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抑郁症的类型  

2015-05-01 17:36:59|  分类: 疾病与治疗 |  标签: |举报 |字号 订阅

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It's normal to feel down once in a while, but if you're sad most of the time and it affects your daily life, you may have depression. It's a condition you can treat with medicine, talking to a therapist, or changes to your lifestyle.

There are many different types of depression. Events in your life cause some, and chemical changes in your brain cause others.

Whatever the cause, your first step is to let your doctor know how you're feeling. She may refer you to a mental health specialist to help figure out the type of depression you have. This diagnosis is important in deciding the right treatment for you.

Major Depression

重性抑郁

You may hear your doctor call this "major depressive disorder." You might have this type if you feel depressed most of the time for most days of the week.

Some other symptoms you might have are:

  • Loss of interest or pleasure in your activities
  • Weight loss or gain
  • Trouble getting to sleep or feeling sleepy during the day
  • Feelings of being "sped up" or "slowed down"
  • Being tired and without energy
  • Feeling worthless or guilty
  • Trouble concentrating or making decisions
  • Thoughts of suicide

Your doctor might diagnose you with major depression if you have five or more of these symptoms on most days for 2 weeks or longer. At least one of the symptoms must be a depressed mood or loss of interest in activities.

Talk therapy can help. You'll meet with a mental health specialist who will help you find ways to manage your depression. Medications called antidepressants can also be useful.

When therapy and medication aren't working, two other options your doctor may suggest are:

  • Electroconvulsive therapy (ECT)
  • Repetitive transcranial magnetic stimulation (rTMS)

ECT uses electrical pulses and rTMS uses a special kind of magnet to increase certain areas of brain activity. This helps the parts of your brain that control your mood work better.

Persistent Depressive Disorder

持续的抑郁症

If you have depression that lasts for 2 years or longer, it's called persistent depressive disorder. It used to be known as dysthymia.

You may have symptoms such as:

  • Change in your appetite (not eating enough or overeating)
  • Sleep too much or too little
  • Lack of energy, or fatigue
  • Low self-esteem
  • Trouble concentrating or making decisions
  • Feel hopeless

You may be treated with psychotherapy, medication, or a combination of the two.

Bipolar Disorder

躁郁症

Someone with bipolar disorder, which used to be called "manic depression," has mood episodes that range from extremes of high energy with an "up" mood to low "depressive" periods.

When you're in the low phase, you'll have the symptoms of major depression.

Medication can help bring your mood swings under control. Whether you're in a high or a low period, your doctor may suggest a mood stabilizer, such as lithium.

The FDA has approved three medicines to treat the depressed phase:

  • Seroquel
  • Latuda
  • Olanzapine-fluoxetine combination

Doctors sometimes prescribe other drugs, such as lamotrigine.

Your doctor might not recommend an antidepressant for this condition, because it carries a small risk of putting you into a "high" phase. Also, there's no proof from studies that these drugs are helpful in treating depression in people with bipolar disorder.

Psychotherapy can also help support you and your family.

Seasonal Affective Disorder (SAD)

季节性情感障碍(SAD)

Seasonal affective disorder is a period of major depression that most often happens during the winter months, when the days grow short and you get less and less sunlight.

If you have SAD, antidepressants can help. So can light therapy. You'll need to sit in front of a special bright light box for about 15-30 minutes each day.

Psychotic Depression

精神病性抑郁

People with psychotic depression have the symptoms of major depression along with "psychotic" symptoms, such as:

  • Hallucinations (seeing or hearing things that aren't there)
  • Delusions (false beliefs)
  • Paranoia (wrongly believing that others are trying to harm you)

A combination of antidepressant and antipsychotic drugs can treat psychotic depression. ECT may also be an option.

Postpartum Depression

产后忧郁症

Women who have major depression in the weeks and months after childbirth may have postpartum depression. Antidepressant drugs can help.

Premenstrual Dysphoric Disorder (PMDD)

经前焦虑障碍(PMDD)

Women with PMDD have depression and other symptoms at the start of their period.

Besides feeling depressed, you may also have:

  • Mood swings
  • Irritability
  • Anxiety
  • Trouble concentrating
  • Fatigue
  • Change in appetite or sleep habits
  • Feelings of being overwhelmed

Antidepressant medication or sometimes oral contraceptives can treat PMDD.

'Situational' Depression

“情境”抑郁

This isn't a technical term in psychiatry. But you can have a depressed mood when you're having trouble managing a stressful event in your life, such as a death in your family, a divorce, or losing your job. Your doctor may call this "stress response syndrome."

Psychotherapy can often help you get through a period of depression that's related to a stressful situation.

Atypical Depression

非典型抑郁障碍

This type is different than the persistent sadness of typical depression. If you have atypical depression, a positive event can temporarily improve your mood.

Other symptoms of atypical depression include:

  • Increased appetite
  • Sleeping more than usual
  • Feeling of heaviness in your arms and legs
  • Oversensitive to criticism

Antidepressants can help. Your doctor may suggest a type called SSRI (selective serotonin reuptake inhibitor).

She may also recommend an older type of antidepressant called a MAOI (monoamine oxidase inhibitor).

WebMD Medical Reference

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