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According to the World Health Organization (WHO), depression is the most common medical illness in the world and is the leading cause of disability. The WHO estimates that about 350 million people worldwide are affected by depression.  Depression is characterized by feelings of sadness and a loss of interest or pleasure in daily activities.  You might say that these are symptoms familiar to all of us; but, medical depression is a not necessarily an expression of mood, it’s roots lie in the biology of neurotransmitters in your brain that make those feelings more severe and persistent.

According to the Centers for Disease Control and Prevention (CDC), 7.6 percent of people over the age of 12 have depression in any 2-week period. This is substantial and shows the scale of the issue.

Quick Facts About Depression :

  • Depression is more common in women

  • The main symptom is persistent feelings of sadness and loss of pleasure in activities and things that would normally give you pleasure

  • Symptoms of depression last on average 6 to 8 months

  • The causes of depression are not fully understood but are likely to be a complex combination of genetic, biological, environmental, and psychosocial factors.

Can You Test For Depression?

There are no specific tests for depression.  There are no blood markers or brain scans that specifically point to depression.  The diagnosis of depression starts with a consultation with a doctor or mental health specialist.  While there are no specific biologic tests for depression, the Hamilton depression rating scale, has 21 questions, with resulting scores describing the severity of the condition. The Hamilton scale is one of the most widely used assessment instruments in the world for clinicians rating depression.

Is There a Difference Between Situational Depression and Clinical Depression?

All of us experience “the blues” from time to time.  Sometimes, the cause might be the weather, or you just broke up with your significant other, or you just had a family member pass away.  These temporary, albeit intense, feelings of sadness does not constitute clinical depression; temporary emotional responses to the challenges of everyday life do not constitute depression.

Clinical depression is a medical biological condition influence by real chemical and possibly physical changes in your brain that predispose you to profound feelings of sadness and despair.  

What Are The Signs And Symptoms of Depression

Symptoms of depression can include:

  • depressed mood
  • reduced interest or pleasure in activities
  • loss of sexual desire
  • loss of appetite
  • difficulty sleeping despite excessive lethargy
  • fatigue or loss of energy
  • feelings of worthlessness or guilt
  • impaired ability to think, concentrate, or make decisions
  • recurrent thoughts of death or suicide, or attempt at suicide

What Are Some of The Causes of Depression?

The underlying cause of depression is not known but is most likely multifactorial.  The underling problem, however, is most likely a biological problem with the brain.  The key is to understand that both genetic and environmental psychosocial factors can influence neural development and physiology.  These factors include but are not limited to childhood trauma, PTSD, and continuous stress.  We know this from neural scans. Understanding that depression is largely a biological problem gives the hope that medications, cognitive, and environmental therapy potentially treat patients with depression.

What Are Some Treatments For Depression?

Depression has until recently been treated as a psycho-behavioral condition that could be treated with talk therapy and and social support. Antidepressant medications were added to the armamentarium more recently. The nerve cells in our brain use various chemicals to pass on impulses. Even though not all details are known, experts believe that depression is caused by an imbalance of certain chemicals like serotonin which then affects some nerve connections. Antidepressants aim to increase the availability of these chemicals. The various drugs do that in different ways.

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Treatment Options For Depression :

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What Antidepressants Are Available?

Many different drugs are available for the treatment of depression. Tricyclic antidepressants have been on the market the longest. They are considered to be first generation antidepressants. SSRIs and SSNRIs are second generation antidepressants.

  • Tricyclic antidepressants (TCAs)
  • Selective serotonin re-uptake inhibitors (SSRIs)
  • Selective serotonin noradrenaline re-uptake inhibitors (SSNRIs)

Some lesser prescribed medications include:

Alpha-2 blockers
Monoamine oxidase (MAO) inhibitors
Selective noradrenaline reuptake inhibitors
Selective noradrenaline/dopamine reuptake inhibitors
Melatonin receptor agonists and serotonin 5-HT2C receptor antagonists

How effective are antidepressants?

Studies show that the benefit generally depends on the severity of the depression: The more severe the depression, the greater the benefits are likely to be. In other words, antidepressants are effective against chronic, moderate and severe depression. They probably don’t work in the treatment of mild depression.

The various antidepressants have been compared in many studies. Overall, the commonly used tricyclic antidepressants SSRIs and SSNRIs performed equally well. Studies of adults with moderate or severe depression showed:

  • Without antidepressants: About 20 to 40 out of 100 people who took a placebo noticed an improvement in their symptoms within six to eight weeks.

  • With antidepressants: About 40 to 60 out of 100 people who took an antidepressant noticed an improvement in their symptoms within six to eight weeks.

In other words, antidepressants improved symptoms in about 20 more people out of 100

What is CBT?  ( also called cognitive-behavioral therapy )?

Psychological or talking therapies for depression include cognitive-behavioral therapy (CBT), interpersonal psychotherapy, and problem-solving treatment. In mild cases of depression, psychotherapies are the first option for treatment; in moderate and severe cases, they may be used alongside other treatment.

How does exercise help with depression?

Aerobic exercise may help against mild depression.  Many readers may have heard of the term “runner’s high”; this refers to the general sense of well being a runner feels after running a while.  It turns out that activity actually has the ability to make you feel better.  The body releases endorphins levels and stimulates the neurotransmitter norepinephrine in response to activity.  Endorphins in return provide a natural antidepressant as significant as many prescription antidepressants.

Ketamine and Depression

Ketamine infusion therapy appears to be on the verge of revolutionizing the treatment of depression. Ketamine is best known as a sedative medication used in operating and emergency rooms to sedate patients before minor procedures.  It was also known in the past as a party drug.  Ketamine has subsequently been shown to significantly reduce the signs and symptoms of depression in close to 70% of all patients tested.  In many cases, the results are immediate.  For the first time, it might be possible to provide immediate relief from depression in the majority of patients.  Ketamine infusion therapy clinics have multiplied throughout the country lately; Virginia Infusion Therapies is the first Ketamine clinic in Loudoun County Virginia near Leesburg; and has established itself as the premier Ketamine treatment center in Virginia.

What is ECT?  ( also known as electroconvulsive therapy )

Severe cases of depression that have not responded to drug treatment may benefit from electroconvulsive therapy (ECT); this is particularly effective for psychotic depression. ECT involves electrical stimulation of the brain in the effort to profoundly release neurotransmitters that help with depression. The stimulation is, however, is not specific and the general stimulation of the brain can result in some significant side effects including memory loss.  In addition, ECT requires general anesthesia to administer.  It is therefore reserved for only significant or profound depression that does not resolve with other methods.

Summary:

Clinical depression is a complex medical problem with many underlying causes.  It appears, however, the biologic basis is a problem with the regulation of brain neurotransmitters like serotonin, norepinephrine, GABA, and endorphins. 

The approach to treatment depends upon the cause and severity of the depression.  Mild cases without obvious underlying causes will benefit from optimizing non-medical methods such as exercising, eating healthy, and UV solar therapy. 

More advanced cases will benefit from taking antidepressant medications such as prozac, wellbutrin, or lexapro just to name a few. 

Severe cases or major depression will benefit from Ketamine infusion therapy; especially if immediate results are necessary or if the signs and symptoms of depression are so severe that other treatments were unsuccessful.  ECT is reserved for the most severe cases

Contact Virginia Infusion Therapies

You don’t need to suffer, stuck in an endless cycle of pain and depression—you have options, especially with Virginia Infusion Therapies. Located in Virginia, we offer ketamine infusions for chronic pain and depression. 

We are happy to offer a free consultation to new patients wishing to learn more about ketamine for chronic pain or depression. Just complete the brief form below and a member of our clinical team will contact you to answer questions and address your concerns.

Get a Free Consultation Today

Phone consultations only take about 15 minutes with a doctor from Virginia Infusion Therapies. Learn more about how ketamine solves for 70% of depression patients and can solve for you.

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