Depression

In the United States, studies found that at least one in every five adults lives with a mental illness. That amounted to 46.6 million Americans in 2017. The National Institute on Mental Health notes that the severity of the mental illness varies as well as the type. For research purposes, there are two categories of mental illness: any and serious. A serious mental illness is one that impairs the individual.

A common mental disorder in the United States is major depression. Data taken from the 2017 National Survey on Drug Use and Health found that:

• At least 7.1% of adults, or 17.3 million, had at least one major depressive episode that year.
• Females had a rate of 8.7% while males had a rate of 5.3%.
• The age bracket 18-25 had the highest rate at 13.1%.
• 4.5% of adults had at least one major depressive episode with severe impairment.
• 63.8% of adults with a major depressive episode had severe impairment.
• 65% of adults with a major depressive episode received combined care by a health professional and medication treatment.

Information for youths ages 12 to 17 was also obtained. It showed that:

• At least 3.2 million, or 13.3% of adolescents in the United States, had at least one major depressive episode.
• At least 2.3 million, 9.4% of adolescents, had at least one major depressive episode with severe impairment.
• Females had a rate of 20% compared to males at 6.8%
• 70.77% of adolescents with a major depressive episode had severe impairment.
• 16.9% of adolescents reporting two or more races had the highest rate for a major depressive episode.
• At least 19.6% of adolescents received care from a health professional alone.
• At least 17.9% of adolescents received combined care by a health professional and medication treatment.

Depression and Substance Use Disorder

Through data, the National Institute on Drug Abuse found that individuals who develop a substance use disorder also develop a mental disorder. It can happen in the other direction too, meaning that someone who has a mental disorder can develop a substance use disorder. In addition, American youth have not been spared; 60% of youths in community-based substance use disorder treatment programs meet the diagnostic criteria for mental illness.

The data also found that:

• There was a high chance of comorbidity, which is the presence of two chronic diseases or conditions.
• Substance use disorder cases often also had generalized anxiety disorder, panic disorder or post-traumatic stress disorder.
• Substance use disorder cases could co-occur with mental disorders such as depression, bipolar disorder or ADHD as well as psychotic illness, borderline personality disorder or antisocial personality disorder.
• Schizophrenia cases had higher rates of alcohol, tobacco and drug use disorders.

Depression and the Body

Individuals who experience depression may feel disconnected from their body. The Centers for Diseases Control and Prevention notes that depression is more than just a bad mood. Depression is defined as a mental illness that:

• Causes feelings of sadness
• Causes loss of interest in activities once enjoyed
• Leads to a loss of productivity

Symptoms of depression include:

• Overeating or not wanting to eat at all
• Not being able to sleep or sleeping too much
• Having trouble concentrating or making decisions
• Feeling very tired
• Feeling hopeless, irritable or anxious
• Having aches or pains, headaches, cramps or digestive problems
• Having thoughts of suicide or death

Six Common Depression Types

According to Harvard Health Publishing, Harvard Medical School, there are six common depression types:

• Persistent depressive disorder
• Bipolar disorder
• Seasonal affective disorder
• Perinatal depression
• PMDD
• Major depression

Both perinatal depression and PMDD are unique to women. PMDD is a severe form of premenstrual syndrome that can be treated with medication. Perinatal depression can occur during pregnancy and up to 12 months after giving birth. One in seven women can develop perinatal depression, which is also known as postpartum depression.

Persistent depressive disorder is characterized by a constant low mood that does not prevent the individual from keeping up with their responsibilities and lasts at least two years. Other symptoms are appetite and sleep changes as well as low self-esteem or hopelessness.

Individuals with bipolar disorder experience depression as well as episodes of high energy or activity. The two episodes are polar opposites of each other. Medications are used to stabilize the mood of the individual. The goal is to prevent the highs from being too high and the lows too low.

Seasonal affective disorder occurs due to the changes of the seasons. It emerges when the days get shorter in the fall and winter. The treatment typically involves light therapy.

Major depression is the most commonly known type. Symptoms are trouble sleeping, changes in appetite or weight, loss of energy and feelings of worthlessness. Suicidal thoughts may occur. Treatment often includes psychotherapy or antidepressant medications. If neither work, electroconvulsive therapy may be an alternative.

Even though depression can feel like a heavy weight for some, the medical community agrees that the condition is treatable. Treatment can be provided in the form of medication or counseling. It depends on the patient’s symptoms, medical history and current health. Additionally, other treatments include:

• Hospitalization
• Self-help strategies
• Combination of medication and therapy

The American Psychological Association defines therapy as the treatment where a client and a licensed professional discuss the client’s problems and try to find solutions for those issues. Therapy is also known as counseling or psychotherapy. For depression, there are seven psychotherapies that are most often used.

• Interpersonal therapy: Interpersonal therapy is a series of structured sessions where the patient has the opportunity to work on their communication and conflict resolution skills. The assumption is that the patient’s depression is stemming from their relationships.

• Cognitive behavioral therapy: Cognitive behavioral therapy has surged in popularity because it is being used to treat substance use disorders as well as depression. This treatment places a focus on behavior. Bad behavior and patterns are addressed, especially the ones that are causing the depression. Then, they are replaced with better behaviors so that the patient is led out of their condition.

• Social skills therapy: Social skills therapy helps a patient improve their communication skills so that they can form healthy relationships. The patient is encouraged to build a social network of peers rooted in honesty and respect.

• Psychodynamic therapy: Psychodynamic therapy takes the patient into their past. The goal is often to uncover past trauma. Depression can stem from unresolved conflicts and past experiences. Issues from the past are addressed so that a patient can move forward in their life in a productive manner.

• Supportive counseling: Supportive counseling is based on listening. The licensed professional uses empathy as they allow the patient to talk about what they believe is causing their depression. This is a supportive environment where the patient and their feelings are the sole focus of the sessions.

• Behavioral activation: Behavioral activation keeps sessions as upbeat as possible to combat depression. Focus is placed on pleasant activities and positive interactions between the patient and licensed professional.

• Problem-solving therapy: Problem-solving therapy is a proactive approach to treating depression. The patient’s problems are defined. Then, solutions are offered. With the help of the licensed professional, a patient walks through the possible solutions to their depression and picks one to try.

Where to Get Help

Any of these therapies can be completed in an outpatient or inpatient setting. Outpatient treatment is often a 90-day program. The patient attends scheduled meetings at the office of a licensed professional. Several appointments are scheduled in the beginning to set the tone, and if progress is made, they are tapered off after a given time period. Outpatient treatment is great for those who are keeping up with their daily responsibilities but need counseling for depression.

Inpatient programs are more intensive. This option is typically an onsite 30-day program at a specialized facility. Patients who require additional time can add another 30 days at a time. An example of an inpatient center for mental health disorders is NFA Behavioral Health in New Hampshire. Inpatient programs are structured so that they keep patients occupied in a therapeutic environment.

A center like NFA Behavioral Health offers some of the above therapy programs mentioned as well as others. Additional therapies for mental health at this center include:

• Holistic programs
• Anger management
• Dialectical behavioral therapy
• Experiential therapy

The center’s philosophy is based around clinical psychotherapeutic support that provides:

• One-on-one individual therapy
• Process groups
• Treatment for co-occurring mental disorders
• Motivational interviewing

At this center, patients can expect a low client-to-clinician ratio so that each patient receives the attention they need. The setting is intimate, and the practices are evidence-based. Every patient is assessed when they arrive. Based on several factors, a customized plan is put together that addresses the patient’s unique needs. For depression treatment, there is no longer a one-size-fits-all approach.

To round out the program, many amenities are offered at NFA Behavioral Health:

• Gender-separate living accommodations
• Access to weekly off-site Family Recovery Workshops
• 24/7 onsite medical staff
• Nutritious, chef-prepared meals
• Meditation and yoga
• Workshops and educational programs
• A serene and secluded location
• Paintball, bowling and mini golf outings

Within all that structure, patients are given time to do some self-reflection. Plus, holistic therapy is incorporated. Yoga and meditation practice are encouraged so that a patient suffering from depression has the opportunity to produce natural endorphins. This is why patients have access to an onsite gym, too. Physical exercise is recommended so that healing of the body and mind can take place during treatment.

Additional Treatment

Depending on a patient’s circumstances, the need for a combination of treatments and therapies may be necessary. The goal is to help the patient out of the hole of depression. If the depression is due to family members or the condition is having a negative impact in the household, family or couple therapy may be recommended. Often, there is a need for a third party to open up the lines of communications. A neutral party provides a buffer among everyone involved.

Hospitalization is recommended for individuals whose depression has become dangerous. If an individual is deemed a risk to themselves, and in some cases others, then hospitalization is the next step. Inpatient hospitalization will be recommended for an individual who is showing signs that they are leaning toward suicide.

During hospitalization, the patient is kept under watch so that they do not harm themselves. Then, therapy is administered. The therapy sessions could include family members. After hospitalization, the patient may be transferred to an inpatient program, such as NFA Behavioral Health. The goal of hospitalization is to stabilize the patient so that they can begin to overcome their depression.

Medications for treating depression continue to evolve. Some that are often used to treat this condition include:

• Tricyclic antidepressants
• Monoamine oxidase inhibitors
• Selective serotonin reuptake inhibitors
• Serotonin and norepinephrine reuptake inhibitors
• Norepinephrine and dopamine reuptake inhibitors
• Esketamine

Tricyclic antidepressants were introduced several years ago. The newer versions of this medication have fewer side effects. With any medication, a patient has to be warned that addiction is a possibility. This is why the CDC released new prescription guidelines especially for opioids in 2016. The medical community knows that the public requires ways to overcome depression and addictions without making the problem worse or starting a new condition.

Monoamine oxidase inhibitors are another antidepressant that was introduced several years ago. Older medications like this one are kept in circulation for patients whose depression is deep-seated.

Selective serotonin reuptake inhibitors are most often prescribed to patients in the form of Prozac and Zoloft.

Esketamine was approved in March 2019. It is used for treatment-resistant depression. This medication is administered at a center by licensed professionals in order to ensure that there are no negative side effects.

Overcoming depression is possible. You can do so through therapy as well as medication, so don’t hesitate to reach out for help.