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CHRISTIAN
SINGLES
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CHRISTIAN
DATING ADVICE
DIAGNOSTIC EVALUATION AND TREATMENT
The first step to getting appropriate treatment for depression is a
physical examination by a physician. Certain medications as well as
some medical conditions such as a viral infection can cause the same
symptoms as depression, and the physician should rule out these
possibilities through examination, interview, and lab tests. If a
physical cause for the depression is ruled out, a psychological
evaluation should be done, by the physician or by referral to a
psychiatrist or psychologist.
A good diagnostic evaluation will include a complete history of
symptoms, i.e., when they started, how long they have lasted, how
severe they are, whether the patient had them before and, if so,
whether the symptoms were treated and what treatment was given. The
doctor should ask about alcohol and drug use, and if the patient has
thoughts about death or suicide. Further, a history should include
questions about whether other family members have had a depressive
illness and, if treated, what treatments they may have received and
which were effective.
Last, a diagnostic evaluation should include a mental status
examination to determine if speech or thought patterns or memory have
been affected, as sometimes happens in the case of a depressive or
manic-depressive illness.
Treatment choice will depend on the outcome of the evaluation.
There are a variety of antidepressant medications and psychotherapies
that can be used to treat depressive disorders. Some people with
milder forms may do well with psychotherapy alone. People with
moderate to severe depression most often benefit from antidepressants.
Most do best with combined treatment: medication to gain relatively
quick symptom relief and psychotherapy to learn more effective ways to
deal with life's problems, including depression. Depending on the
patient's diagnosis and severity of symptoms, the therapist may
prescribe medication and/or one of the several forms of psychotherapy
that have proven effective for depression.
Electroconvulsive therapy (ECT) is useful,
particularly for individuals whose depression is severe or life
threatening or who cannot take antidepressant medication.3 ECT often
is effective in cases where antidepressant medications do not provide
sufficient relief of symptoms. In recent years, ECT has been much
improved. A muscle relaxant is given before treatment, which is done
under brief anesthesia. Electrodes are placed at precise locations on
the head to deliver electrical impulses. The stimulation causes a
brief (about 30 seconds) seizure within the brain. The person
receiving ECT does not consciously experience the electrical stimulus.
For full therapeutic benefit, at least several sessions of ECT,
typically given at the rate of three per week, are required.
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