What depression is
Major depressive disorder involves low mood or loss of interest and pleasure most of the day, nearly every day, for at least two weeks, with an impact on daily life. Dysthymia, now called persistent depressive disorder, is a milder but longer-lasting form, with symptoms for two years or more that are often mistaken for “just the way I am”.
Signs and symptoms
- Persistent sadness, emptiness or irritability
- Loss of interest or pleasure in activities
- Fatigue and low energy
- Changes in sleep and appetite
- Poor concentration and indecision
- Guilt or feelings of worthlessness
- Thoughts of death or suicide
In older adults, depression may show up as physical complaints, memory problems or withdrawal rather than open sadness.
How it is diagnosed
The psychiatrist assesses the intensity and duration of symptoms, previous episodes, family history, medications and substances, and life context, and looks for medical conditions that cause or worsen depression, such as thyroid problems, anemia and vitamin deficiencies. Telling depression apart from bipolar disorder is essential, because treatment differs.
Treatment
- Psychotherapy, effective in mild to moderate depression and part of care in severe cases
- Antidepressant medication, when indicated, chosen according to symptoms, other illnesses, other medications and previous experience
- Sleep, physical activity and routine, which support recovery
- For depression that does not respond, review of the diagnosis and other strategies
When to see a psychiatrist
When symptoms last more than two weeks, affect work and relationships or do not improve. Thoughts of death or suicide need immediate help: in Brazil, call 188 (CVV) or go to an emergency room.
Follow-up at the practice
At the practice in Campinas, Dr. Petrus Raulino devotes the first appointment to a full assessment and explains the diagnosis and treatment options to the patient and, if they wish, to their family. Follow-up visits are in person or by video.
Staging: text awaiting medical review by Dr. Petrus before publishing.
This content is for information only and does not replace a medical consultation. Diagnosis and treatment depend on an individual assessment. In crisis or having thoughts of suicide? In Brazil call 188 (CVV, 24 hours, free) or go to the nearest emergency room. In an emergency, call 192 (SAMU).