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Most primary care physician can successfully treat uncomplicated mild or moderate forms of major depression in their settings with careful psychiatric management (e.g., close monitoring of symptoms, side effects, etc.); maintaining a therapeutic alliance with their patient; pharmacotherapy (acute, continuation, and maintenance phases); and / or referral for psychotherapy.The following situations require referral to psychiatrist: suicide risk, bipolar disorder or a manic episode, psychotic symptoms, severe decrease in level of functioning, recurrent depression and chronic depression, depression that is refractory to treatment, cardiac disease that requires tricyclic antidepressants treatment, need for electroconvulsive therapy (ECT), lack of available support system, and any diagnostic or treatment questions.The dual action reuptake inhibitors venlafaxine and bupropion are generally regarded as second line agents.
Antidepressant medications’ effectiveness is generally comparable across classes and within classes of medications.
The medications differ in side effect profiles, drug-drug interactions, and cost.
For more severe depression, psychotherapy may be appropriate in combination with the use of medications.
The most effective forms of psychotherapy are those with structured and brief approaches such as cognitive behavioral therapy, interpersonal therapy, and certain problem solving therapies.
The history of a positive response to a particular drug for an individual or a family member, as well as patient preferences, should also be taken into account.
Most psychiatrists agree that an SSRI should be the first line choice.
Writing this cause and effect essays require more skills than writing descriptive or narrative type.
The writer must write factual material, which makes this writing different from descriptive and narrative.
The second type is cause type, which discusses many different reasons for the something happened.
The final type is effect type, which focus on different happenings after the event.