depression Treatment
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Major depression is an illness that can affect your ability to work, have fun, and enjoy life. It's not a weakness or character defect, or something you can just "snap out of". No more than you could simply “get over” having a bad headache.
There is help for this! You can feel better. We regularly evaluate and treat depression at Bloom Mental Health. |
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How Do I Know If I Have Depression? Depression often manifests as an overwhelming feeling of sadness, exhaustion, mental "fog", and loss of interest in the things you used to enjoy. It can last for weeks or months on end, and make you feel as though life is a chore, with feelings of helplessness and wishing it would hurry up and end. Depression is sometimes confusing and hard to recognize because the most obvious symptoms vary from person to person. Everyone is different in what part of being depressed bothers them the most. For some, it is primarily a feeling inside of being sad, pessimistic, hopeless about the future. For others, depression looks more like a physical illness. It can present with disturbances in sleep, appetite, and mental clarity. Many report feeling unmotivated and excessively tired. In fact, many people seek treatment first with their primary care doctor because of these more “physical” sounding symptoms, and may believe they have a serious underlying medical illness, or reaction to something in the environment. We have treated many patients that were secretly worried that they had developed cancer or an autoimmune disease. Whatever the primary symptoms, people who are depressed tend to start having problems with their daily life, as it starts to impact relationships, work/school, and even physical health. Depressed people often seem to start retreating from life, preferring to stay at home, be alone, sleep excessively. They often end up spending excessive time on their phone or watching TV. In fact, one of the main problems with being depressed is that it eventually causes most people to retreat from things they used to enjoy, and relationships with people they value. Thankfully, there is help for depression! You can feel better. |
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Normal Sadness vs Major Depression
We are often asked what makes depression different from just being sad. Many loved ones will point out that sadness is a normal human emotion, and wonder how we know when the sadness has gone too far, and becomes a problem that needs to be treated. It is definitely normal to have feelings of sadness or discouragement when you are stressed, or something goes wrong! These sad feelings can last for hours, days, or even weeks but eventually go away on their own. Normal sadness will typically resolve when the problem itself is fixed, or in cases of grief and less, after a couple of weeks or processing the emotions.
Major depression is different. It involves more severe symptoms of sadness and hopelessness that go beyond what is helpful for the situation they are in, and is often accompanied by other physical symptoms like a lack of energy, changes in appetite or weight, and disturbed sleep (insomnia, especially waking up in the morning before you really meant to). People with major depression also often feel very down about themselves, and have a sense of doom or hopelessness. They may also have suicidal thoughts. These thoughts are a big concern for people with severe depression because they can become overwhelming and lead to extreme behaviors to end their pain.
It’s important to recognize that normal sadness should never lead to these more severe depression symptoms, especially feelings of hopelessness and wanting it all the end. This is a sign that the sadness has “gone too far”, and has turned into something else that isn’t healthy or helpful.
Thankfully, Major Depression can (and should!) be treated. With proper treatment, most people can manage or fully treat their depression, and get back to normal.
We are often asked what makes depression different from just being sad. Many loved ones will point out that sadness is a normal human emotion, and wonder how we know when the sadness has gone too far, and becomes a problem that needs to be treated. It is definitely normal to have feelings of sadness or discouragement when you are stressed, or something goes wrong! These sad feelings can last for hours, days, or even weeks but eventually go away on their own. Normal sadness will typically resolve when the problem itself is fixed, or in cases of grief and less, after a couple of weeks or processing the emotions.
Major depression is different. It involves more severe symptoms of sadness and hopelessness that go beyond what is helpful for the situation they are in, and is often accompanied by other physical symptoms like a lack of energy, changes in appetite or weight, and disturbed sleep (insomnia, especially waking up in the morning before you really meant to). People with major depression also often feel very down about themselves, and have a sense of doom or hopelessness. They may also have suicidal thoughts. These thoughts are a big concern for people with severe depression because they can become overwhelming and lead to extreme behaviors to end their pain.
It’s important to recognize that normal sadness should never lead to these more severe depression symptoms, especially feelings of hopelessness and wanting it all the end. This is a sign that the sadness has “gone too far”, and has turned into something else that isn’t healthy or helpful.
Thankfully, Major Depression can (and should!) be treated. With proper treatment, most people can manage or fully treat their depression, and get back to normal.
Understanding Co-morbidity:
Co-morbidity is defined as the simultaneous presence of two or more diseases or medication conditions in a patient.
Addictions are a major problem in society, and certainly very common in those suffering from mental health disorders. As a psychiatric practice seeing a broad range of conditions, we regularly treat clients that are suffering from mental health disorders who also have substance use concerns. In many cases, the treatments we offer can help, such as treating a mental health disorder that may be also causing someone to seek out addictive substances. Certain mental health treatments can also provide benefits in multiple domains. For instance, someone with depression who is treated with bupropion may also experience less intense cravings for tobacco.
Co-morbidity is defined as the simultaneous presence of two or more diseases or medication conditions in a patient.
Addictions are a major problem in society, and certainly very common in those suffering from mental health disorders. As a psychiatric practice seeing a broad range of conditions, we regularly treat clients that are suffering from mental health disorders who also have substance use concerns. In many cases, the treatments we offer can help, such as treating a mental health disorder that may be also causing someone to seek out addictive substances. Certain mental health treatments can also provide benefits in multiple domains. For instance, someone with depression who is treated with bupropion may also experience less intense cravings for tobacco.
How Does Depression Get Diagnosed?
It is easy to look up the symptoms of major depression, and there are many free questionnaires online like the PHQ-9 that can provide some insight into whether you might have major depression. The basic, most common symptoms are sometimes summarized by the acronym SIG E CAPS:
It is easy to look up the symptoms of major depression, and there are many free questionnaires online like the PHQ-9 that can provide some insight into whether you might have major depression. The basic, most common symptoms are sometimes summarized by the acronym SIG E CAPS:
- S - sleep disturbances in sleep are very common. Waking up too early is an especially telling sign.
- I - interest: in depression, it is common to lose interest in hobbies or people you used to enjoy. This is sometimes referred to as anhedonia.
- G - guilt: depressed people often feel excessively guilty about things they have done, or feel bad for being a burden to others around them. This symptom is particularly problematic as it can sometimes convince patients that they aren’t even worth treating.
- E - Energy: depression often causes one to feel extremely tired, with low energy. It can feel hard to get going and do what you need to. This can cause major problems in work and school.
- C - concentration: people who are depressed commonly have serious problems concentrating. In fact, this symptom often causes the suffer to start failing tests or do poorly at work, and can lead to loved ones seeking help.
- A - appetite changes. Depression causes some people to lose their appetite, or paradoxically, to sometimes want to eat even more.
- P - psychomotor changes. Depression people often feel agitated or unsettled, and will feel like they want to move around, and find it hard to sit still. This can mimic symptoms of ADHD. We often see referrals for ADHD that turn out to have depression causing these “hyperactivity” changes. Conversely, depression sometimes can slow the sufferer down. They can appear “flat”, expressionless, and as though the life is being drained out of them.
- S - suicide. Severe depression can cause people to feel hopeless worthless, and like life isn’t worth living. In some cases it becomes so severe that the sufferer will end their life. This sometimes takes loved ones by surprise, since the sufferer may feel bad about being a burden to others, and try to hide their plans until it is too late. This is partly why it is important to get depression treated fast, and effectively!
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It can be profoundly difficult to say “I need help for depression”, and online questions can be helpful to get this conversation started. That said, there are many other medical and psychiatric illnesses that can present like severe depression. It is important to seek help for depression from a qualified professional to assist in making this diagnosis.
A formal diagnosis of major depression is often made by a primary care provider (family practitioner, pediatrician, etc), since this condition is so common that people often first seek help in primary care when they don’t feel well. In many cases, primary care providers can successfully treat uncomplicated cases of depression. In fact, depression is one of the most common conditions treated in many primary care practices. |
While online questions can be helpful to get a conversation started, there are many other medical and psychiatric illnesses that can present like depression.. |
Specialists such as a psychiatrist, psychiatric nurse practitioner, or a psychologist can also diagnose major depression, and are often asked to help with more complicated or difficult to treat cases. These mental health professionals are often consulted when the patient may have more than one co-occurring mental health concern, or when first-line treatments have not helped the patient recover. At Bloom, we are typically consulted by primary care specialists for these more complicated cases. Families will also often seek help from us as they want the extra time and expertise to make sure the problem is accurately diagnosed and treated.
Specialists also have the advantage of being able to spend more time considering alternative diagnoses, and also are typically aware of more creative and cutting edge methods of treating the disorder. At Bloom, we insist that our practitioners stay up to date by regularly reading scientific journals, attending conferences, and collaborating with thought leaders in mental health to make sure that we offer what is truly most helpful.
As noted before, people suffering from depression often appear tired, and physically ill. Sometimes loved ones will secretly worry that the sufferer has a serious medical illness. There are no laboratory tests or consistent physical signs that can confirm or rule out the diagnosis of major depression, which can make this disorder confusing and frustrating to understand. Also, many symptoms of major depression are associated with other medical disorders or conditions, and can co-occur with these other serious illnesses. Because of this, it is common for care providers to run other medical tests to assess for other underlying medical conditions first. At Bloom, we regularly consult with other medical providers and also order laboratory tests to help rule out medical problems that could mimic depression, or perhaps make the depressive symptoms worse.
It is important to note that depression is often the result of a number of factors and so it is important to have a thorough assessment and diagnostic workup, to make sure your treatment is as safe, healthy, and effective as possible. And most of all, so that you get to feeling better, fast! Help with depression is available!
Specialists also have the advantage of being able to spend more time considering alternative diagnoses, and also are typically aware of more creative and cutting edge methods of treating the disorder. At Bloom, we insist that our practitioners stay up to date by regularly reading scientific journals, attending conferences, and collaborating with thought leaders in mental health to make sure that we offer what is truly most helpful.
As noted before, people suffering from depression often appear tired, and physically ill. Sometimes loved ones will secretly worry that the sufferer has a serious medical illness. There are no laboratory tests or consistent physical signs that can confirm or rule out the diagnosis of major depression, which can make this disorder confusing and frustrating to understand. Also, many symptoms of major depression are associated with other medical disorders or conditions, and can co-occur with these other serious illnesses. Because of this, it is common for care providers to run other medical tests to assess for other underlying medical conditions first. At Bloom, we regularly consult with other medical providers and also order laboratory tests to help rule out medical problems that could mimic depression, or perhaps make the depressive symptoms worse.
It is important to note that depression is often the result of a number of factors and so it is important to have a thorough assessment and diagnostic workup, to make sure your treatment is as safe, healthy, and effective as possible. And most of all, so that you get to feeling better, fast! Help with depression is available!
What is Treatment Resistant Depression?
The symptoms for treatment resistant depression (TRD) are largely the same as those seen in other depressive disorders, but they do not respond to many of the conventional treatments used for other types of depression, and so often requires a more creative approach. TRD is something we specialize in treating at Bloom.
Treatment-resistant depression (TRD) is a debilitating disorder that can cause significant distress and limitations in daily function. It may affect 20-40% of individuals with major depressive disorder (MDD) who do not respond well to standard antidepressant medication therapies. This is a high percentage! It means that if you or your loved one does not respond well to standard treatments (antidepressants and therapy), you are not alone. It is unfortunately common to not respond to these first line treatment. It can seem hard to know how to fight depression in these cases, but as specialists we are very used to this, and are excited and ready to help!
Thankfully, there are many new options for severe depression and treatment resistant depression (TRD). We offer multiple options at Bloom, and would be happy to discuss these with you. Examples include augmenting standard antidepressants with other classes of medications (anti-inflammatories, mood stabilizers, thyroid supplements), as well as natural/holistic treatments such as sleep fasting (triple chronotherapy), and certain supplements shown to be helpful in some cases of depression. We also have strong, very effective treatments that can be given by IV infusion, and are happy to discuss these options with you.
Ketamine is a powerful, evidence-based treatment that we routinely use to treat major depression. There is building evidence that ketamine may also help with substance use concerns common in depression, including alcohol use disorder (Worrell, 2021). (Worrel: https://pubmed.ncbi.nlm.nih.gov/33989669/)
The symptoms for treatment resistant depression (TRD) are largely the same as those seen in other depressive disorders, but they do not respond to many of the conventional treatments used for other types of depression, and so often requires a more creative approach. TRD is something we specialize in treating at Bloom.
Treatment-resistant depression (TRD) is a debilitating disorder that can cause significant distress and limitations in daily function. It may affect 20-40% of individuals with major depressive disorder (MDD) who do not respond well to standard antidepressant medication therapies. This is a high percentage! It means that if you or your loved one does not respond well to standard treatments (antidepressants and therapy), you are not alone. It is unfortunately common to not respond to these first line treatment. It can seem hard to know how to fight depression in these cases, but as specialists we are very used to this, and are excited and ready to help!
Thankfully, there are many new options for severe depression and treatment resistant depression (TRD). We offer multiple options at Bloom, and would be happy to discuss these with you. Examples include augmenting standard antidepressants with other classes of medications (anti-inflammatories, mood stabilizers, thyroid supplements), as well as natural/holistic treatments such as sleep fasting (triple chronotherapy), and certain supplements shown to be helpful in some cases of depression. We also have strong, very effective treatments that can be given by IV infusion, and are happy to discuss these options with you.
Ketamine is a powerful, evidence-based treatment that we routinely use to treat major depression. There is building evidence that ketamine may also help with substance use concerns common in depression, including alcohol use disorder (Worrell, 2021). (Worrel: https://pubmed.ncbi.nlm.nih.gov/33989669/)
How To Help a Friend With Depression
It can be really heartbreaking to watch a friend suffering, while trying your best to offer helping dealing with depression. Many people struggle for years before seeking help. It can be difficult to find the right words when giving advice to a friend suffering from major depression.
Talking to someone about their symptoms does not mean you are accusing them or making assumptions: it means you care about the person and want what is best for him/her. It is true that sometimes people with depression may have some feelings of guilt or denial about the severity of their condition. But they also often can tell that something is wrong, they just may not know what to make of it, or may feel too overwhelmed to get help. One of the best things you can do is to lend your support as a listener here.
Unfortunately, many people do not seek help because it feels like they are imposing on their friends or family members. If this is the case, you can express your concerns and be especially sympathetic to how they might be feeling about themselves. They should understand that you care and are worried about them, but should feel free to seek treatment without feeling judged or disrespected.
If the loved one is a family member or very close friend, it can sometimes help to offer to help them get a treatment appointment set up, or even go with them to the first appointment. Often, the first step to getting help (reaching out for the first time) is by far the hardest step. In our clinic, loved ones often help with this step either by encouraging the patient or even helping to get something set up. It is typically much easier to keep going in treatment once you’ve already started and are familiar with the process, and the people helping.
It can be really heartbreaking to watch a friend suffering, while trying your best to offer helping dealing with depression. Many people struggle for years before seeking help. It can be difficult to find the right words when giving advice to a friend suffering from major depression.
Talking to someone about their symptoms does not mean you are accusing them or making assumptions: it means you care about the person and want what is best for him/her. It is true that sometimes people with depression may have some feelings of guilt or denial about the severity of their condition. But they also often can tell that something is wrong, they just may not know what to make of it, or may feel too overwhelmed to get help. One of the best things you can do is to lend your support as a listener here.
Unfortunately, many people do not seek help because it feels like they are imposing on their friends or family members. If this is the case, you can express your concerns and be especially sympathetic to how they might be feeling about themselves. They should understand that you care and are worried about them, but should feel free to seek treatment without feeling judged or disrespected.
If the loved one is a family member or very close friend, it can sometimes help to offer to help them get a treatment appointment set up, or even go with them to the first appointment. Often, the first step to getting help (reaching out for the first time) is by far the hardest step. In our clinic, loved ones often help with this step either by encouraging the patient or even helping to get something set up. It is typically much easier to keep going in treatment once you’ve already started and are familiar with the process, and the people helping.
comprehensive
We understand that you long for a life of freedom from mental health concerns...to be yourself again.
At Bloom Mental Health we believe in a comprehensive approach to treating mental health, providing the latest in both natural and traditional therapies, to ensure we get you back on your feet in the healthiest, most efficient way possible. |
Convenient
We understand that finding time to fit treatment into a busy schedule can be overwhelming.
At Bloom Mental Health we make finding time for treatment easy. We offer both in-office appointments as well as telehealth (phone or video) sessions with Dr. Webb, as well as adjunct therapeutic care between clinical visits with our team of highly trained mental health support professionals. We ensure you have the support and access you need to feel confident on your path to healing. |
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We understand that there is no substitute for knowing you are cared for, and have access to your doctor when you need it.
At Bloom Mental Health you can get the care you need, when you need it. Whether you are a new patient with questions about our practice, or an existing patient needing to schedule an appointment, our friendly and caring ream will assist you in scheduling the right type of appointment. |