Depression

Depression is a serious medical illness affecting millions of Americans every year. The World Health Organization has declared depression to be the leading cause of disability worldwide. Depression results in a persistent state of sadness or loss of interest or pleasure that interferes with a person’s thoughts, behavior, mood, and physical health.

Depression can also be a lethal disease. In fact, each year in the U.S., over 30,000 people die by suicide, 60% of whom suffer from depression. Overall, women are almost twice as likely as men to suffer from depression; however, some experts believe that depression in men is underreported. Depression has no racial, ethnic or socioeconomic boundaries. About two-thirds of those who experience an episode of depression will have a second episode, and possibly more, in their lives.

More Information About Depression

Depression results in a persistent state of sadness or a loss of the ability to experience pleasure. Those experiencing depression often lose interest in everyday activities or hobbies that were once enjoyed.

According to the standard diagnostic guide (DSM-5) published by the American Psychiatric Association, the following are the criteria for Major Depressive Disorder. Five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Additionally, the episode is not attributable to the physiological effects of a substance or another medical condition.

Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
Insomnia or hypersomnia nearly every day.
Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Treatments for Depression

Depression is most often treated with a combination of psychotherapy and antidepressant medication. Although antidepressants can be effective for many patients, they don’t work for everybody. In fact, one-third of patients with depression do not receive adequate relief from antidepressant medications and/or cannot tolerate the side effects caused by them. For these patients, alternative treatments are available that usually involve the use of a medical device. These treatments include transcranial magnetic stimulation (TMS), esketamine, electroconvulsive therapy (ECT), and vagus nerve stimulation (VNS). Our doctors will work with you to put together the best treatment plan to help you remain symptom free.