One of the most common mood disorders in the United States is depression. Also called major depressive disorder, the condition causes persistent feelings of sadness and loss of interest in daily activities.
Depression can affect all aspects of life, including how the person feels, how they behave, how they think, and how they act. Due to such day-to-day consequences, many people affected by depression find life difficult to live, or in severe cases may experience suicidal thoughts.
Woman struggling with depression | Image credit: Kittiphan – stock.adobe.com
Depression can affect a person for a long time and it takes time to recover or learn to cope. Patients with depression require long-term treatment and supportive care, either with medication or non-pharmaceutical options.¹
Some of the symptoms of depression are sadness, emptiness and hopelessness. Some patients may feel angry, be more irritable than usual and lose interest in normal daily activities such as hobbies, sports, family events or relationships. Insomnia or sleeping too much can also affect some patients with depression. Fatigue, anxiety, restlessness, slowed thinking, decreased appetite and weight loss may be other symptoms that some of these patients present and experience.¹
Diagnosing depression may include a physical exam, which could refer to identifying physical health problems that may be causing depression. It also includes lab tests, such as thyroid-related labs, which can be high or low and cause depression symptoms and lack of energy. Exams may also include psychological and psychiatric evaluations to understand patients’ thought processes, behaviors, and background information that may have negatively affected the person. Finally, the Diagnostic and Statistical Manual of Mental Disorders is used to confirm the person’s depression diagnosis.¹
Antidepressants are one of the main classes of medications that can reduce the symptoms of depression. Antidepressants work by correcting the chemical imbalances in the brain and stabilizing the neurotransmitters, which can help depression symptoms, improve mood, and allow the person to function at near-normal capacity as much as possible.
The main neurotransmitters involved in depression are serotonin, dopamine and norepinephrine. If the nerves that receive the neurotransmitters are blocked, the sending nerves reabsorb their own neurotransmitters. This causes a lack of communication with neurotransmitters and thus more depression symptoms. Antidepressants work by inhibiting the reuptake of specific neurotransmitters and improving communication between nerves.²
Examples of antidepressants include tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MOIs), and others.
Some of the most common antidepressants currently used in the US include duloxetine (Cymbalta; Eli Lilly), desvenlafaxine (Pristiq; Pfizer), vilazodone (Viibryd; Allergan), citalopram (Celexa; Allergan), sertraline (Zoloft; Pfizer) , fluoxetine (Prozac; Lilly), trazodone (Desyrel; Zydus), and escitalopram (Lexapro; Forest Laboratories).³
Other forms of therapy may include psychotherapy, which can help patients manage their depression and identify issues that can help the provider provide the best targeted treatment options. Another nonpharmaceutical treatment option is electroconvulsive therapy, which involves passing electrical currents through the brain to affect the function of the neurotransmitters. The next option may be transcranial magnetic stimulation, which may be an option for patients who have not responded to medications. This therapy sends out magnetic pulses to stimulate nerve cells in the brain.¹
Other therapeutic options include cognitive therapy, behavioral therapy, cognitive behavioral therapy, interpersonal psychotherapy, mindfulness-based cognitive therapy, psychodynamic therapy, and supportive therapy.⁴
An estimated 21 million adults in the United States suffer from depressive episodes, or about 9% of the adult population. Women are more likely to have such episodes or full-blown depression. With current treatment options available, including drug therapies, as well as greater awareness and acceptance, these patients have a better chance of managing their symptoms and moving towards a better and more normal life routine.⁵
References
1. Depression (major depressive disorder). Mayo clinic. October 14, 2022. Accessed May 24, 2023. https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
2. Medicines for depression (antidepressants). WebMD. August 14, 2022. Accessed May 24, 2023. https://www.webmd.com/depression/guide/depression-medications-antidepressants
3. What Are The Top 10 Antidepressants? eMedicine health. Reviewed May 24, 2022. Accessed May 24, 2023. https://www.emedicinehealth.com/what_are_the_top_10_antidepressant_drugs/article_em.htm
4. Adult Depression Treatments. American Psychological Association. August 2019. Accessed May 24, 2023. https://www.apa.org/depression-guideline/adults
5. Severe depression. National Institute of Mental Health. Updated January 2022. Accessed May 24, 2023. https://www.nimh.nih.gov/health/statistics/major-depression#:~:text=Prevalence%20of%20Major%20Depressive%20Episode%20Among%20Adults,-Figure%201%20shows&text=An%20estimated% 2021.0%20million%20adults,compared to%20to%20men%20(6.2%25).