Depression/Anxiety

Diagnosis

• Clinical Evaluation:
  A thorough assessment by a mental health professional (e.g., psychiatrist, psychologist) to evaluate the severity, duration, and impact of symptoms.

• Diagnostic Criteria:

  • Depression: Using criteria from the DSM-5 or ICD-10 (e.g., presence of five or more symptoms lasting at least two weeks for major depressive disorder).
  • Anxiety: Diagnosing based on the DSM-5 criteria (e.g., generalized anxiety disorder, panic disorder, social anxiety disorder), focusing on the presence and impact of excessive worry and physical symptoms.

• Screening Tools:

  • For Depression: Tools like the Beck Depression Inventory (BDI) or Hamilton Depression Rating Scale to assess symptom severity.
  • For Anxiety: Generalized Anxiety Disorder 7 (GAD-7) and Panic Disorder Severity Scale (PDSS) for identifying the type and severity of anxiety.

• Medical Tests:
  Ruling out other physical conditions (e.g., thyroid dysfunction, vitamin D deficiency) that could mimic symptoms of depression and anxiety.

3. Giving Appropriate Counselling, Therapy, or Medicines

Counselling/Therapy

• Cognitive Behavioral Therapy (CBT):
  • Focuses on identifying and changing negative thought patterns and behaviors that contribute to depression and anxiety.
  • Teaches practical coping strategies and helps with problem-solving.
• Interpersonal Therapy (IPT):
  • Focuses on improving personal relationships and addressing interpersonal stressors that may trigger or worsen depression or anxiety.
• Mindfulness-Based Cognitive Therapy (MBCT):
  • Combines mindfulness meditation with CBT to prevent relapse, especially for depression, and manage anxiety.
• Acceptance and Commitment Therapy (ACT):
  • Encourages acceptance of difficult emotions and focuses on living in alignment with values rather than avoiding or eliminating negative feelings.
• Psychodynamic Therapy:
  • Explores how past experiences, unconscious conflicts, and unresolved issues contribute to current emotional struggles, providing insight and long-term change.
• Supportive Therapy:
  • Provides emotional support and validation, often used in conjunction with other therapies to address day-to-day emotional challenges.

Medicines (Pharmacological Treatment)

• Antidepressants:
  • SSRIs (Selective Serotonin Reuptake Inhibitors): Commonly prescribed for both depression and anxiety (e.g., fluoxetine, sertraline, escitalopram).
  • SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors): Effective for both conditions, helping regulate serotonin and norepinephrine (e.g., venlafaxine, duloxetine).
  • Tricyclic Antidepressants (TCAs): Older medications sometimes used for severe depression, though with more side effects (e.g., amitriptyline).
  • MAOIs (Monoamine Oxidase Inhibitors): Typically used when other medications are ineffective (e.g., phenelzine, tranylcypromine).
• Anti-Anxiety Medications:
  • Benzodiazepines: Fast-acting medications used for acute anxiety episodes, but not recommended for long-term use due to dependency risks (e.g., alprazolam, lorazepam).
  • Buspirone: A non-habit-forming medication used for chronic anxiety, less sedative than benzodiazepines.
• Other Medications:
  • Atypical Antipsychotics: Occasionally added to treatment when other medications fail, especially for treatment-resistant depression or severe anxiety (e.g., quetiapine).
  • Mood Stabilizers: For patients with co-occurring mood disorders, such as bipolar disorder, where depression and anxiety symptoms overlap (e.g., lithium, valproate).
  • Beta-Blockers: Used to manage the physical symptoms of anxiety (e.g., trembling, rapid heartbeat), often in social anxiety or performance anxiety situations.

4. Integrated Approach

• Combination of Therapy and Medication:
  For many individuals, combining psychotherapy with medications provides the most effective treatment for depression and anxiety.

• Lifestyle Changes:
  Encouraging physical activity, healthy sleep habits, and proper nutrition as part of a holistic approach to treatment.

• Regular Follow-up:
  Continuous monitoring of symptoms, adjusting therapies and medications as needed, and ensuring long-term support to prevent relapse.

• Crisis Management:
  Immediate care and intervention for individuals in acute distress or at risk of self-harm or suicide, including safety planning and emergency services.