About Depression

Major Depressive Disorder is a medical condition that affects 14 million American adults each year. It is a serious condition that can affect multiple aspects of your life: mood can be sad or irritable; energy levels are low; there is little enjoyment of activities that usually provide pleasure; sleep is often disturbed, either the inability to sleep or oversleeping; and significant increases in bodily aches and pains. These symptoms combined can lead to profound disturbances in personal functioning at home, at work, and in personal relationships. Researchers estimate that by the year 2020, depression will be the second leading cause of disability worldwide.

What is Clinical Depression?

Depression is a recurrent illness. If you have had one episode of depression and recovered, you are 2 ½ times more likely to suffer another depressive episode than the average person is to have a first episode. If you have had three episodes of depression or more, then it is up to 85% likely you will have another one. Depression is associated with brain cell death and atrophy of the parts of the brain that control mood. The longer someone is depressed, the more cells die so that the very parts of the brain we target in our treatments are no longer there to be stimulated. This brain atrophy is at least partially reversible with appropriate treatment, but it remains the case that in general, each episode of depression lasts longer, is more severe, and is harder to treat than the previous episode and that treatments that worked early on start failing as the illness progresses. Overall women are almost twice as likely as men to suffer from depression; however, many experts feel that depression in men is under-reported or masked by using alcohol or other substances. Depression can be a lethal disease. In fact, each year in the USA over 30,000 people die by suicide, 60% of whom suffer from depression.

Anyone Can Experience Major Depression- Even Liesl (The Sound of Music)


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Causes of Major Depressive Disorder

Despite its devastating impact and frequent occurrence, the exact cause of depression is not known. One leading theory is that depression is caused by an imbalance of the chemicals the brain uses to transmit information, called neurotransmitters. These neurotransmitters include serotonin, dopamine, and norepinephrine. Many medication treatments target these neurotransmitters. Other theories about the cause of depression look at the impact of chronic stress on the hormonal systems of the brain including elevations of cortisol which leads to dropping levels of chemicals which are necessary for healthy functioning of brain cells, such as BDNF. Low levels of BDNF are correlated with depression. Other theories focus on immunologic or inflammatory processes. Regardless, the common thread is that some areas of the brain become under active and this is what leads to the illness. Restoring activity in these regions is key to recovery from depression. And full resolution of all the symptoms of depression gives the best chance to avoid progression of the illness into further episodes. Unfortunately, many people settle for improvement but not remission from all symptoms.

Antidepressant Medications

Antidepressants medications are a mainstay of treatment. Often effective, they are not universally so. Many patients find side effects such as weight gain, sexual difficulties, becoming sleepy, sedated or intellectually sluggish, chronic diarrhea or constipation, or sweating so uncomfortable that they choose not to remain on medications. Others get side effects if they miss a dose of medication. Still others worry about the fact that medications circulate throughout the whole body, affecting other organ systems, when the target is actually just the brain cells themselves. And for others, medications simply do not work or may work for awhile but then stop working and replacement medications fail to prove effective. For these patients, a new way back from depression is needed, one that focuses selectively on the brain itself.

Colorado Mental Health Statistics

– 7% of the Colorado adult population met the criteria for depression
– 12% of Colorado adults have been diagnosed for anxiety at some point
– 18.8% of unemployed adults and 40.9% of Colorado adults unable to work were depressed
– additional statistics available at http://www.cdphe.state.co.us/hs/pubs/depressionAnxiety.pdf

References:
Kessler, RC, et al. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun: 62 (6):617-27.

Greenberg, PE, et al. The economic burden of depressive disorders in the United States: How did it change between 1990 and 2000? Journal of Clinical Psychiatry. 2003; 64 (12): 1465-1475.
Murray CJ, Lopez AD. Evidence-based health policy – lessons from the Global Burden of Disease Study. Science. 1996; 274 (5288): 740-743.
Heron, Melonie, et al. Deaths: Final Data for 2006. National Vital Statistics Reports, 57 (14). April 17, 2009.
Kessler, RC, et al. The epidemiology of major depressive disorder; results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003; 289(23): 3095-3105.
Data on file



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