, but usually begin during adulthood. For children and adolescents who experience depression, symptoms may include irritability or a change in attitude and behavior that causes distress in school, at home, in social situations, or in other areas of life. This kind of depression is unique to children and teens in that it is associated with peer pressure, academics, and puberty.
There are many treatments available to help with depression. Depending on the cause and severity of depression, your treatment plan may include:
- Psychotherapy, such as Cognitive Behavioral Therapy (CBT), interpersonal therapy, or problem-solving therapy. Psychotherapy is a great treatment for those suffering from depression because they have the opportunity to uncover and work through their obstacles with someone else. Therapy also offers a sense of support and partnership.
- Medications, which will usually be an antidepressant. Medications are a good treatment option for those suffering from depression because they can be highly effective and low maintenance. Taking medicine doesn’t often require quite as much energy and time as some of the other treatment options.
- Lifestyle adjustments including establishing a daily routine, exercising, boosting nutrition, and getting enough sleep. Lifestyle adjustments can be useful when treating depression because they involve seemingly small, but significant, changes to a person’s day-to-day life that can impact their overall health and wellbeing. These kinds of adjustments can also improve all aspects of a person’s life.
While depression can be daunting, there are some things you can do to help either prevent or minimize its impact on your everyday life. Here are a few tips to consider:
- Try to control your stress, increase your resiliency, and boost self-esteem.
- Connect with loved ones who can offer support and comfort.
- Seek treatment early to prevent worsening symptoms.
- Consider long-term treatment, which can sometimes help prevent symptoms from returning.
Discussing Depression with an Online Therapist
Online therapists are here to help with depression. During a video consultation on Amwell, your therapist or psychiatrist will ask you a series of targeted questions to determine the best treatment plan for you. This will be based on duration and severity of symptoms and your medical history. Your provider may also ask about your work and home environments as well as your lifestyle habits. Once your provider makes a diagnosis, they will review the risks and benefits of various treatment plans.
Because you will be getting care at home rather than in person, you don’t need to worry about traveling to the provider’s office — especially when you may already be feeling emotionally and/or physically drained. Home may also be a much more familiar and comfortable environment compared to a provider’s office. Plus, appointments are available at convenient times, including nights and weekends.