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By Ashley Barnes, M.S.
Reviewed by: Mark Hrymoc, MD
National Depression and Mental Health Screening Month
October is National Depression and Mental Health Screening Month and was created to call attention to the illness of depression on a national level, emphasizing the importance of educating the public about symptoms and effective treatment. Further, screening for mental health issues is essential in the course of effective treatment.
Thankfully, depression is a highly treatable condition with various treatment options available. A mental health professional can evaluate and assess, diagnose, and determine the best course of action to combat depression symptoms and improve a patient’s quality of life.
Depression
Depression is one of the most common mental health challenges that people experience. According to Harvard Health Publishing, “Research suggests that depression doesn't spring from simply having too much or too little of certain brain chemicals. Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, and stressful life events. It's believed that several of these forces interact to bring on depression” (2022).
Common symptoms of depression are:
Depressed mood: feelings of sadness, hopelessness, emptiness.
Lack of pleasure: in various activities, even those you love most.
Fluctuations in weight: eating more or less than usual.
Sleep changes: you may find yourself sleeping more or less than you normally would.
Slowing down: you may be observed by others to move and talk slower than usual.
Loss of energy: you may experience tiredness and lack of energy.
Guilt: this feeling may become excessive and may be accompanied by feelings of worthlessness.
Concentration changes: you may have trouble focusing or making decisions.
Thoughts of death: some people experience thoughts of suicide or related ideation.
If you have any of these thoughts and have an intent to act on them, please contact the National Suicide Prevention Lifeline: 988 for your own safety.
How to help
First and foremost, it is crucial to be screened and evaluated by a mental health professional if you suspect that you are experiencing depression. Psychiatrists and therapists have extensive training in the area of assessment and will be able to best determine if what you are experiencing meets the criteria for clinical depression. Mental health professionals may use validated assessment tools such as the Beck Depression Inventory to screen for depression symptoms, using the results as supplementary information in reaching an accurate diagnosis.
Psychotherapy, also known as “talk therapy,” has also been studied to be extremely effective in the treatment of depression, especially when paired with psychotropic medications like antidepressants. Psychotherapy gives us the opportunity to develop coping strategies while simultaneously working through our thoughts and feelings in an effective, healthy manner.
Antidepressant medications are prescribed by psychiatrists and have been widely studied to diminish the symptoms that negatively impact the lives of those suffering from depression; selective serotonin reuptake inhibitors (SSRIs) are some of the most widely utilized medications for the treatment of depression and are known to work by allowing more serotonin to be received by neurons in the brain.
Yet, some individuals find that their depression symptoms still persist, even after trying several types of antidepressants. According to research, antidepressants don’t improve symptoms for around 10-15 percent of people living with depression; additionally, around 30-40 percent observe only partial improvement in depression symptoms (Tundo et al., 2015). Mental health professionals understand this circumstance as treatment-resistant depression.
Treatment-Resistant Depression
In simple terms, Treatment-Resistant Depression (TDR) is “depression that doesn’t respond to antidepressants,” also known as treatment-refractory depression (Healthline, 2022). Someone with TRD may try two or more antidepressant medications such as Selective serotonin reuptake inhibitors (SSRIs) and feel no effect. In other words, if you have tried more than two antidepressants and experienced no effect, you may be living with Treatment-Resistant Depression.
Treatment Options for Treatment-Resistant Depression
Ketamine is an effective option for treatment-resistant depression. Ketamine, when administered by a mental health care professional at the clinically appropriate dose, targets neurons in a way that stimulates the activity of neurotransmitters in a way that combats depression symptoms.
Ketamine-Assisted Psychotherapy (KAP), a combination of psychotherapy and ketamine treatment, is another effective way to combat treatment-resistant depression. In KAP, a therapist guides the patient through the session, engaging the patient in sensitive and attentive psychotherapeutic work to process the experience.
Ketamine Therapy has been researched to have a high response rate in Treatment-Resistant Depression with 70% of patients reporting improvement in contrast with only 15% for another oral antidepressant (Trivedi et al., 2006).
The results of a clinical study published in 2022 found that 89% of participants in the study experienced improvement in symptoms of both anxiety and depression after undergoing Ketamine Therapy treatment, with 63% of participants experiencing more than a 50% reduction in depression symptoms (Hull, et. al, 2022). In the same study, ketamine was found to reduce suicidal ideation in 64% of patients who participated in the study. (Hull, et. al, 2022).
Based on sound research, Ketamine Therapy treatment is to be conducted in 6 sessions over the course of three weeks for the best results. After the 6 sessions are completed, patients may schedule “booster sessions.” Though the standard 6 sessions will be consistent across all patients, the route of administration can vary. Routes of ketamine administration that the Ketamine Therapy Center offers include intramuscular injection (IM), intravenous infusion (IV), and nasally (Spravato). Treatment may also involve Ketamine Assisted Psychotherapy (KAP), which involves a psychotherapist sitting in and conducting a therapy session during the ketamine experience.
Ketamine Therapy Center
Ketamine Therapy Center is a treatment branch from the Mental Health Center that specializes in ketamine infusion therapy.
We offer Ketamine Therapy Evaluations to thoroughly assess patients for ketamine therapy candidacy; from here, Ketamine Therapy doctors collaborate with patients to develop treatment plans. Our office in the Cedars- Sinai Medical Office towers houses rooms specially designed for patient comfort. Highly experienced and talented nurses are well-versed in ketamine infusion therapy and help patients feel comfortable as they move through the treatment process. Therapists that work with us are trained in Ketamine Assisted Psychotherapy (KAP) and offer therapeutic guidance to enhance the psychological benefit of the treatment while simultaneously creating a grounded and safe space.
For more information, please do not hesitate to explore our website or contact our office!
Resources
National Suicide Prevention Lifeline - a 24/7, free and confidential support line for those in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States. National Suicide Prevention Lifeline: 988
SAMHSA’s National Helpline - “a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.”
References
Harvard Health Publishing. (2022). What causes depression? Harvard Medical School. Retrieved May 23, 2022, from https://www.health.harvard.edu/mind-and-mood/what-causes-depression
Healthline Media. (2020). How to manage treatment-resistant depression. Healthline. Retrieved November 30, 2022, from https://www.healthline.com/health/treatment-resistant-depression
Hull, T. D. et. al, (2022). At-home, sublingual ketamine telehealth is a safe and effective treatment for moderate to severe anxiety and depression: Findings from a large, prospective, open-label effectiveness trial. Journal of Affective Disorders. Volume 314, 1 October 2022, Pages 59-67. https://www.sciencedirect.com/science/article/pii/S0165032722007625?via%3Dihub#s0085
Trivedi, M.H., Rush, A.J., Wisniewski, S.R., et al. (2006). Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: Implications for clinical practice. Am J Psychiatry, 163(1): 28–40. doi: 10.1176/appi.ajp.163.1.28.
Tundo, A., de Filippis, R., & Proietti, L. (2015).Pharmacologic approaches to treatment resistant depression: Evidences and personal experience. World J Psychiatry. 2015 Sep 22;5(3):330-41. doi: 10.5498/wjp.v5.i3.330. PMID: 26425446; PMCID: PMC4582308.
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