Everyone feels sad from time to time, but when the sadness becomes persistent and interferes with different areas of your life, it could point to something more serious, like depression. For many, the weight of depression can make even simple tasks, like taking a shower, feel impossible.
So, what is a depressive episode? It’s a period where those feelings last longer than usual and affect your ability to function. With one in three women and one in five men experiencing a depressive episode by the age of 65, depression is a common challenge many people will face at some point in their lives.
Defining a Depressive Episode
A depressive episode is a period where a person experiences depression symptoms that last for at least two weeks. According to the DSM-5, five or more symptoms must be present during this two-week period for it to qualify as a depressive episode. At least one of the symptoms must involve either a depressed mood or a loss of interest or pleasure in activities that once felt enjoyable.
Depressive episodes can happen in many mental health conditions, including major depressive disorder (MDD) and bipolar disorder (BD). In BD, depressive episodes typically alternate with manic episodes.
The severity of a depressive episode can depend on several factors, but it can be classified as either major or minor. Major depressive episodes tend to involve more severe symptoms and a greater level of disruption to everyday life.
How Long Can a Depressive Episode Last?
The duration of a depressive episode can vary and depends on an individual’s personal circumstances, other underlying health conditions, and the severity of symptoms. On average, the median duration of an episode is around three to six months. However, some people may experience shorter or longer episodes. Without proper intervention, a depressive episode can last for several months or even years.
What Causes a Depressive Episode?
Certain life events can leave a person feeling drained, frustrated, and, in some cases, isolated without much support. These often overwhelming feelings may become too much to handle, resulting in a depressive episode. A depressive episode can be triggered by:
- Physical stressors, such as various serious health conditions (e.g., diabetes, cancer)
- Psychological stressors, like losing someone close to you
- Social stressors, including losing a job or going through a divorce
Researchers have found that these types of events contribute to higher rates of getting depression, especially events like the COVID-19 pandemic when many people became unemployed.
Keep in mind that everyone reacts to stressors in their own way. Just because one person may become depressed after experiencing a stressful event doesn’t mean someone else going through something similar will have the same response.
Signs of a Depressive Episode
It’s important to differentiate a depressive episode from regular feelings of sadness. While everyone experiences moments of sadness, these typically don’t interfere with everyday life. People may feel less enthusiastic, but they can still function in their day-to-day without much interruption.
In contrast, depressive episodes bring on more severe symptoms that can and do interfere with daily tasks and responsibilities. Some signs of a depressive episode include:
- Feelings of worthlessness or excessive guiltiness
- Extreme fatigue or a lack of energy
- Trouble sleeping or sleeping too much
- Significant changes in appetite
- Unexplained weight loss or gain
- Physical ailments that don’t respond to treatment, like headaches or digestive issues
- Restlessness, irritability, or feeling agitated
- Difficulty concentrating, remembering, or making decisions
- Thoughts of death or suicide
Everyone experiences depression differently, so you might only have some of these symptoms, or you might even have other symptoms that are not mentioned. These symptoms are also normal from time to time, and they don’t necessarily mean you’re having a depressive episode. If you’re concerned you might be depressed, it’s important that you seek help from a mental health professional as soon as possible.
How to Cope During a Depressive Episode
There isn’t one direct way to deal with a depressive episode, but rather several strategies you can utilize to help you get through this difficult period. From self-care practices to cutting-edge technologies like transcranial magnetic stimulation (TMS), feeling better is possible.
Self-Care Practices
When someone is going through a depressive episode, self-care probably isn’t top of mind; however, making yourself a priority can actually make a big difference in how you feel. In fact, experts report that those who practice healthy self-care habits have the lowest levels of depression.
Here are some self-care ideas that you can try implementing into your daily routine during a depressive episode:
- Exercise to boost mood and energy
- Eat a balanced, nutritious diet
- Make sure you’re getting enough restful sleep
- Start journaling to express your emotions and reflect on your thoughts
- Seek support from family and friends
- Try yoga or meditation to relax both your mind and body
- Spend time in nature to reconnect with the environment
- Practice positive self-talk to combat negative thoughts
Psychotherapy
Psychotherapy is an effective way to manage and treat depressive episodes. There are several types of therapy that each uses their own techniques, including:
- Interpersonal therapy (IPT) focuses on improving relationships and communication skills while addressing interpersonal issues that may be contributing to depression.
- Cognitive-behavioral therapy (CBT) helps individuals identify and challenge negative thought patterns by replacing them with more positive and realistic thinking.
- Mindfulness-based cognitive therapy (MBCT) combines mindfulness practices with cognitive therapy to help break the cycle of depression by promoting awareness and acceptance of the present moment.
If you’re unsure which therapy would benefit you the most, a mental health professional will be able to guide you in the right direction based on your symptoms and situation.
Medication
When a depressive episode is long-lasting or severe and other interventions have not been enough, medication may be prescribed. For depression, the FDA has approved different classes of medication, including:
- Selective Serotonin Reuptake Inhibitors (SSRIs) are the first line of treatment for depression (e.g., fluoxetine, sertraline, citalopram)
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) may work better than SSRIs for some people (e.g., venlafaxine, duloxetine, desvenlafaxine)
- Atypical Antidepressants can be prescribed on their own or when patients experience sexual side effects from SSRIs or SNRIs (e.g., bupropion, mirtazapine)
- Tricyclic Antidepressants are an older class of medications that may cause more side effects (e.g., amitriptyline, imipramine, clomipramine)
- Monoamine Oxidase Inhibitors (MAOIs) can interact with certain foods and medications, making them a less popular choice (e.g., tranylcypromine, phenelzine, selegiline)
Mood stabilizers and antipsychotics are other medications that may be added to an antidepressant to enhance effects. Always consult with a doctor before starting any medication.
Treatment-Resistant Options
While many therapies are effective for managing depressive episodes, around 30% of individuals with MDD may not respond to treatment or achieve sustained remission. This is known as treatment-resistant depression, or TRD. For those with TRD, alternative treatments, like electroconvulsive therapy (ECT), ketamine infusion, and TMS, may be necessary to help bring relief.
TMS, specifically, is gaining traction as a treatment for depression as it is non-invasive, does not require anesthesia, and patients can return to their normal activities immediately after a session. By using magnetic fields to stimulate certain areas of the brain involved in depression, TMS shows promise for those whose depression hasn’t improved with traditional medications or psychotherapy. In a recent trial, TMS showed significantly higher response rates compared to placebo treatments, demonstrating just how effective it can be in treating depression.
Break Free From The Cycle of Depression Today
If you think you might be going through a depressive episode, know that you are not alone. From therapy to TMS and medication management, the compassionate team at Cura Behavioral Health is here to help you through this challenging period. Reach out today to learn more about how we can help you manage and overcome your depression.
Sources:
- What is the lifetime risk of depression? – Our World in Data
- DSM-5-TR diagnostic criteria for a major depressive episode – UpToDate
- Duration of major depressive episodes and sleep architecture: an exploratory study – Journal of Psychiatric Research
- Major Depressive Disorder: a General Overview – Shanghai University
- The Role of Self-Care Activities (SASS-14) in Depression (PHQ-9): Evidence From Slovakia During the COVID-19 Pandemic – Frontiers in Public Health
- Major Depressive Disorder – StatPearls
- Trend and geo-availability of somatic therapies for treatment resistant depression in the US – Psychiatry Research Communications
