Learn More about Depression Treatment Options
The Knowledge To Heal
The exact cause of depression remains a mystery, but many factors have been identified that may contribute to depression. Depression strikes people of all races, socio-economic groups, gender, ages, and ethnicities. In recent years, teens have been particularly impacted by depression, with suicide now the third leading cause of death among young people aged 15-24. Women are twice as susceptible as men in experiencing a depressive illness.
Among the possible contributors attributed to depression are:
- Genetic and biological factors. First-degree relatives of people with severe depression are more likely to also suffer from this mental health condition than the general population. Biologically, various areas of the brain are likely involved. Neuroimaging of the brain of a depressed person reveals a smaller or less active amygdala, hypothalamus, and anterior cingulate cortex.
- High stress life events. Significant events, both positive and negative, can trigger distress, including starting a new job, moving, marriage or divorce, having children, or retirement, to name a few.
- Long-term illness. Although it is a physical illness, being bedridden or having physical activity severely limited can trigger depression.
- Traumatic past events. Physical, emotional, or sexual abuse can contribute to a depressive illness sometimes years after the traumatic event occurred. Also, being raised in a dysfunctional home environment where addiction, neglect, or mental illness was present can also cause latent depression.
- Being female. The reproductive and hormonal fluctuations that women experience via the menstrual cycle, pregnancy, and childbirth are key contributors to mood shifts.
- Age. Hormonal fluctuations are more pronounced in young people, making them more vulnerable to developing a depressive disorder. Also, seniors may also develop depression due to the ending of their career, loneliness after the loss of a spouse, or deteriorating health.
The symptoms of depression are difficult to miss. A distinct change in the demeanor and habits of a loved one that lasts more than two weeks signals that something is causing them pain and distress. The primary symptoms of a depressive illness include:
- Anger and frustration expressed, even over seemingly small matters
- Persistent feelings of sadness, hopelessness, and emptiness
- Slowed thinking and movements
- Agitation, anxiety, and restlessness
- Loss of interest in normal activities once enjoyed, such as sports, hobbies, or sex
- Sleep disturbances, either sleeping in excess or insomnia
- Changes in appetite and eating habits, resulting in weight gain or loss
- Feelings of guilt and worthlessness, feeling like a failure
- Trouble concentrating, remembering things, or making decisions
- Unexplained physical problems, such as headaches or back pain
- Obsession with death and dying, or suicide attempts, or suicide
Children and teens may exhibit slightly different symptoms. Common signs of depression among children may include clinginess, worry, refusal to go to school, sadness, irritability, becoming underweight, and complaints of aches and pains. In teens, symptoms may include feeling negative and worthless, feeling misunderstood, extreme sensitivity, angry outbursts, eating or sleeping in excess, self-harm, avoidance of social interaction, and using drugs or alcohol.
The spectrum of depressive illness includes specific traits that define the type of depression being experienced. These include:
Major Depressive Disorder (MDD)
Major Depressive Disorder is the most common type of depression, and is also referred to as clinical depression. MDD falls within the defined FDA guidelines that allow for insurance to cover TMS treatment. MDD is episodic, with each episode lasting at least two weeks, but can last months or years. MDD is frequently co-occurring with anxiety, which TMS therapy can also help to alleviate.
Persistent Depressive Disorder (PDD)
PDD is also referred to as dysthymia or chronic depression, characterized by a continuous, but usually less severe, form of depression than MDD. Both PDD and MDD share common traits, such as both causing overall low mood and a lack of interest in hobbies and activities once enjoyed. Also, both can cause normal daily activities and tasks to be difficult to perform. Because PDD and MDD can be difficult to distinguish, some who were first diagnosed as PDD may actually satisfy the criteria for MDD, thus for insurance coverage for TMS treatment. Because of this, it is important to pursue a second opinion if necessary in order to determine the best treatment plan.
Postpartum depression affects 10-15% of new mothers in the 12 months following the birth of a child. Symptoms last more than two weeks and include feelings of sadness, hopelessness, and guilt. Those afflicted may feel irritated and angry, have difficulty sleeping or eating, have problems concentrating or staying focused. Sometimes these new mothers feel disconnected, and can’t seem to bond with their baby. Many who suffer from postpartum depression are reluctant to seek help out of fear of having their child taken from them. TMS can help ease or alleviate depression before, during, and after pregnancy, including through the breastfeeding phase, where antidepressants would not be permitted.
Seasonal Affective Disorder (SAD)
To date, the cause of Seasonal Affective Disorder is unknown. The symptoms of SAD typically begin in the fall and last through the winter months, with the most severe symptoms during the darkest months. SAD is thought to be caused by reduced sunlight, which changes brain chemicals and leads to the depressive symptoms. Factors such as high melatonin levels, low serotonin levels, and low levels of vitamin D are associated with the disorder. Symptoms include fatigue, trouble concentrating, apathy, loss of interest in sex, decreased activity level, overeating, insomnia, anxiety, and crying spells.
Thankfully, there are several options available in regard to treating depression. Recognizing the ongoing symptoms and then taking the first step in meeting with a mental health professional for a thorough screening and evaluation is key. The treatment options for managing or curing a depressive illness include:
Transcranial Magnetic Therapy (TMS)
TMS has also been proven to be a highly effective therapeutic treatment for depressive illness, but with advantages to ECT. TMS involves the use of a coil to deliver electromagnetic currents through the scalp to the prefrontal cortex. TMS is noninvasive and requires no sedation or medication. The procedure itself is easily tolerated with mild if any side effects. Patients are alert throughout the session and are able to return to their normal activities immediately following treatment.
Medications such as antidepressants, mood stabilizers, and antipsychotic medications are typically the first line of treatment for depression. Selective serotonin reuptake inhibitors (SSRIs) include Prozac (fluoxetine), Paxil (paroxetine), Lexapro (escitalopram), Celexa (citalopram), and Zoloft (sertraline). Serotonin and norepinephrine reuptake inhibitors (SNRIs) include Cymbalta (duloxetine), Effexor (venlafaxine), and Pristiq or Khedezla (desvenlafaxine). Side effects of these medications can include sleep disturbance, sexual dysfunction, headaches, weight gain, and intestinal problems.
Professional psychological therapy can be provided by therapists, counselors, and psychologists to treat a depressive disorder. There are various approaches to psychotherapy available, but for treating depressive illnesses it has been found that cognitive behavioral therapy (CBT) is the most effective. In addition, family or systems focused therapy or interpersonal therapy are also effective treatment modalities. A psychiatrist provides minimal actual psychotherapy, but is licensed to prescribe proper medications, as well as to prescribe TMS or ECT therapies.
Electroconvulsive Therapy (ECT)
ECT has been in use since the 1930s, and involves delivering electric currents into the brain with the goal of triggering short seizures. As a result, it can be effective in causing shifts in the brain chemistry that reduce the symptoms of mental illness, including depression. ECT has been found to be successful when other traditional methods have failed to provide relief from symptoms. ECT is an invasive procedure that requires sedation with a general anesthesia. Side effects can include confusion and memory loss.
Additional treatments and therapies
There are various self-management strategies available to help alleviate the symptoms of depression. These include the practice of yoga, meditation, massage, prayer, and physical exercise. Mindfulness training has been found to help control some of the negative self-talk and anxiety related to depression. A nutritious diet is also a key factor in attaining improved mental health.
Depression, anxiety, and suicidal thoughts have no socioeconomic boundaries. Mental illness can affect anyone at any stage of their lives and the effects can be as devastating as any other disease or disorder. According to the Centers for Disease Control and Prevention (CDC), “in 2016, suicide was the tenth leading cause of death overall in the United States, claiming the lives of nearly 45,000 people” (2018). Studies have shown that 50% of people who commit suicide suffer from depression.
At Achieve TMS East, we understand the correlation between depression and the risk of suicide. In order to help those at risk, we believe that it is important to understand the warning signs; there, we would like to share The Anxiety and Depression Association of America (2018) guidelines for people at risk for suicide below.
If a person talks about:
Being a burden to others
Experiencing unbearable pain
Having no reason to live
Specific Behaviors to look for:
Increased use of alcohol or drugs
Looking for a way to kill themselves, such as searching online for materials or means
Withdrawing from activities
Isolating from family and friends
Sleeping too much or too little
Visiting or calling people to say goodbye
Giving away prized possessions
People who are considering suicide often display one or more of the following moods:
Loss of interest
If you are in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential. http://www.suicidepreventionlifeline.org
Approximately half of patients being treated with medications to treat a depressive illness do not experience relief in their symptoms. Thanks to TMS, these patients now have another option for treating their depression, and without the side effects associated with medications. TMS therapy helps to reset and rebalance the neurotransmitters that have become inactive or less active due to depression, restoring healthy brain function.
Because TMS is noninvasive and requires no sedation, it is a safe, natural treatment solution. The sessions involve being seated in a comfortable chair, and then the doctor determines the placement of the helmet and the correct strength level for the TMS pulses. Over the course of the 4-6 weeks of sessions (five per week), the strength of the pulses may be adjusted. If treatment for anxiety is also prescribed, that can be included in the sessions using a different positioning of the coil.
The FDA cleared the use of TMS in 2008 for the treatment of medication-resistant major depressive disorder. For patients who have tried antidepressants without success, insurance will usually cover the cost of TMS treatments. Contact Achieve TMS East for a free consultation today at (877) 297-5816.