Depression - There are many different causes of depression and varying degrees of it as well. I will be looking for medical causes (i.e. problems with the thyroid gland or medicines prescribed). We also know that genetics play a role. So, I will be looking to see if your family members have had or do have depression because if they do it will put you at greater risk of having depression.
We know that abuse, personal conflicts, major events in your life or death or loss can make one more vulnerable to depression. So, as your doctor, I will be evaluating this as well.
What is depression as we now know it to be? It is a chemical imbalance caused by the aforesaid reason body chemistry, stressors in life, genetics... Even the changing of the seasons will trigger depression; here in Scottsdale this is mitigated for obvious reasons - the only seasons we have are hot and hotter! We think that it is a deficiency of the neurotransmitters in the brain (i.e. Serotonin, Norepinephrine, and Dopamine) that causes the symptoms of low mood or apathy, decreased energy and motivation, feelings of worthlessness or excessive feelings of guilt, psychomotor agitation or retardation, poor concentration and memory, a change in appetite with weight gain or loss and a change in sleep with either hypersomnia or hyposomnia. These symptoms must be present for a period of two weeks or longer to meet the definition of Major Depressive Disorder. In the more severe cases of depression, patients can have recurrent thoughts of suicide.
We know that if a person has repeated severe stressors in their life and they have a genetic predisposition to depression, their risk of developing depression is quite high. When one has one bout of depression, it in a sense kindles or makes subsequent episodes of depression more likely.
How do we treat depression? We treat it with the use of antidepressant medications and psychotherapy. Studies have shown that the two used in conjunction is the most effective way to treat depression. The antidepressants get to the root of depression by correcting the neurotransmitter deficiency, in that; they elevate the levels of these neurotransmitters. In minor cases sometimes exercise and diet will treat the depressive symptoms.
We have found that depressive episodes last from 6 months to one year and sometimes longer. With being on antidepressant medication, the symptoms can go away in about four weeks. Sometimes, it is a shorter amount of time and other times it takes longer because the medication needs to be changed due to problematic side effects. Usually when the correct antidepressant is given, people don't have problematic side effects and they don't even know that they are on them except that their depressive symptoms are no longer present. The role of the antidepressant medication is to increase the neurotransmitters, and therefore correct the chemical imbalance that is from a deficiency of the neurotransmitters. Genetic studies are showing promise that "maybe" in the near future we will be able to conduct genetic repair in parts of the brain and actually cure depression. This is still being pioneered and is a ways off but gives us reason for hope! Vagal Nerve Stimulation is also another type of therapy depression as well as DBS and TMS for those that don't respond well to medications.
A new function that we have also discovered through research is that the antidepressant medication, protects the neurons( i.e. brain cells) from damage from the stress hormones called glucocorticoids. It protects the sheath of the the neurotransmitters thus increasing overall brain health. This is something that you don't hear very much with medication. So getting on the proper medication has its values well beyond dealing with the symptoms of and overcoming depression. Symptoms of Depression
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This article is for informational purposes only and not to be used in diagnosing or treating any potential illness