Is Your Major Depression Treatment Plan Working?

Track your progress with a journal of your clinical depression symptoms.

As you start to overcome major depression (also known as clinical depression, major depressive disorder, or MDD), you can boost your success by being an active member of your own treatment team. Once you’ve worked with your doctor and/or a psychotherapist to put a depression treatment plan in place, the next step is to watch for signs that you’re feeling better. Overcoming depression may take some time, but keeping regular tabs on your progress will help your depression-treatment team fine-tune the right mix of antidepressant medication and psychotherapy for you.

Keep a Depression Symptoms Journal

Day-to-day variations in your depression symptoms can be misleading, so it may be more helpful to assess your progress at the end of each week instead of daily. To keep track of subtle changes in your symptoms, use a depression symptoms journal for at least the first month of treatment. Write in it daily.

Use this checklist to assess your progress around the same time each week:

___I feel more rested in the morning.
___I’m interested at work and able to concentrate.
___My energy level seems to be improving.
___Feelings of lethargy or restlessness were less noticeable.
___I tried to eat regularly and healthfully most days of the week.
___I took my antidepressant medication daily (if applicable).
___I exercised at least 3 times this week.
___Feelings of loss, sadness, guilt, or worthlessness were not distracting.
___I engaged in an activity with friends or family.
___Overall, this week was better than last week.

If you’re taking an antidepressant, take note of the following potential side effects and contact your doctor or therapist right away if you have them:

  • Feelings of worthlessness or thoughts of self-harm
  • Worsening depression
  • Changes in your sexual interest

Modifying Your Depression Treatment Plan

Research shows that a combination of antidepressant medication plus psychotherapy offers the best chance for lasting relief from major depression, says Gerry Neely, MA, LMFT, who works with clients in her Seattle practice. For people who feel a stigma about taking medication, Neely adds, “finding the right medication can serve as a short-term bridge to feeling better and being able to fully engage with life.”

If you don’t see improvement right away, don’t give up hope. Research funded by the National Institutes of Mental Health (NIMH) shows that switching antidepressants or adding a medication to your depression treatment plan can help. If your symptoms persist, your doctor will review your current plan and your overall health to be sure nothing was missed. Your psychotherapist can try a variety of techniques to find the right match.

Can You Recognize Major Depression Symptoms?

The signs of major depressive disorder may surprise you.

When you’re depressed, you expect to feel sad, blue, or down in the dumps — a state known as dysphoria. You may also suffer from anedonia, which is a lack of interest or pleasure in almost all activities, most of the day. These are two hallmarks of depression.

To be diagnosed with major depression, also known as major depressive disorder (MDD) and clinical depression, you must experience at least five depressive symptoms from the following list, including dysphoria and anhedonia. These symptoms must be present most of the day nearly every day for at least two weeks:

  • Depressed mood
  • Loss of interest, particularly in activities you typically enjoy
  • Significant weight loss or gain
  • Trouble sleeping or sleeping too much
  • Feeling restless, agitated, irritable, unable slow down
  • Fatigue, loss of energy, or feeling tired all the time
  • Feelings of  hopelessness, worthlessness  or guilt
  • Impaired concentration and difficulty making decisions
  • Recurrent thoughts of death or suicide

To be classified as MDD, these symptoms must cause significant distress or impairment in social, occupational, and other important areas of functioning. A formal clinical depression diagnosis will also rule out other medical causes of depressed mood, including medication side effects, substance abuse, or a medical condition, such as an underactive thyroid. Finally, the symptoms should be distinguished from the grief or bereavement associated with loss of a loved one or extraordinarily stressful life events.