Depression

Depression goes beyond the intense sadness that we may feel from time to time, especially during or after difficult experiences. This mood disorder involves continual sadness and disinterest that may persist for days, weeks, or even longer. It can interfere with just about every aspect of your life, from your relationships to your job to even just simple things like getting out of bed.
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Depression is more than just feeling low.

Thanks to the ’90s, the picture that pops in the mind of most people when they think of depression is a tired, sad-looking person in a darkened room all alone, probably in bed hugging their knees. But depression, for a lot of people, presents quite differently.

It may start with a feeling of fatigue, or maybe irritability. Perhaps things and people you used to find delightful have become annoying. Maybe you’re more anxious than you remember being, sleeping more than you used to. It could be that you just can’t muster the same gumption that you used to have, and taking a look around your room or house has you wondering how it got so messy. Maybe you can’t seem to remember anything lately.

These symptoms of depression are rarely depicted in advertisements and they can creep in slowly over time, making people suffering from depression wonder if they’re really depressed.

Depression affects one in 15 adults in any given year and one in six at some point in life. It is a common medical illness that can lead to other health problems, including heart disease.

Fortunately, it is also treatable.

“Depression is an incredibly common and highly treatable illness,” said Alicia Bulin, a psychiatric nurse practitioner at bonmente. “More likely than not, we’ll all have depression at some point in our lives, but rather than let it take over and cause unnecessary suffering, we need to make just one phone call. That’s how treatment starts. One call.”


What causes depression?

Depression is caused by a number of factors, some of which pose a higher risk than others. For example, women are twice as likely as men to suffer from depression. Depression can also present with other conditions, not just those that are mental health-related. People with cancer, heart attacks, strokes, Parkinson’s, addiction issues, HIV, diabetes and polycystic ovarian syndrome often experience depression in conjunction with their physiological illness. Though depression is not a normal part of aging, some studies have shown that body changes associated with aging may increase someone’s risk for depression.

In general, depression can be caused by:

  • genetic characteristics
  • hormone levels
  • environmental triggers
  • certain medications
  • chronic illness
  • thyroid dysfunction
  • exposure to violence, neglect, abuse or poverty
  • grief and loss due to death of a loved one
  • personality
  • brain chemistry
  • low self esteem
  • vitamin deficiencies

What are symptoms of depression?

Depression does not present the same in every patient, and the severity of symptoms can also vary. Some people may be hugging their knees in a dark room and be sad. Others may start gaining or losing weight without trying. Changes in sleep often accompanies depression, as do complaints of fatigue or lack of energy. Depression can interfere with brain function, making it hard to make decisions or concentrate on a task. Restlessness or irritability can indicate a depressed mood state, as can a decline in personal hygiene. For some, social isolation, such as canceling plans, skipping out on social events, and avoiding close friends and family, is a key symptom of depression. At its worst, depression can lead to thoughts of or attempts at suicide.

Five common signs of depression are:

  • Over- or under-sleeping: Depression can cause insomnia (struggling to fall asleep or waking up frequently at night) or hypersomnia, which involves oversleeping or feeling excessively tired despite getting enough sleep.
  • Low energy: This mood disorder can cause a fatigue that blurs the line between feeling physically tired and being persistently drained. Lack of motivation along with finding no joy in once-enjoyable activities are also common symptoms. Inadequate sleep, which can affect neurotransmitters like serotonin and dopamine, can compound this energy problem. 
  • Struggling to keep up with the basics: Tasks that once were easily accomplished while on autopilot may now go undone. Common examples include personal hygiene basics like showering, brushing teeth, and fixing one’s hair. The decrease in energy and motivation can spread to many other basic tasks as well. 
  • Socially isolating: Many studies show that socializing is foundational to good mental health, but depression can make maintaining a good social life burdensome.
  • Increased anxiety and irritability: Anxiety and depression sometimes tag-team, and irritability can also join in. The result is you may get overly frustrated over small things.

How’s my depression?

The Patient Health Questionnaire-9 (PHQ-9) is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. If you are unsure about your level of depression, complete this questionnaire and learn more.

PLEASE NOTE: This self-test is not a replacement for professional evaluation. If you are experiencing concerning symptoms, please call us at 310-360-7200 for an appointment.
Icon quote
I found that with depression, one of the most important things you could realize is that you’re not alone.
– Dwayne Johnson

How is depression treated?

If you or someone you know is struggling with symptoms of depression, the mental health professionals at bonmente can help. Treatment for depression starts with a diagnosis, which comes from a psychiatric evaluation. The providers at bonmente screen and monitor all patients for depression, as it is the most common mental health problem in the world. Fortunately it is also one of the most treatable mental health problems, with 80-90% of those getting treatment seeing improvement and many returning to pre-depression mood levels.

In addition to a proper diagnosis, bonmente’s providers will create a mental health treatment plan based on each patient’s preferences and provide specific guidance to meet wellness goals. Depression is typically treated with medications, therapy, and lifestyle changes, including good sleep, healthy food, and exercise.

Several medications exist for the treatment of depression:

  • Selective serotonin reuptake inhibitors (SSRI), such as Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram), Lexapro (escitalopram), and Paxil (paroxetine)
  • Serotonin and norepinephrine reuptake inhibitors (SNRI), such as Effexor (venlafaxine), Cymbalta (duloxetine), Strattera (atomoxetine), Pristiq (desvenlafaxine), Fetzima (levomilnacipran), and Savella (milnacipran)
  • Atypical antidepressants such as Wellbutrin (bupropion), Desyrel (trazodone), Trintellix (vortioxetine), and Remeron (mirtazapine)
  • Tricyclic antidepressants (TCA), such as Elavil (amitriptyline), Asendin (amoxapine), Norpramin (desipramine), Silenor (doxepin), Tofranil (imipramine), Pamelor (nortriptyline), Vivactil (protriptyline), and Surmontil (trimipramine)
  • Monoamine oxidase inhibitors (MAOI), such as Marplan (isocarboxazid), Nardil (phenelzine), Parnate (tranylcypromine), and Emsam (selegiline)

Antidepressant medications work by modifying brain chemistry, targeting neurotransmitters like serotonin, norepinephrine, and dopamine. They often take a few months to have a full effect, and your bonmente provider will monitor your response and modify your dosage during this crucial time. Common antidepressants are not habit forming and generally non-stimulating.

Therapy, including modalities like cognitive behavioral therapy (CBT), has also proven valuable in the treatment of depression. Depending on the patient, therapy may involve the individual, family members, and/or support groups. In some cases, especially those where traditional treatment approaches fail, transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT) may be indicated.

When it comes to treating depression, the sooner you address it, the better. Early intervention increases the odds of early remission, so if you’ve noticed any of these early warning signs, reach out to bonmente. Our telepsychiatry services make it quick and convenient to access professional help from the comfort of your own home.

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