Author: Dr Christa Maria Joel Poster on Depression

1. Signs and symptoms:
1. Mild sadness to extreme guilt and a sense of
worthlessness.
2. Disturbed sleep and anxiety.
3. Constipation, insomnia (No sleep), anorexia (eating
disorder).
4. Loss of interest and chronic fatigue.
5. Suicidal ideation, delusions, severe agitations, loss
of appetite and sex drive.
6. No substance use disorder.
7. Decreased concentration and thinking.
8. Atypical symptoms- hypersomnia (oversleeping),
overeating, rejection sensitivity.
Treatment:
1. Cognitive behavioural therapy (CBT)- talking with a
therapist about your feelings and thoughts.
2. Antidepressants. Have the potential for withdrawal
syndromes and therefore requires gradual dose
reduction. Drug allergy history is important to
prescribe.
3. Drugs like Lithium, thyroid hormone, or second
antidepressant are prescribed if the response to the
first agent is inadequate.
4. Combination of CBT and antidepressant medications
is the most effective method to treat depression.
5. Severe depression- electroconvulsive therapy is
suggested. Common side effects- headache and
memory disturbances.
Laboratory tests:
1. Complete blood cell count.
2. Serum TSH (thyroid stimulating hormone).
3. Vitamin D levels.
4. Red blood cell folate.
5. Toxicology screen.