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Depression Treatment in Raleigh/Durham & the Triangle

Is depression making it hard for you to enjoy time with friends, family, and life in general? Getting relief may be easier than you think. 

 

At Raleigh Wellness & Behavioral Health our team of highly trained psychiatry providers offers the most up to date treatments and support possible to help alleviate depression and any related symptoms, such as anxiety.

 

We are only a video call away, and we’re here to empower you to take charge of your mental health so that you can live the way you want to.

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What Causes Depression?

It’s often said that depression is simply caused by a chemical imbalance in our brain and body - but it is not nearly that simple. Chemicals are part of the process, but depression’s causes are much more complex than a chemical imbalance.


There are many things that may cause depression, including unsound mood regulation, genetics, stressful life events, social isolation, and abnormal changes in brain chemistry and brain structures.

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Symptoms of Depression

It can be hard to recognize the symptoms of depression if you’re going through it. The common symptoms of depression are below, and during depressive episodes are experienced most of the day nearly every day.

  • Feelings of sadness, tearfulness, emptiness or hopelessness

  • Angry outbursts, irritability or frustration, even over small things

  • Withdrawing from family or friends

  • Loss of interest or pleasure in things you used to enjoy

  • Sleep disturbances, including insomnia or sleeping too much

  • Tiredness and lack of energy, so even small tasks take extra effort

  • Reduced appetite and weight loss or increased cravings for food and weight gain

  • Anxiety, agitation or restlessness

  • Slowed thinking, speaking or body movements

  • Feelings of worthlessness or guilt, fixating on past failures or self-blame

  • Trouble thinking, concentrating, making decisions and remembering things

  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

  • Unexplained physical problems, such as back pain or headaches

Closeup of a hand on a window in the rain signifying depression.

How is Depression Diagnosed & Treated?

 

Treatment for depression usually includes a combination medication and talk therapy.

Some medications, such as mood stabilizers and antidepressants, can be used to help manage the chemicals in your brain. The combination of medication and therapy may be the best way to treat depression if medication alone does not adequately address your symptoms..

 

There are a few therapies that  have been shown to be effective in treating depression. Cognitive Behavioral Therapy (CBT) is one of the most effective. It works by helping you develop healthy habits and new ways of thinking. People with depression can also benefit from holistic therapies such as music, yoga, and pet therapy.

Diagnosis

Your medical provider may require one or all of the below in order to diagnose depression.

  • A Physical exam. It is possible for depression to be linked or caused to underlying physical health problems, which a physical can detect.

  • Lab tests. This lets your provider determine if factors such as thyroid function are a factor.

  • Psychiatric evaluation. During this, your mental health provider asks about your symptoms, thoughts, feelings, and behavior patterns. You may also be asked to fill out a questionnaire to gather this information.

  • DSM-5. Your mental health professional will use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is what health professionals use to diagnose all mental health disorders.

Treatment

Most cases of depression can be successfully treated, although a portion of people who have experienced major depression episodes will experience a recurrence.

A quicker diagnosis and treatment is associated with a faster response to treatment and a greater chance of remission.

Medications and psychotherapy are the main treatments for major depressive disorder.

 

In many cases, you can see results and start improving within days if taking medications that target anxiety and/or insomnia.

 

Comparatively, it takes antidepressant medications up to several weeks to start helping as they need time to build up within your system.

The most common types of medications include:

  • Selective Serotonin Re-Uptate Inhibitors (SSRIs)

    • Citalopram (Celexa)

    • Escitalopram (Lexapro) 

    • Fluoxetine (Prozac)

    • Fluvoxamine (Luvox)

  • Serotonin-Norepinephrine Re-Uptake Inhibitors (SNRIs)

    • Desvenlafaxine (Pristiq)

    • Duloxetine (Cymbalta)

    • Milnacipran (Ixel)

    • Venlafaxine (Effexor)

  • Monoamine Oxidase Inhibitors (MAOI)

    • Isocarboxazid

    • Phenelzine

    • Selegiline, transdermal

  • Atypical Antidepressants

    • Bupropion (Wellbutrin)

    • Mirtazapine (Remeron)

    • Nefazadone (Serzone)

  • Tricyclic and Tetracyclic Anti-Depressants

    • Amitriptyline

    • Amoxapine

    • Clomipramine

    • Desipramine

Although many people experience depression, only a third of adults get treatment. Our team utilizes a number of evidence-based modalities to treat your depression and improve your quality of life. To get the treatment you deserve, make an online appointment today.


Our psychiatry providers also offer medication management, helping you find the right antidepressant and optimal dose to alleviate your symptoms.

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Depression Overview & Prevalence 

 

Depression is all too common struggle, with about 280 million people worldwide suffering from depression, with 21 million adults in the U.S. suffering from at least one major depressive episode. It affects about 5% of all adults, and 4.4% of children suffer from depression.

 

Because of the toll it takes on people’s lives, there is an accompanying economic burden for people and the country at large. Compared to 2010, the economic burden of depression reached $235 in 2018, a staggering 35% increase since. The large increase is due to the toll depression takes on people, with the higher costs being caused by more direct medical costs as well as indirect factors such as reduced work productivity, absenteeism, and suicite-related losses.

Clinical Depression vs. Feeling Depressed (Situational Depression)

There is a lot of confusion about the difference between clinical depression and feeling depressed/situational depression. Everyone feels down at times. Feelings of sadness can be caused by a poor grade, losing your job, an argument, or even the weather such as a rainy day. Sometimes, there is no trigger and it just happens out of the blue. Then, things change and the sad feelings vanish.

 

What’s different is clinical depression. It is a medical disorder that will not go away just because you wish it would. It can be chronic and last a long time, affecting one's ability and enjoyment of work, socializing, and life in general.

 

Depression can cause problems in a person's daily life, including the ability to go to work, school, take care of children, or maintain relationships with loved ones and friends. It causes pain for both the person with it and those who love him or her. Depression can be triggered by loss of a loved person, divorce, bereavement, being socially isolated, hormonal changes, traumatic events, and stress.

The Diagnostic Criteria for Major Depressive Disorder

 

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

 

  •  Depressed most of the day, nearly every day as indicated by subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful)

  • Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by subjective account or observation) 

  • Significant weight loss when not dieting or weight gain (e.g., change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day

  • Insomnia or hypersomnia nearly every day

  • Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)

  • Fatigue or loss of energy nearly every day

  • Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

  • Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

  • Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

 

The symptoms being experienced cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

 

The depressive episode is not attributable to the physiological effects of a substance or to

another medical condition.

FAQ

 

What’s the Difference Between Anxiety and Depression?

Anxiety is characterized by feelings of worry, fear, and nervousness, while depression is characterized by feelings of sadness, hopelessness, worthlessness, and reduced energy. 

Is Depression Genetic?

For most cases of depression, about 50% of the cause is related to genetics and the other half is unrelated to genes.

Is Depression a Mental Illness?

Yes, depression is a common mental illness that affects millions of people.

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