When people think about a diagnosis of depression, they typically picture lethargy, lack of energy, exhaustion and low motivation. There is another type of depression, however, called agitated depression that manifests itself in a far different manner. Displaying bouts of anxiety, anger and agitation are all symptoms of a condition called agitated depression. Formerly referred to as melancholia agitata, it is now referred to as both agitated depression and mixed mania.
Patients diagnosed with agitated depression or mixed mania have been previously diagnosed with a severe depressive disorder. The agitation appears anywhere from weeks to months after the onset of the depressive state. The criteria for meeting such a diagnosis include the following combination of symptoms. There must first have been an episode of major depression combined with any two of these factors: motor agitation, severe inner tension, and/or periods of uncontrollable racing thoughts.
According to the American Journal of Psychiatry, agitated depression is often found in people diagnosed with bipolar disorder. It estimates that nearly 20 per cent of bipolar disorder patients also have agitated depression.
Although drug therapy will be necessary to treat a patient diagnosed with agitated depression, it is imperative that he also seek regular psychotherapy sessions with a psychologist skilled in this form of depression. Sessions should take place weekly at first, and possibly reduced to every other week once the condition seems to be under some control.
One form of medication used in the treatment of agitated depression are psychostimulants. Since psychostimulants have a rapid onset within the body's chemistry, they get to work quickly and may be taken indefinitely. Methylphenidate is among the more popular options for psychostimulants.
When taking any kind of drug for agitated depression, it is important for the patient to keep regular appointments with a psychiatrist in addition to therapy sessions with a psychologist. A psychiatrist is licensed to prescribe such medications and can discuss side effects and dosages with the patient.
SSRIs (selective serotonin reuptake inhibitors) are highly effective depression medications known to treat agitated depression. They include , sertraline and citalopram. There are several others as well. SSRIs have proven to be well tolerated by most patients, and more than 70 per cent of patients with agitated depression who are treated with SSRIs achieve success in their treatment plan, according to an article by Dr. Robert L. Fine (Baylor University Medical Center Proceedings; Depression, Anxiety and Delirium in the Terminally Ill Patient; Robert L. Fine, MD; April 2001).
While most doctors don't like to prescribe sedatives to patients (sedatives tend to make most patients very lethargic), there are certain times when they are needed for the treatment of agitated depression. The most common choices prescribed by psychiatrists are haloperidol, risperidone and olanzapine. Patients typically build up a tolerance to these drugs, which alleviate the lethargy symptoms, however, they soon find they need their dose increased. This begins the cycle of lethargy once again.
Most cases of agitated depression can be effectively treated using a combination of treatments including therapy. Close monitoring by a therapist and psychiatrist, as well as consults with the patient's medical doctor, offer the best chance for a full recovery.
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