Why is it Important to Identify & Treat Clinical Depression?
Depression can be a confusing illness.
It often looks different in men vs. women or younger vs. older people. Additionally, there is uncertainty about what causes it. There is so much we do not know, and so much we do not understand.
One thing is certain: getting a diagnosis and treatment from a medical professional is vital. Depression is not something that you can “power through” – it is a medical illness that should be treated.
What Does It Mean to be Clinically Depressed?
Clinical depression is also known as major depressive disorder or MDD. The American Psychiatric Association (APA) describes it as “a common and serious medical illness that negatively affects how you feel, the way you think and how you act.”
Depression can rob you of the motivation to engage in life – including causing “feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home,” according to the APA.
The APA’s website lists the following symptoms – which can be mild to severe and need to be present for at least two weeks to be considered depression:
- “Feeling sad or having a depressed mood
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite — weight loss or gain unrelated to dieting
- Trouble sleeping or sleeping too much
- Loss of energy or increased fatigue
- Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others)
- Feeling worthless or guilty
- Difficulty thinking, concentrating or making decisions
- Thoughts of death or suicide”
Scientists haven’t figured out a specific cause of depression. According to the American Academy of Clinical Psychology, possible causes of depression include a combination of “biological, psychological, and social sources of distress. Increasingly, research suggests these factors may cause changes in brain function, including altered activity of certain neural circuits in the brain.”
Why is it Important to Identify and Treat Clinical Depression?
NOT treating depression may lead to dire consequences.
“Untreated depression increases the chance of risky behaviors such as drug or alcohol addiction,” according to an article on WebMD. “It also can ruin relationships, cause problems at work, and make it difficult to overcome serious illnesses.”
In addition, an article on the Centers for Disease Control and Prevention’s (CDC’s) website indicates that “various studies have shown the impact of trauma, depression, anxiety, and stress on the body, including stress on the heart,” and that “people experiencing depression, anxiety, stress, and even PTSD over a long period of time may experience certain physiologic effects on the body, such as increased cardiac reactivity (e.g., increased heart rate and blood pressure), reduced blood flow to the heart, and heightened levels of cortisol. Over time, these physiologic effects can lead to calcium buildup in the arteries, metabolic disease, and heart disease.”
If left untreated, depression can severely impact one’s sleep patterns, leave one feeling hopeless and irritable, and could even result in weight gain or loss.
Treatment – which can include medication, talk therapy, alternative treatments or a combination – can help minimize these symptoms. Talk therapy helps patients to address negative thoughts and feelings and get them back to being themselves. Medication therapy can help reduce the symptoms of depression.
“Research suggests these treatments may normalize brain changes associated with depression,” according to the American Academy of Clinical Psychology.
What is Prescribed for Clinical Depression?
There are several types of medications that are commonly prescribed for depression.
Selective serotonin reuptake inhibitors (SSRIs) are the medications most commonly prescribed to treat depression by increasing serotonin levels in the brain. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). Certain SSRIs are also used to treat other mental health conditions such as anxiety disorders and obsessive-compulsive disorder.
Serotonin norepinephrine reuptake inhibitors (SNRIs) work in a way similar to SSRIs.
“The main difference is that [SNRIs] also block the body’s reuptake of norepinephrine, another neurotransmitter involved in mood,” according to an article on the VeryWellMind website.
SNRIs used for depression include desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor).
Mayo Clinic describes tricyclic antidepressants (TCAs) and tetracyclic antidepressants (TeCAs), also called cyclic antidepressants, as being “among the earliest antidepressants developed. They’re effective, but they’ve generally been replaced by antidepressants that cause fewer side effects. However, cyclic antidepressants may be a good option for some people. In certain cases, they relieve depression when other treatments have failed.”
Some depression treatments may incorporate L-methylfolate (Deplin), a form of the B-vitamin folate, which is “typically used alongside antidepressants to help treat depression,” according to an article on the VeryWellMind website. L-methylfolate helps to make the brain’s monoamine neurotransmitters (serotonin, dopamine, and norepinephrine) associated with moods.
Not all medications work for everyone. There are a lot of different factors that influence whether a medication is effective for you including your diagnosis, weight, age, other medications you are taking, what foods you eat, allergies, etc., as well as your unique genetic code.
The GeneSight test is a genetic test that can help inform doctors about how your genes may impact how you metabolize and/or respond to 61 FDA-approved medications commonly prescribed for depression, anxiety, ADHD, and other psychiatric conditions.
Can Major Depression be in Remission?
Getting to remission is the primary goal when treating clinical depression. Remission is commonly understood to be getting you back to feeling like yourself. Patients reaching remission claim to feel more motivated, excited for social outings, less obsessive, and more stable regarding their mood.
If you think you are suffering from depression, please speak to your doctor. If medication treatment is an option, consider asking them to order the GeneSight test before making a prescribing decision, particularly if an antidepressant has failed you in the past.
Learn more about GeneSight here: https://genesight.com/depression-treatment/
Our articles are for informational purposes only and are reviewed by our Medical Information team, which includes PharmDs, MDs, and PhDs. Do not make any changes to your current medications or dosing without consulting your healthcare provider.
The GeneSight test must be ordered by and used only in consultation with a healthcare provider who can prescribe medications. As with all genetic tests, the GeneSight test results have limitations and do not constitute medical advice. The test results are designed to be just one part of a larger, complete patient assessment, which would include proper diagnosis and consideration of your medical history, other medications you may be taking, your family history, and other factors.
If you are a healthcare provider and interested in learning more about the GeneSight test, please call us at 855.891.9415. If you are a patient, please talk with your doctor to see if the GeneSight test may be helpful.