Treatment Resistant Depression​

Depression

Clinical depression, is a medical condition that causes extreme feelings of sadness and emptiness. People who suffer from depression may lose interest in activities they once enjoyed and experience a constant feeling of hopelessness on a daily basis. Depression, also known as clinical or major depression, may be triggered by certain events or occur along with other illnesses. Severe depression can interfere with a person's ability to work, sleep, eat, interact with others or enjoy life. With treatment, however, depression can become a manageable condition.

Causes of Depression

The exact cause of depression is unknown. Depression can sometimes be triggered by a traumatic event such as the death of a loved one, divorce, emotional or financial stress, or childhood trauma. Other factors that may contribute to depression include:

  • Hormonal changes
  • Heredity
  • Chemical imbalances or changes within the brain

The use of certain medications such as steroids, or alcohol or drug abuse may contribute to the onset of depression. Patients suffering from serious illnesses such as cancer or other long-term conditions may also develop depression.

Symptoms of Depression

While most people may feels sad or blue every once in a while, clinical depression affects the lives of those afflicted on a daily basis. Symptoms of major depression include:

  • Feeling sad or hopeless
  • Loss of interest in normal activities
  • Crying spells
  • Trouble sleeping
  • Trouble concentrating
  • Irritability
  • Change in appetite
  • Fatigue
  • Unexplained aches and pains
  • Suicidal thoughts

Depression is a serious condition that can severely affect individuals and their families. Left untreated, depression may lead to anxiety, isolation, difficulties at work or school, alcohol or substance abuse, and in extreme cases, suicide.

Diagnosing Depression

To diagnose depression, the doctor will conduct a full physical examination and a review of all symptoms. Blood and urine tests may also be performed to rule out any underlying medical conditions that may contribute to the depression. A full psychological evaluation is also performed to make a proper diagnosis and create a treatment plan.

Treatment Resistant Depression

Depression is typically treated with a combination of psychotherapy and antidepressant medication. Antidepressants help to alter the brain chemistry to improve mood. Psychotherapy, in the form of therapy or counseling, aims to treat depression by by teaching the individual new ways of thinking and behaving, and changing habits that may be contributing to the depression.

Individuals with severe depression that does not respond to a medication or therapy, may benefit from more comprehensive treatment approach which might include combination of medication or augmentation pharmaceutical modalities. The combination method include using medications from two different class of antidepressants. Augmentation strategies include use of certain medications (e.g., Lithium, Thyroid, etc.) to boost the effects of traditional antidepressants. Other FDA approved treatment modalities to treat depression not responding to common antidepressants and or therapy include TMS (transcranial magnetic stimulation) and nasal Es-Ketamine. In severe cases of depression not responding to these treatments, electroconvulsive therapy (ECT) is an option. ECT is administered under anesthesia and is administered in a hospital setting. ECT may result in some short or long-term memory loss.

In extreme cases, hospitalization may be temporarily necessary if the patient cannot properly care for themselves or if they are in danger of harming themselves or others.

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