Understanding Depression
When an individual declares that they are “depressed,” the actual type or severity of their low mood can fall along a wide spectrum of depressive mood disorders, from a simple transient case of the blues to the persistent and debilitating symptoms of major depressive disorder (MDD). At the milder end of the depression continuum, hitting a low point that leaves one feeling down and fatigued, the symptoms often resolve on their own within a week or two. With MDD, however, life-altering symptoms may persist for weeks, which can represent a serious mental health disorder or crisis.
Diagnostic Criteria for Major Depressive Disorder
Battling depression is exhausting and discouraging, potentially rendering a person so depleted that they cannot carry out even the most basic daily tasks. When an individual experiences two or more of the following symptoms most of the day and lasting more than two weeks, they meet the diagnostic criteria for major depressive disorder as outlined by the DSM-5 when symptoms are not attributable to another medical condition:
- Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others.
- Markedly diminished interest or pleasure in all, or almost all, activities more of the day, nearly every day.
- Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
- Insomnia or hypersomnia nearly every day.
- Psychomotor agitation or retardation nearly every day.
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
- Diminished ability to think or concentrate, or indecisiveness, nearly every day.
- Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Treatment protocol for newly diagnosed MDD is a trial of antidepressants combined with psychotherapy (talk therapy). In many cases, even after trials of several different antidepressants, traditional medical treatment fails to yield successful results. With this outcome the patient is said to have treatment-resistant MDD, meaning that there was no significant reduction in symptoms and/or intolerance to the adverse effects of the antidepressants.
Types of Depression
Different Types of Depression
The factors that contribute to depression can involve genetics, life experiences, childbirth, chemical imbalance, and even lack of sun exposure, but the common result is a life that is dull, unproductive, and colorless. Because depression can take various forms, it is helpful to have a basic understanding of the different types of depression.
- Major depressive disorder (MDD) is a serious mood disorder that can negatively impact all aspects of life, including work, family, and social spheres. (symptoms above)
- Perinatal depression is depression experienced during or following pregnancy, with symptoms of severe sadness, fatigue and anxiety
- Persistent depressive disorder is prolonged symptoms that vary in severity over a period of at least two years
- Psychotic depression has the symptoms of MDD with accompanying symptoms of hallucinations or delusions
- Seasonal affective disorder (SAD) is depression that aligns with the winter months when shortened days limit natural sunlight exposure
PHQ-9 Depression Screening
Anew Era TMS & Psychiatry offers an online version of the commonly used Depression Screening tool called the PHQ-9. The nine items of the PHQ-9 are based directly on the nine diagnostic criteria for major depressive disorder in the DSM-IV.
How TMS Treats Depression
It is important that an individual diagnosed with treatment-resistant depression seek out an alternative therapeutic treatment method. Transcranial magnetic stimulation (TMS) offers a safe, noninvasive therapy that uses magnetic fields to induce changes in the electrical responses along the brain’s neuropathways.
TMS effectively treats the symptoms of depression by targeting brain cells in the prefrontal cortex, which is associated with mood and executive functioning. By delivering repetitive magnetic pulses directly to this “mood center,” TMS stimulates the underactive cells, a feature common in depression patients, and eventually rebalances brain chemistry.
TMS therapy is administered while the patient is completely alert, eliminating the risks of anesthesia, with no downtime required. Over the course of treatments spanning 4-6 weeks, TMS therapy can safely and effectively improve a patient’s general sense of wellbeing and mood, as well as increase energy levels and improve concentration and sleep quality. TMS therapy is well-tolerated, with few side effects. Those that do occur, such as scalp irritation or mild to moderate headache, will gradually subside as the treatment sessions proceed.
