As people grow older, they face more and more problems, and many times the negative emotions of adults are slowly accumulating until they collapse and are no longer able to cope. The number of people suffering from depression is increasing, but the rate of seeking medical help lags far behind other illnesses, with over 90% of patients not receiving effective diagnosis and treatment.
Depression is a common mood disorder that can be caused by various reasons, with significant and persistent low mood as its main clinical feature. However, depression is not just simple sadness. Some believe that individuals with depression can recover by adjusting their mood. In reality, it is because of some obstacles that depressed patients remain in a low mood unable to break free.
Emotional depletion can range from feeling down to extreme sadness, self-deprecation, even pessimism, and aversion to life, leading to suicidal attempts or behaviors; some may experience catatonia, unable to find joy in their activities. Some cases exhibit noticeable anxiety and psychomotor agitation; severe cases may include hallucinations, delusions, and other psychotic symptoms. Each episode lasts for at least 2 weeks or longer, with some lasting for years. Most cases have a tendency to recur, with each episode mostly easing over time, while some may have residual symptoms or turn chronic.
The exact mechanism of depression onset is not yet clear. However, in the research of antidepressant drugs, it was found that the occurrence of depression might be related to abnormalities in various neurotransmitter levels. Biochemical studies have shown that in depressed patients, the levels of serotonin, dopamine, and norepinephrine in the brain are lower than in normal individuals. Encountering stressful life events in adulthood is an important trigger for clinically significant depressive episodes to appear.
Currently, the main treatments for depression include psychotherapy, medication, and physical treatments.
1. Medication: Medication is the primary treatment measure for moderate to severe depressive episodes. Currently, the frontline antidepressants in clinical practice mainly include selective serotonin reuptake inhibitors (SSRIs – representing drugs like sertraline, fluoxetine, paroxetine, fluvoxamine, citalopram known as the “five golden flowers” of antidepressants), serotonin and norepinephrine reuptake inhibitors (SNRIs), and norepinephrine-specific and serotonin-specific antidepressants (NaSSA), among others.
Currently, the most commonly used antidepressant is escitalopram oxalate, which has a broad indication among similar drugs and the lowest resistance.
2. Psychotherapy: For patients with obvious psychosocial factors in depressive episodes, psychotherapy is often needed in conjunction with medication. Common psychotherapeutic methods include supportive psychotherapy, cognitive-behavioral therapy, interpersonal therapy, marriage and family therapy, psychodynamic therapy, among others, with cognitive-behavioral therapy being widely recognized for its effectiveness in treating depressive episodes.
3. Physical treatments: In recent years, a new physical treatment modality has emerged – repetitive transcranial magnetic stimulation (rTMS) therapy, mainly applicable to mild to moderate depressive episodes.
A study tracking patients with depression for 10 years found that 75% to 80% of patients experience multiple recurrences, hence preventive treatment is necessary for depression patients. Those who have had more than 3 episodes should undergo long-term treatment, possibly lifelong medication.
Psychotherapy and social support systems also play a crucial role in preventing the recurrence of this disease. Efforts should be made to alleviate the heavy psychological burden and stress on patients as much as possible, help them solve practical difficulties and problems in their life and work, enhance their coping abilities, and actively create a positive environment to prevent relapses.
