Counsel Patients On the Range of Treatments for Depression

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 life activities.

Depression can affect all aspects of life, including how the person feels, how they behave, how they think, and how they act. Because of such day-to-day impacts, many individuals impacted by depression find life difficult to live, or, in severe cases, can experience suicidal thoughts.

Woman struggling with depression | Image credit: Kittiphan - stock.adobe.com

Depression can impact a person for a long time and takes time to recover from or learn to manage. Patients with depression require long-term treatment and supportive care, either with medications or non-pharmaceutical options.¹

Some of the symptoms of depression include feeling sadness, emptiness, and hopelessness. Some patients may feel angry, be more irritable than usual, and have loss of interest in normal daily activities, such as hobbies, sports, family events, or relationships. Insomnia or sleeping too much might also affect some of the patients with depression. Tiredness, anxiety, restlessness, slowed thinking, reduction in appetite, and weight loss might be other symptoms some of these patients demonstrate and experience.¹

Diagnosis of depression may include a physical exam, which could link to identifying physical health problems that can cause depression. It also includes lab tests, such as thyroid-related labs, which may be high or low, causing 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 impacted the person negatively. Lastly, 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 drugs that can reduce the symptoms of depression. Antidepressant drugs work by correcting the chemical imbalances in the brain and stabilizing the neurotransmitters, which can help the depression symptoms, improve the mood, and make the person function at close to normal capacity, as much as possible.

The main neurotransmitters involved in depression include serotonin, dopamine, and norepinephrine. If the nerves receiving the neurotransmitters are blocked, the sending nerves reuptake their own neurotransmitters. This causes lack of neurotransmitter communication, and therefore more depression symptoms. Antidepressants work by inhibiting the reuptake of specific neurotransmitters and increase the nerves’ communications.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 antidepressant used currently 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 therapies may include psychotherapy, which can help patients manage their depression and identify issues that may help the provider offer the best targeted treatment options. Another non-pharmaceutical treatment option is electroconvulsive therapy, which passes electrical currents through the brain to impact the neurotransmitters’ function. The next option may be transcranial magnetic stimulation, which may be an option for patients that have not responded to medications. This therapy transmits magnetic pulses to stimulate the nerve cells in the brain.¹

Other therapeutic options are 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 approximately 9% of the adult population. Women are more likely to have such episodes, or full depression. With the current treatment options available, including medication therapies, as well increased awareness and acceptance, these patients can have a better chance to addressing their symptoms and move toward 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. Depression Medications (Antidepressants). WebMD. August 14, 2022. Accessed May 24, 2023. https://www.webmd.com/depression/guide/depression-medications-antidepressants

3. What Are the Top 10 Antidepressant Drugs? eMedicinehealth. Reviewed May 24, 2022. Accessed May 24, 2023. https://www.emedicinehealth.com/what_are_the_top_10_antidepressant_drugs/article_em.htm

4. Depression Treatments for Adults. American Psychological Association. August 2019. Accessed May 24, 2023. https://www.apa.org/depression-guideline/adults

5. Major 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%20to%20males%20(6.2%25).