Depression | Valley Behavioral Health
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October 5, 2015 By Dr. Todd Thatcher, DO, CMO

Do you or someone you love feel depressed? Well, you may not be as alone as you think. According to the World Health Organization, 350 million people of all ages worldwide suffered from depression in 2012.

Just in the United States, the National Institute of Mental Health reports that 16 million (6.7%) Americans battle depression every year, and women are 70% more likely than men to have depression in their lifetimes.

Interestingly, data from Met Life Insurance (2001), and the Journal of the American Medical Association (2003) estimated that depression caused 200 million lost days of work costing American business as much as 44 million dollars annually. Unfortunately, Utah consistently has the highest depression rates in the country. This is a big problem for our world, our countries, our communities, ourselves and our families.

Fortunately, there is a lot that can be done to properly diagnose and treat depression. The sad truth is that only 29% of people with depression make contact with mental health services to get help, according to the National Center for Health Statistics (2008). Why do you think this is?

First, it’s important to understand the difference between feeling depressed – a normal human emotion – and having a major depressive disorder, which is a medical problem. Life is a rich emotional experience because our brains sometimes make us feel sad.

It is good and natural to feel down at funerals, goodbyes, bad news, great movies, or listening to tear-in-the-beer country songs. Sharing down moments helps us emotionally bond with each other. It is okay and normal and a very beautiful gift. It shows you are human and have a kind heart.

However, feeling down consistently for more than two weeks is not helpful or healthy. The same brain that generates sadness also gives us pleasurable emotions from common activities such as reading, watching movies, talking with others, sports, etc. Those good feelings help lift us out of sad moods, usually in hours to days.

The medical problem called major depressive disorder happens when people feel down and can’t feel up at all for more than two weeks. The usual fun activities don’t feel fun anymore. Sleep, appetite, and sexual drive can change. Crying and feelings of guilt can increase, and thoughts of suicide can become acceptable and even desirable where they weren’t before. These are clear signals that something in the brain is not working properly.

Sometimes, sad and depressed feelings can be caused by other problems in the body besides the brain. Physicians like psychiatrists and family practitioners, and advanced practice registered nurses (APRNs), can help rule out other causes of depression such as thyroid problems, undiagnosed diabetes, or hormone deficiencies.

Once clinical professionals have diagnosed major depression there are several effective treatments. All treatments overcome depression by changing the way the brain works.

So you have to honestly assess yourself and ask, how severe is your depression?

In mild cases of depression, talk therapy is very effective. It can help improve negative ways of thinking that have become destructive habits over the years. As you develop new ways of thinking and responding to problems, your brain cells change the ways they are connected and interact with each other. You can find ways to conquer this type of depression by merely retraining your habits and brain cells.

In moderate to severe depression, a combination of medications and talk therapy is most helpful. The medications improve chemical and structural pathways between brain cells.

In the most severe form of depression, people can become psychotic meaning they lose the ability to distinguish their thinking and senses from reality. They might hear voices, or see things that aren’t there. They may become convinced that people or organizations like the government are targeting them for persecution or harm. This type of depression does not respond well to talk therapy and instead needs medications.

The single most effective treatment for depression is also the least used; electroconvulsive therapy (ECT). Many Americans know about this therapy from Jack Nicholson’s experience in the movie, One Flew Over the Cuckoo’s Nest. This therapy works by inducing a grand mal seizure after delivering electricity to the brain under anesthesia. It is about 70% to 80% effective. It is not used frequently because of its high cost (nearly $20,000), and significant side effects like memory loss, anesthesia recovery, and recommendations to avoid driving or operating heavy equipment for 24 hours.

An alternative to ECT, called transcranial magnetic stimulation (TMS), was introduced to the American market in 2009 after FDA approval. It is approved for use after the failure of one antidepressant. It works by delivering magnetic pulses to the front part of the brain which activates and stimulates better connection between brain cells. It is delivered outpatient in 20-minute sessions, costs about 75% less than ECT, does not induce seizures, requires anesthesia, cause memory loss, or impose driving restrictions. The only TMS machines in the state of Utah are at Highland Springs Clinic in Holladay and the University of Utah.

October is National Depression Awareness Month. This is an important time to ask yourselves and loves ones these tough questions. Are you in need of medical help? Could you be happier than you are now? Remember, there is hope and there is a path to a happier life!

If you or someone you love is suffering from excessive or abnormal amounts of feeling down without the ability to feel better through normal means of pleasure, then please get help. Visit your doctor. See a therapist. Call one of the many mental health treatment facilities in our community like Highland Springs. Don’t suffer unnecessarily. Take the first steps that will help you find happiness again.

Dr. B. Todd Thatcher

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