Depression is a brain disorder, caused by abnormalities in the levels of neurochemicals in the brain. Clinical depression, also called Major Depressive Disorder (MDD), is a serious, long-term illness that can effect a person’s daily functioning and quality of life. Depression is not the same as a short-term feeling of sadness or emptiness. It’s more than a temporary case of “the blues”.
What are the causes of Depression?
Research tells us that other factors may contribute to the onset of depression, including genetics, changes in hormone levels, certain medical conditions, stress, trauma, grief, drugs or drug and alcohol abuse. Any of these factors alone or in combination can precipitate change in brain chemistry that lead to depression’s many symptoms.
What are the symptoms of Depression?
Recurring feelings of sadness or hopelessnessLoss of interest in hobbies or favorite activities, including sexPessimismFatigue or decreased energyChanges in sleep such as early morning wakefulness, excessive sleeping or insomniaChanges in appetitePersistent aches, pains or digestive problemsThoughts of suicide
Of course, depression is more than just a collection of symptoms. It’s a medical condition that can feel overwhelming and often interfere with people’s daily functioning. Depression can often make things like work, school, and relationships more difficult to manage.
How common is Depression?
Depression is a very common illness that affects approximately 14 million adults in the United States. Some studies report that perhaps as many as 25% of women and 15% of men have experienced a depressive disorder at some time in their lives.
What is Treatment-Resistant Depression?
Sometimes, no matter what strategies are employed to try to manage depression, the symptoms don’t seem to respond. Individuals who have not experienced satisfactory improvement after trying numerous medications and/or psychotherapy approaches are often characterized as having treatment-resistant depression (TRD).
Mental health professionals are now recognizing that TRD occurs among a significant percentage of people struggling with depression. As awareness of TRD has increased, so have the new approaches emerging to address this condition. TRD can be treated.
How is Treatment-Resistant Depression addressed?
To determine whether depression is treatment-resistant it is important to first talk with your healthcare provider to confirm that your diagnosis is correct and that other health issues are not being overlooked. Determining “adequate duration” of both medications and psychotherapy are key starting points. You and your healthcare provider must also devote sufficient time to fully exploring several different courses of evidence-based treatment. In recent years, large-sample clinical trials have suggested that a combination of medications may be advisable. These include mood stabilizers and antipsychotic drugs. Another option which has been proven effective in helping patients who have not responded to medication-based treatment is the use of transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS), or electroconvulsive therapy (ECT).
Impact of Depression
Depression does not discriminate. Men and women of every age, educational level, and social and economic background suffer from depression. There is no area of life that is not affected when depression is present. Marriage, parenting, friendships, careers, finances – every aspect of daily living is compromised by this disease. Once an episode of depression occurs, it is also quite likely that it will recur. And the impact of depression can be even more severe when it occurs in combination with other medical illnesses such as diabetes, stroke, or cardiovascular disease, or with related disorders such as anxiety or substance abuse.
The problems caused by depression are made worse by the fact that most people suffering from the disease are never diagnosed, let alone treated or in many cases treatment is inadequate. In addition, research shows that ineffectively treated depression tends to recur more often and with more severity of symptoms The good news is that when depression is promptly identified and treated, it’s symptoms are manageable and there are many effective strategies for living with the disease. Depression and bipolar disorder are both treated most effectively in their earliest stages when symptoms are less severe.
Depression is an Illness that has a profound impact on family members. When family members are perplexed and confused about why their relative is behaving differently, they may experience negative emotions and family problems may get exacerbated. Depression can have a negative impact on the parental role and numerous research studies indicate that ongoing depressive symptoms can contribute to marital friction.
TMS for Depression
TMS was recently approved by the FDA to treat major depressive disorder, specifically for patients who have failed to respond to a prior antidepressant medication. Although numerous antidepressant and other treatments are available, many patients suffer multiple depressive episodes that are not well controlled with existing treatments. Approximately 1/3 of patients treated with conventional antidepressants fail to achieve remission. Many patients suffer from intolerable side effects to commonly used antidepressants, such as nausea, weight gain, insomnia, sedation, emotional blunting and sexual dysfunction. Therefore, TMS is a proven strategy for patients who don’t fully respond to antidepressant medication or are sensitive to their side effects.