Unipolar Depression

Unipolar Depression Treatment Options

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Unipolar depression is a mental health condition characterized by a low, sad, or hopeless mood. It is a type of major depressive disorder. The term unipolar comes from the roots ‘uni’ (one) and polar (end) and signifies patients who experience symptoms from only one end of the mood spectrum. 

Unipolar depression is a major depressive disorder, also called major depression, clinical depression, or depression. Mood episodes last weeks or months, after which symptoms will generally improve. The term unipolar depression also includes other major depressive disorders, such as:

Persistent depression

Also called dysthymia or chronic depression, this condition lasts at least two years. While the symptoms of depression are generally milder, they never entirely disappear. Depressive symptoms are persistent and ongoing for most days. 

Seasonal affective disorder

SAD is a type of MDD with a seasonal pattern. Generally, patients experience depression symptoms during the cold, gloomy months, while symptoms disappear during warmer months. However, this isn’t always the case; some patients experience the reverse. 

Postpartum depression

This condition generally emerges after pregnancy.

Situational depression

Symptoms of situational depression usually emerge within three months of a traumatic event. These symptoms show up as a reaction to a specific stressor. 

Many people are familiar with bipolar affective disorder, which is characterized by alternating periods of mania and depression. In some instances, bipolar depression may be misdiagnosed as unipolar depression. Unlike bipolar disorder, unipolar depression lacks manic or hypomanic episodes, with prolonged depressive episodes. 

Symptoms of unipolar depression include: 

  • Having a low mood for at least two weeks, but often longer
  • Feelings of sadness, irritability, or general discontentment with life
  • Anhedonia, or decreased excitement, enjoyment, or pleasure, even doing things you would normally enjoy
  • Changes in appetite, usually by feeling hungry more often or having no desire to eat
  • Changes in weight by at least 5% in one month
  • Fatigue, or tiredness, no matter how much you sleep
  • Sleep disturbances, which may include insomnia, sleeping too much, or having problems staying asleep
  • Psychomotor changes, such as fidgeting constantly or feelings as though you are moving slower than usual
  • Extreme guilt, which may lead to feelings of worthlessness
  • Difficulty thinking, remembering, concentrating, or making decisions
  • Thoughts of suicide

Unipolar depression can have a wide range of symptoms, and not every person will experience all symptoms. However, you will need at least five of the symptoms above to be diagnosed with unipolar depression, according to the DSM-5 published by the American Psychiatric Association. 

Treating Unipolar Depression

There are several treatment options for unipolar depression, including:

Antidepressant medications

According to the American Psychiatric Association, unipolar depression is commonly treated with second-generation antidepressants, such as:

  • Selective serotonin reuptake inhibitors (SSRIs), which affect serotonin levels
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs), which affect serotonin and norepinephrine levels
  • Norepinephrine/dopamine reuptake inhibitor (NDRI), which affects norepinephrine and dopamine levels

Psychotherapy

Many journal studies and research support the idea that combining therapy and medication is more effective than medication alone. Therapeutic approaches may include cognitive behavioral therapy, behavioral activation therapy, interpersonal therapy, and others. Specific therapeutic strategies are selected by a mental health professional and may depend on the patient’s unique symptoms, concerns, and treatment goals. In addition, online therapy is becoming a popular alternative as it makes treatment more accessible for many patients. 

Alternative approaches

Patients with treatment-resistant depression or those who cannot take traditional antidepressants may seek alternative therapy. Alternative therapies for unipolar depression include

  • Transcranial magnetic stimulation (TMS): This therapy stimulates nerve cells in the brain with electromagnetic pulses, which may promote pre-depression activity levels in the brain.
  • Light therapy: This alternative uses a box that emits bright light for a set period each day. It is usually used for seasonal mood disorders. 
  • Meditation: Meditation may enhance overall mental health by helping the individual name and accept uncomfortable emotions and work on acceptance and equanimity.
  • St. John’s wort: This medicinal supplement has anti-anxiety and antidepressant effects. It can be helpful for some patients with unipolar depression.
  • Ketamine: Ketamine is a standard analgesia that can be used for treatment-resistant depression. It has rapid antidepressant effects, which may immediately address patients experiencing suicidal ideation. Ketamine may be administered by IM or IV. Esketamine, which is a type of ketamine, may be administered nasally.

Major depressive disorder is a mental illness affecting between 20% and 26% of women and 8%-12% of men. Usually, many factors contribute to a diagnosis of unipolar depression. And unfortunately, this condition can make everyday life much more difficult. 

Therefore, those experiencing symptoms aligned with a major depressive disorder should contact their primary care physician or a mental health professional for an immediate assessment. Prompt treatment is vital, especially for patients with thoughts of self-harm or suicide. A reputable mental health professional can recommend the best treatment course given the unique factors contributing to each patient’s condition. 

Yvette Kaunismaki

Yvette Kaunismaki

Yvette Kaunismaki, MD, specializes in psychiatry with a holistic approach, focusing on integrating therapy and medication for women’s issues, depression, anxiety, and bipolar disorder. She emphasizes a team-based method, aiming for balanced mental health through collaborative care with experienced therapists.

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