Dealing with Depression—Brighter Days Ahead

Dealing with Depression—Brighter Days Ahead

Dr. Drew W. Edwards

Depression is a bad disease that happens to good people—young and old. It’s no one's fault really, and It is more common than you might think. In fact, as many as 20% of adults will suffer from depression in their lifetime. Maybe even more shocking is that one in five high school kids report that they have seriously considered, or attempted suicide. Depression is also highly lethal. More that 15% of people with untreated or under-treated depression kill themselves. For those with substance use disorders the prevalence of depression and suicide is even higher. But there is good news. Advances in our understanding of this disease have yielded new and improved treatment. Thus, in the hands of a well-trained clinician, depression is highly treatable.

What Causes Depression?

Studies have shown that depression is rarely due to a single event or condition. As with many diseases, some people are more likely to acquire  it than others. For example, it is more common among people with chronic illness, individuals who have been traumatized, or those who suffer from chronic pain. And recently, scientist have found a genetically acquired risk factor that may surprise you. Approximately 30% of the US population have a genetic aberration called Reward Deficiency Syndrome.  As a result, they have less dopamine (a neurotransmitter that produces reward and pleasure) in their brain compared to same age cohorts, making them highly susceptible to depression, stress disorders, and addictive disease.

A PET scan comparing brain activity during periods of depression (left) with normal brain activity (right). The blue and green colors indicate decreased brain activity due to depression. Whereas the yellow colors indicate normal brain activity. (NIDA)

Are their different kinds of depression?

Yes. Major Depression and dysthymia are the most common types. Persistent sadness, hopelessness, social isolation and thoughts of suicide are common symptoms of major depression. The course of a depressive episode can vary. If untreated major depression generally lasts one year.

Dysthymia is a “low-grade” depression characterized by persistent feelings of sadness and worry that last for at least a year. It is less severe in terms of mortality, yet people with this type tend to have low self-esteem, are social withdrawn and pessimistic about their life. They often have low energy, difficulty in school or work, and trouble in relationships. Dysthymia can follow or precede major depression, or be entirely unrelated.

The third type is called bipolar depression, which remains poorly understood. Mood swings between severe bouts of depression and periods of extreme elation, called mania, accompanied by distorted thinking are the most common symptoms of this confounding illness. 

Symptoms of Major Depression and Dysthymia may include the following

  • intense feelings of sadness on most days
  • difficulty concentrating
  • fatigue and loss of energy
  • negative attitude
  • feelings of guilt, worthlessness or helplessness
  • feelings of hopelessness
  • sleeping problems
  • irritability
  • loss of interest in activities that were once pleasurable, including sex
  • overeating or appetite loss
  • aches and pains, headaches, or stomach problems
  • thoughts of suicide, suicide attempts

Treatment and Recovery

If you feel that you might be depressed talk with somebody right away. Your family doctor is a good place to start. He or she may refer you to a psychiatrist for further evaluation and treatment or , depending on your symptoms, start you on medication right away. Treatment for depression typically involves individual counseling and medication.

Medications for depression are thought to work by modulating amount and availability of neurotransmitters, primarily serotonin, norepinephrine, and dopamine, which can restore neurochemical balance and improve mood.

However, most take several weeks before symptoms improve. Yet some of the undesirable effects such as, dry mouth, fatigue, insomnia, sexual dysfunction, and anxiety occur immediately. Some symptoms subside within a week, while others, such as sexual dysfunction, may persist. In some very rare instances, these medicines increase depression and suicide attempts. Therefore they should only be used under the care and supervision of an experienced medical professional.

Synaptamine is a newly patented, novel nutraceutical developed by neuroscientists from the University of Texas and the University of Florida. It is designed to increase the bioavailability of the neurotransmitter dopamine in the Mid-Brain and Prefrontal Cortex. Recent clinical trials have demonstrated its efficacy in patients with depression,  ADHD, Chronic  Pain, Addictive Disease and Hedonic Overeating.  It is available without a prescription and has no known adverse effects.

Counseling for depression varies, depending on the training and skills of the clinician.  The best outcomes are associated with professionals who take the time to understand their patients, help reframe their negative thoughts and irrational beliefs, while teaching adaptive coping strategies for stressful situations,troublesome memories, and strained relationships.

Recovery from depression takes time and often occurs in stages. There may be times when the symptoms have all but disappeared and you feel  normal  once again. However, it is important to continue your treatment to avoid a relapse. Ongoing communication with your doctors about problems, stressors and setbacks are essential. 

At its worse, depression will tell you that there is no hope. That’s a lie. With proper treatment, the burdens you bear will become lighter as your old self gradually reappears, and peace and joy re-enter your life once again.  

For more information on depression, treatment and recovery : www.drdrewedwards.org

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