Major depression is one of the commonest psychiatric illnesses globally. There is no test for depression and the diagnosis is based on a good history and examination. The signs and symptoms of clinical depression are often missed or explained away. One example is postpartum depression that occurs in one out of 10 pregnant mothers and is often undiagnosed bipolar depression.
There is no cure for depression but very effective treatments are available with a good evidence base. The treatments for depression include medications like SSRIs or SNRIs or other new generation antidepressants as well as augmentation therapies. For treatment resistant cases ECT, rTMS, VNS and DBS are often helpful. Finally there are several proven therapies that help patients with depression. These include cognitive behavior therapy, and interpersonal therapy.
Anxiety disorders are the commonest psychiatric illnesses globally. There is no test for anxiety disorders like panic disorder, PTSD,OCD or social anxiety disorder and the diagnosis is based on a good history and examination. The signs and symptoms of anxiety disorders are often missed or explained away. Anxiety disorders are also commonly comorbid with other psychiatric disorders particularly mood disorders.
There is no cure for anxiety disorders but very effective treatments are available with a good evidence base. The treatments for anxiety disorders include medications like benzodiazepines, SSRIs or SNRIs or other new generation antidepressants, atypical antipsychotics, as well as augmentation therapies. Several proven therapies are also efficacious in patients with anxiety disorders. These include cognitive behavior therapy, relaxation training, and prolonged exposure therapy. Yoga and meditation have also demonstrated benefits.
Bipolar disorder is a common and disabling psychiatric illness. It often misdiagnosed particularly in patients presenting with depressive episodes. Clinicians need to consider this diagnosis in all patients presenting with depressive symptoms since up to 20% of patients with unipolar depression will go on to develop a bipolar disorder. Even celebrities like Catherine Zeta-Jones have publicly spoken about having the illness so as to encourage others to seek help. The treatment of bipolar disorder can be challenging even though the treatment armamentarium is extensive particularly for manic and mixed episodes. Most patients will need a combination of medications along with adjunctive proven psychotherapies for optimal outcomes. Long term often lifelong maintenance treatment is indicated for most patients with this illness.