Early signs of depression: How to identify it?

Effective treatment of depression requires early detection. Depression can be difficult to identify among subgroups of patients with co-morbid medical illnesses, substance abuse disorders, brain injury, and dementia, or those who are at either end of the age spectrum.

Prevalence and risk factors

The most powerful predictive risk factor is a first-degree relative with depression. Being raised by a depressed parent compounds this risk. Therefore, primary care physicians can readily identify their young patients at highest risk—offspring of depressed parents. Conversely, the detection of depression in a preadolescent child is a strong marker for the recent or concurrent presence of depression in one or both of the parents.

Early-onset depression may be more severe and genetically determined, and thus more similar to treatment-resistant adult cases, and is more likely to lead to bipolar disorder.

Early-onset cases also tend to have other risk factors that may promote a depressogenic cognitive and behavioral coping style. Early losses or trauma may also result in persistent biological changes that predispose to depression. Furthermore, when a young person becomes depressed, life quickly becomes complicated by negative events that perpetuate the illness.

These include school failure, loss of friendships, dropping out of activities such as sports and artistic endeavors, and negative reactions from parents and teachers who are frustrated by the child’s low motivation and output. Even after recovery, deficits in academics and social relationships persist; there appears to be a developmental cost of having a depressive episode in the childhood or teen years. 

Presentation and diagnosis

There are age-related differences in presentation. Major depression in preadolescents is accompanied by symptoms of separation anxiety in 50% of cases, which may obscure the symptoms of depression. Initial and terminal insomnia, as well as reduced eating and weight loss or failure to gain appropriately, are common.

In contrast, lethargy, hypersomnia, and increased appetite and eating are more characteristic among adolescents. At all ages, decline in academic functioning, social withdrawal, and irritability are seen. Marked irritability may result in angry or even aggressive outbursts that obscure the underlying depression.

Adolescents may show temporary cheering-up in the presence of peers, and in all young people, mood may be more reactive than in adults with depression. The decline in function, however, clearly indicates the severity of the condition.

Physical concerns such as fatigue, abdominal pain, headaches, or sleep disturbance are commonly the reason that depressed children and adolescents are initially brought to the family physician, so screening questions for depression should be asked in these situations.

The family physician should look for a change in function, such as a decline in school grades and/or social withdrawal. The best diagnosis is obtained by combining information from both child and parents, as parents accurately report behavioural change while children report their subjective emotional state.

Many children will have trouble identifying their mood state and may focus on physical symptoms or angrily blame others rather than express the guilt and self-blame more typical of an adult patient. Adolescents are better at identifying depressed mood. 

In adolescents, marijuana abuse and dependence can both complicate and mimic depression. Other substance abuse such as alcohol abuse and dependence, or abuse of stimulants such as methamphetamine, will be challenging to distinguish from primary depression. 

Managing Depression

Depression can cause difficulty for the patients as well as the people around them. Hence, it is important to get treatment for it. Psychological and psychiatric interventions are two major ways of how a patient can be treated. It is a great idea to start with the treatment as soon as the early signs of depression show up. 

• Psychological Interventions:

Many experts have mentioned that the psychological method that is also known at times as the talking method can help the patients in getting rid of depression. The experts understand first what are the early signs of depression of the patient and plan accordingly. The purpose of this method is to bring changes in the way the patient thinks and to help them in feeling better than before. There are several ways of how an expert can offer psychological help to patients. Here are some of the ways: 

• Cognitive Behaviour Therapy or is much better known as CBT.
• Interpersonal therapy, also known as IPT.
• MBCT is also a kind of cognitive behaviour but is based on mindfulness.
• Behaviour therapy.

Among all these methods, CBT is the most commonly used treatment method that helps the patients from detoxing negativities and coping up better with life. Most of the time, the experts start with CBT before trying any other method of treatment. 

• Psychiatric Interventions:

When a psychiatrist checks the patient, the expert first runs a number of tests such as a physical exam, lab tests, psychiatric evaluation, DSM-5 to diagnose the condition of the patient. As per the diagnosis, there are different types of depression that a patient can have such as anxious distress, atypical features, catatonia, and others. 

The psychiatric expert will diagnose the case of the patient and will prescribe medication accordingly. The doctor may prescribe antidepressants, inhibitors, and any other type of medication depending upon the category and condition of the depression in a patient. 

When you reach out to the team at Cadabam’s Hospitals for depression treatment, the experts can offer you a combination of solutions that may consist of:

• Counselling of the patient - The psychologist talks to the patient and tries to heal out the negativities. For this, the patient has to take several sittings with the expert and the number of sittings depends upon the condition of the patient. 

• CBT - Different CBT methods are used to see changes in the patient.

• Family therapy - Counselling is also provided to the family members to teach them how to take care of the patient at home. 

• Interpersonal Therapy - This is a kind of counselling of the patients who have got depressed due to a particular incident.

• Medication - While the above-mentioned procedures are continuing, the patient will be also on medication, if needed. The expert runs a few tests on early signs of postpartum depression and others to understand the type and condition of the depression before prescribing the right medication to the patient. 

Even after the treatment is completed, the experts at Cadabam’s Hospitals will extend their post-care support to the patients. Our multispecialty team will ensure to make a solution-oriented and personalised treatment plan best suited to the needs of you or your loved one. 

Ms.Suhita Saha