Treatments for Major Depressive Disorder (MDD)

Drug Therapy

Blood tests, physical and psychological exams, as well as an assessment using the criteria outlined in the DSM-5-TR manual are used to diagnose major depressive disorder (MDD) in a person with a history of alcohol misuse.  Cognitive behavioral therapy or psychotherapy may be used in conjunction with medication to treat MDD (McHugh & Weiss, 2019). Additional requirements could include treatment plans and hospital stays. The following are examples of drug therapy: Drugs known as SSRIs (selective serotonin reuptake inhibitors), Tricyclic and other types of antidepressants, Inhibitors of the reuptake of serotonin and norepinephrine (SNRIs), and Inhibitors of monoamine oxidase (MAOIs). Alcohol abusers should not receive benzodiazepines for the treatment of MDD because they run the risk of overdosing. It could take up to 6 or 8 weeks for the medication to have its full therapeutic impact. With regular follow-ups, nevertheless, the duration of the medicine and therapy might be extended.

Predictors of Late Onset Generalized Anxiety Disorder (GAD).

A history of depression, persistent illnesses, trauma or abuse, and a family history of anxiety disorders are four factors that can predict the development of a late-onset GAD (Mohlman, 2020). Adults with previous bouts of depression are more prone to acquire GAD in later life. Because of the stress and unpredictability of dealing with ongoing medical conditions, chronic diseases like heart disease or diabetes might potentially raise the risk of GAD. People who have undergone traumatic situations may be more prone to having GAD, therefore a track record of abuse or trauma may also serve as a predictor. Another predictor is having a history of GAD in the family, as those people may be more prone to experience the illness themselves.

4 Potential Neurobiology Causes of Psychotic Major Depression.

Abnormal activity within the Hypothalamic-pituitary-adrenal (HPA) axis, atypical noradrenergic system action, anomalous serotonergic system action, and abnormal dopaminergic system action are four proposed neurobiological reasons for psychotic MDD (Buch & Liston, 2021). Anomalous action in the HPA axis, which controls stress and the body’s reaction to it, can result in psychotic severe MDD. The noradrenergic system controls stimulation and attention, and aberrant action in this structure can cause psychotic severe depression to develop. Serotonin is a neurotransmitter that controls mood and emotion, and aberrant serotonin levels can cause psychotic severe depression to develop. It is regulated by the dopaminergic system, which also controls impetus and reward, and aberrant action in this structure can result in the advancement of MDD.

Symptoms required for MDD Episode to Occur

According to the American Psychological Association (APA), a depressive incident is defined as a period that persists longer than 2 weeks and is characterized by several indications, including protracted feelings of hopelessness or a lack of excitement or desire, absence of enthusiasm or exhaustion, difficulty concentrating or making decisions, variations in appetite or sleeping patterns, guilt emotions or inadequacy, and suicidal ideations (Reynolds III, Lenze & Mulsant, 2019). These symptoms must considerably impair one’s ability to operate in social, occupational, or other spheres or cause great suffering. Additionally, neither a general medical condition nor the substance’s direct physiological consequences may be the cause of the symptoms.

3 Classes of Drugs

Beta-blockers, corticosteroids, and antidepressants are three medication types that might cause insomnia (Siegel et al., 2021). Fluoxetine is one antidepressant that has a history of contributing to sleeplessness. Propranolol is a prime example of a beta-blocker that can lead to sleeplessness. Prednisone is an illustration of a corticosteroid that might impair sleep. By changing the concentrations of the brain’s sleep-regulating neurotransmitters such as 4 Serotonin and dopamine, these medicines can result in insomnia. Additionally, they can disrupt the circadian cycle of the body, making it difficult to fall asleep or stay asleep. These medications should be taken cautiously in people who have a track record of insomnia or other sleep disorders, it’s crucial to remember. If the lack of sleep fails to go away, individuals should change their dosage or medicine.

References

Buch, A. M., & Liston, C. (2021). Dissecting diagnostic heterogeneity in depression by integrating neuroimaging and genetics. Neuropsychopharmacology, 46(1), 156-175. https://doi.org/10.1007/s12264-021-00638-3

McHugh, R. K., & Weiss, R. D. (2019). Alcohol use disorder and depressive disorders. Alcohol Research: Current Reviews, 40(1). https://doi.org/10.35946%2Farcr.v40.1.01

Mohlman, J. (2020). Neurocognitive predictors of long-term outcome in CBT for late-life generalized anxiety disorder. Journal of Anxiety Disorders, 74, 102246. https://doi.org/10.1016/j.janxdis.2020.102246

Reynolds III, C. F., Lenze, E., & Mulsant, B. H. (2019). Assessment and treatment of major depression in older adults. Handbook f Clinical Neurology, 167, 429-435. https://doi.org/10.1016/B978-0-12-804766-8.00023-6

Siegel, A. N., Meshkat, S., Benitah, K., Lipsitz, O., Gill, H., Lui, L. M., … & Rosenblat, J. D. (2021). Registered clinical studies investigating psychedelic drugs for psychiatric disorders. Journal of Psychiatric Research, 139, 71-81. https://doi.org/10.1016/j.jpsychires.2021.05.019