Depression is a complex and mysterious mental health disorder that affects over 16 million U.S. adults each year. While in some cases the advent of a depressive episode may be linked to distressing life events, such as the death of a loved one, divorce, loss of a job, or a serious medical diagnosis, it is just as likely that depression will envelop one with no rhyme or reason. One day you just don’t feel like yourself, but can’t seem to point to any concrete reason for feeling so lethargic and sad. To date, science has yet to pinpoint the cause of depression, although certain factors have been identified that can be involved in developing the disorder.
One of the most daunting challenges a doctor will face is treating a patient with major depression. Even with dozens of antidepressants available for this purpose, in about half of depression patients they simply do not alleviate the symptoms in a meaningful way. This is a source of great dismay and frustration for the patient, who is likely dealing with crippling depression symptoms with no cure in sight. Not only were the antidepressants ineffective for these individuals, but the side effects of the drugs can be highly unpleasant as well.
In 2008 transcranial magnetic stimulation (TMS) was FDA-cleared as a treatment option for individuals who were unable to find relief of these crippling depression symptoms with antidepressants. This novel approach to treating drug-resistant depression provides a safe and non-invasive alternative treatment method using electro-magnetic energy to make adjustments in brain chemistry. There is a slew of clinical data available repeatedly demonstrating how in clinical trial after clinical trial, TMS has led to high response and remission rates for these patients who were not helped with the drugs.
The first-line treatment protocol for someone exhibiting the symptoms of major depressive disorder remains a combination of psychotherapy and antidepressant drug therapy. Antidepressants are available in several different forms, including SSRIs, SNRIs, tricyclic antidepressants, and MAOIs. A doctor will initially select the drug he or she believes will have the most positive effect on the symptoms. The drug will be trialed by the patient for 4-6 weeks, and at the end of the trial period it will be determined if the drug is a good fit. This is because side effects can make these drugs very hard to tolerate, so adjustments can be made to the dosing, or a new drug can be trialed.
Psychotherapy is a mainstay in the treatment of depression as well. During sessions with a clinical psychologist or a psychiatrist, the individual will examine issues that may be contributing to the depression, and the therapist can help guide the patient toward new methods of perceiving these issues and managing the associated emotions.
