Depression

How Depression Affects Work Performance

Depression is a serious and sometimes debilitating mental health condition that can affect nearly every aspect of an individual’s life, especially when left untreated. In fact, worldwide, depression is a leading cause for disability–and it’s a common condition. The National Alliance on Mental Alliance reports that one in five adults experiences depression each year. Major depression can impact a person’s personal life, but also their work performance and job. Depression or anxiety that persists for more than two weeks is likely cause for clinical concern. Knowing how major depressive disorder affects work will help you identify the signs, and hopefully, prompt you to seek treatment.

What Is Depression?

Depression is a mental health disorder that negatively affects how you’re feeling, how you think, and even how you behave. Classified among mental health healthcare professionals as a mood disorder, depression can occur in various forms such as major depressive disorder, postpartum depression, bipolar disorder, persistent depressive disorder, and seasonal affective disorder. Although each condition involves its own unique characteristics, they generally share common signs and symptoms that can include:

  • Feeling persistently sad or hopeless

  • Feeling irritable

  • Feeling helpless and overwhelmed

  • Having difficulty sleeping or sleeping too much

  • Reduced energy level 

  • Feeling unmotivated

  • Experiencing changes in appetite

  • Having difficulty concentrating

  • Losing interest in formerly enjoyed activities

  • Experiencing physical symptoms like headache or digestive problems

  • Experiencing suicidal thoughts

What Is Anxiety?

Like depression, clinical anxiety can also negatively impact a person’s life. Anxiety involves persistent worry, fear, and even panic and may occur on its own or with another mood disorder like depression. Signs and symptoms of generalized anxiety disorder include:

  • Feeling nervous or tense

  • Increased heart rate

  • Catastrophizing thoughts

  • Feelings of impending doom or panic

  • Increased sweating and trembling

  • Trouble focusing / concentrating

  • Sleep problems

  • Digestive problems

How Does Depression and Anxiety Affect Your Ability to Work?

A person who experiences depression or anxiety cannot simply turn off their symptoms when they clock in for work. The symptoms accompany them wherever they go. A person feeling depressed and unmotivated doesn’t just experience a ‘bad day’ on the job. They experience a string of bad days that not only takes a further toll on their mental health, but also affects their work performance and, often, even their work colleagues. Anxiety, too, can negatively impact a person’s work performance. Here are just a few ways that these mental health disorders can affect work:

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Safety

Sleep disturbance, sometimes severe, are common symptoms of depression and anxiety. Without adequate sleep, especially for days on end, a person will suffer from reduced focus and even coordination. That can lead to seriously unsafe conditions if the individual is tasked to operate machinery or work in a potentially hazardous setting (i.e. work with chemicals, work at heights, etc…). 

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Missed Deadlines

A person who is depressed or anxious finds it hard to concentrate. That often manifests as reduced productivity. It may take an employee longer to complete tasks than usual or they may begin to miss deadlines because they can’t focus long enough to get their work completed on schedule.

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Increased Mistakes

When a person is not able to focus well, they’re apt to make more mistakes. A worker with anxiety and depression can’t focus fully on their job or the task at hand because they’re mind is caught up in the symptoms of their condition. While small mistakes might be overlooked for a while, they can add up and lead to poor work performance. Serious mistakes can even jeopardize a person’s employment. 

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Problems with Other Employees

Depression and anxiety can cause a person to experience skewed perceptions as well as increased irritability. This can lead to miscommunication and even unpleasant exchances that affect the culture of the work environment. A depressed or anxious person may find it impossible to hide their negativity from coworkers, which can also negatively impact the work setting and work relationships.

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Absenteeism

People suffering with depression and anxiety may experience symptoms that make it difficult to go to work. The emotional upheaval and associated symptoms may make it hard for them to commute to work or get through the day. Anxiety and depression can manifest in physical symptoms just as stress can. It’s not uncommon for sufferers to experience severe headaches and gastrointestinal complaints that require them to use sick time. 

What Does Depression and Anxiety Look Like to Coworkers?

Employers and other employees are not always likely to understand when someone they work with is suffering from depression or anxiety. They aren’t mental health specialists, so their impression of a depressed or anxious employee might include some of these perceptions:

  • Employee procrastinates too much 

  • Employee is lazy, undermotivated, or doesn’t care about their work/job

  • Employee is unsocial or withdrawn

  • Employee doesn’t seem to care about their appearance

  • Employee lacks confidence

  • Employee has poor communication skills

  • Employee is prone to accidents, missed deadlines, tardiness

Of course, when a suffering individual perceives that their coworkers or management feel these ways about them, it only increases their feelings of depression and anxiety, causing more exacerbation. Long work hours and depression can result in a worsening of symptoms too.

Employees, Mental Health, and Treatment

Unfortunately, many employees are apprehensive about discussing their mental health condition in the workplace. They may fear the stigma associated with these conditions and worry that their mental health will affect their job in some way. While there are protections for employees with health conditions, including mental health conditions, many people aren’t aware of them or still fear repercussions in the workplace. 

Employees like other citizens have a right to their medical privacy. They should also remember that their condition warrants treatment. In fact, without treatment, their condition can worsen. Today’s treatments for depression and anxiety are diverse and highly effective. Once conditions like depression and anxiety are well managed, their impact on an individual’s work performance will be reduced–even eliminated. 

TMS Treatment Elkridge, MD

If you’ve been diagnosed with depression or anxiety, you may be an ideal candidate for TMS therapy in Maryland. Gemini TMS specializes in TMS therapy and has helped thousands of sufferers successfully manage their condition and its symptoms. Standard treatments like medications don’t work for everyone suffering from these mental health conditions. Moreover, many patients find the side effects associated with some medications to be problematic. Fortunately, the medical community has developed other innovative methods like TMS for treating anxiety and depression. 

What Is TMS?

TMS stands for transcranial magnetic stimulation. According to Mayo Clinic, TMS is a noninvasive procedure used to treat depression and anxiety, particularly when other treatments have been ineffective or have caused discomfort for the patient. It’s also an FDA-approved treatment and requires no anesthesia. During TMS treatment, practitioners use magnetic fields to stimulate the brain’s nerve cells in order to alleviate unpleasant mental health symptoms. 

During TMS treatment sessions, an electromagnetic coil is placed near the patient’s head or scalp and delivers electromagnetic pulses to the part of the brain that controls mood. While researchers are still studying just how these pulses are able to achieve positive results, they do know that the signals ‘reactivate’ brain activity that had been less active before treatment. 

TMS therapy is painless and is regarded as a safe procedure. Most patients tolerate the procedure with ease. Some may experience side effects, including headache or some scalp discomfort. Procedures tend to last for about 40 minutes. It typically takes a couple weeks before patients notice improvement in their condition. TMS may also accompany other forms of treatment such as psychiatric therapy. 

How Gemini TMS Can Help You

Often, people who have clinical anxiety and depression don’t experience relief without some type of treatment. Patients who visit Gemini TMS for treatment have often found other forms of treatment ineffective or problematic in some way. Patients can visit us and our team of mental health experts can evaluate their condition to determine if TMS is an ideal treatment for their needs. 

If TMS is right for you, we can schedule your therapy, which will take place in sessions over the course of several weeks. Most patients begin to feel improvement early on in the TMS treatment process. We always encourage patients to tell us if they have any side effects like headache or lightheadedness. Again, these are common symptoms associated with the treatment but they generally subside. 

As an FDA-approved treatment for depression and anxiety, TMS treatments qualify for medical insurance plan coverage. If you have questions about your insurance coverage and the costs of treatment, be sure to get in touch with Gemini TMS to get answers you need.

If you are experiencing depression or anxiety, contact Gemini TMS to learn more about its TMS treatments and how they can help you manage your condition to prevent it from undermining your personal and professional life. It’s never a good idea to put off mental health treatment. At Gemini TMS, you can get the medical support and care you need to manage your depression or anxiety symptoms to experience profound relief. Call to schedule an evaluation today.

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A women suffering from depression side effects
Anxiety, Depression

Side Effects Of TMS Therapy

An estimated 21 million adults in the United States suffered from at least one major depressive episode in 2020. 

While many are prescribed antidepressants, there are alternative treatments with promising results gaining popularity among sufferers.  

Transcranial magnetic stimulation (TMS) is an alternative brain stimulation therapy. It can improve symptoms of neurological or mental health disorders, including major depression

But what are the side effects of TMS therapy? 

Learn more about TMS therapy's side effects before weighing up your treatment options. 


What Is TMS Therapy?

TMS therapy is a noninvasive procedure. The technique uses magnetic pulses to stimulate nerve cells in a specific brain area. It is a treatment designed for people with severe depression who haven't had any success on antidepressant medication. 

While TMS has shown great promise with major depression, it is also a possible treatment for schizophrenia, attention deficit-hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD). 

In 2008, the FDA cleared TMS therapy for treatment in depressed adult patients when antidepressants have failed to work. Although it was developed in the 1980s, relatively few know about TMS's advantages and disadvantages. 


How Does TMS Work?

TMS works by treating the underactive areas of the brain that are responsible for your mood with mild magnetic pulses that stimulate cells and improve brain function.

These pulses encourage the cells to re-activate and release mood-enhancing signals throughout the body, relieving stubborn depression symptoms. 

During a TMS session, an electromagnetic coil is placed against the patient's head. The coil directs a concentrated magnetic field to pre-determined mapped areas on the brain. It encourages the brain to produce serotonin improving mood and relieving symptoms. 

As the magnetic pulses are delivered into the brain, it will make a clicking noise, and a patient may also feel a tap on their head with each pulse. This is entirely normal. While earplugs are provided, many choose to listen to music through earbuds or headphones.  

Treatment sessions vary in length. This typically depends on the number of pulses delivered. For most patients, treatment lasts around 40 minutes. Once finished, patients are welcome to resume their everyday duties. 


Is TMS Therapy Safe? 

Yes. Unlike other invasive treatments, TMS does not require surgery and is considered safe and well-tolerated.

Some of the benefits of TMS include:

  • Noninvasive 
  • FDA-approved 
  • Promote improved sleep 
  • Elevate mood
  • Provide long-lasting relief from depression
  • It does not require anesthesia 
  • Improve mild anxiety  

Many patients who receive TMS therapy report several improvements in their depression symptoms. They include an elevated mood, decreased feelings of sadness, and a renewed interest in hobbies.


Side Effects of TMS Therapy

As with any treatment, it's important to understand the pros and cons. While the negative side effects of TMS therapy are minimal, knowing what to expect will help you decide whether to go ahead with the treatment. 

The following are possible transcranial magnetic stimulation side effects that patients may experience during treatment. 


Mild Headaches

Mild headaches are one of the most common side effects patients report when undergoing TMS therapy. Headaches during and after TMS are not uncommon and are typically resolved with over-the-counter pain relief. Patients are more likely to experience headaches during their first session, but the frequency decreases with subsequent sessions. 

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Scalp Pain

While the pulses are emitting, patients may experience mild scalp irritation. This is caused by the light tapping sensation on the scalp. The few who experience scalp pain often find it improves over time as they get used to the tapping sensation. 

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Neck Pain

It is not uncommon for patients to experience mild neck pain during and after their treatment session. The pain tends to diminish throughout treatment. However, adjustments can be made in coil repositioning and stimulation settings to reduce discomfort. 

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Tingling

Most TMS patients experience no side effects, but some report tingling sensations in the jaw, face, and scalp. However, most find the tingling sensation decreases within a few weeks after the completion of treatment. 

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Facial Twitching

Because TMS utilizes magnetic waves to stimulate peripheral nerves, patients may experience mild facial twitching. While it may feel odd, it is normal to feel your face twitch during treatment sessions. They are harmless and nothing to feel concerned about.  

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Low Risk of Seizures 

The vast majority of patients who undergo TMS will not experience seizures. However, there are several factors that can impact the probability of seizures.

Factors include patients with:

  • Epilepsy 
  • Traumatic brain injury 
  • Excessive alcohol use 
  • Sleep deprivation

Healthy patients with no preexisting conditions have an extremely low risk of experiencing seizures due to TMS therapy. A recent study found that the risk of TMS-related seizures is <1% overall. 

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Time Commitment 

Depending on how you respond to the treatment, TMS therapy can last for about 4 to 6 weeks with five sessions per week. This requires a significant time commitment that not everyone can achieve.

However, TMS therapy does not require sedation that can interfere with the ability to work or drive. Once your session is over, you can resume normal activities. 


Depression Medication Side Effects

Antidepressants are the most common medicine prescribed to treat major depression. They aim to correct chemical imbalances of neurotransmitters in the brain. 

Unfortunately, antidepressants can cause unpleasant side effects. The following are possible antidepressant side effects that patients may experience.

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Nausea

Nause is a common side effect during the first few weeks of taking the medication. As your serotonin levels increase, the stimulation can cause GI-related symptoms such as nausea. Patients may also experience nausea when treatment is stopped too suddenly. 

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Weight Gain

Weight gain is an unpleasant side effect of nearly all antidepressant medications. Some patients are unfazed by weight gain as it outweighs their symptoms of depression. While others, especially younger individuals, are more affected. 

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Dry Mouth

Dry mouth is a typical side effect of many antidepressants. That's some because antidepressants have an inhibiting influence on saliva production. This may lead to a dry mouth. 

Many patients find sipping water regularly, and chewing gum are strategies to reduce dry mouth. 

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Blurred Vision

Blurred vision is not an uncommon side effect for patients taking antidepressants. Select SSRIs such as Prozac and Lexapro can affect the muscle function of the eye and make it difficult to focus on objects. Depression medications may also increase the risk of developing cataracts in order patients. 

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Serotonin Syndrome 

While uncommon, serotonin syndrome is a severe set of side effects linked to SSRIs and SNRIs. It occurs when your serotonin levels are too high. Symptoms may include: 

  • Confusion
  • Agitation
  • Muscle twitching
  • Sweating
  • Shivering

More severe serotonin syndrome symptoms include seizures, arrhythmia, and unconsciousness. 

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Suicidal Thoughts 

The ultimate goal of antidepressants is to reduce the symptoms of depression. In rare cases, patients may experience suicidal thoughts and a desire to self-harm. This typically occurs in patients under 25. 

Those who experience suicidal thoughts on depression medication should reconsider their treatment options. 


Who Cannot Get TMS Therapy?

TMS therapy isn't for everyone. While it is considered safe, some people should avoid this treatment. 

You cannot get TMS therapy if you have the following: 

  • Metal devices or objects implanted in your head  
  • History of epilepsy or seizures
  • History of substance abuse 
  • Facial tattoos with metallic ink 
  • Stents in the neck or brain

Since TMS has a strong magnet, patients with any form of a metal non-removable head implant are advised not to pursue this treatment. The magnet can make implants move or heat up, causing severe head trauma. 


Who Will Benefit From TMS Therapy?

TMS doesn't work for everyone. But when it does, symptoms of depression can improve significantly. In some cases, they may go away completely. 

To benefit from TMS therapy, you will need to be the right candidate. You may be able to have TMS therapy if you: 

  • Have a major depressive disorder diagnosis 
  • Traditional medications have failed to work
  • You're not satisfied with the results from traditional medication
  • You can't tolerate the side effects of medication 
  • You have an illness that restricts what types of medication you can take
  • Your depression continues to interfere with your day-to-day life

During your initial consultation, your physician will review your history and conduct an assessment to determine if TMS therapy is right for you. 


Invigorate Your Life With TMS Therapy 

When you consider the side effects of TMS therapy, it's important to weigh them up against other forms of treatment, including antidepressants. 

At the end of the day, TMS has advantages and disadvantages. While antidepressants may provide short-term relief, some people need to take them long-term to experience continued success. Coming off can also cause withdrawal and set you up for a relapse. 

On the other hand, TMS therapy works relatively quickly with a high success rate for treating depression. While you may experience symptoms, these are generally mild and will go away after several treatments. 

If you're suffering from severe and debilitating depression, TMS therapy may be right for you. 

Contact of TMS office in Mt. Airy Maryland to schedule a consultation today. 

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Anxiety, Depression

Alternative Treatments for Depression and Anxiety

Depression and anxiety are some of the most common types of mental health disorders found in people today. Approximately 40 million US adults have an anxiety disorder and an estimated 16.1 million US adults are struggling with depression, with it being the number one cause of disability. Depression and anxiety are typically treated with medication or a type of therapy or a combination of both. However, if these methods have not worked for you then there are alternative treatments that you can try. 

 

Overview of Depression and Anxiety 

Major depressive disorder, also known as clinical depression, is a mood disorder that is recognized for causing a persistent feeling of sadness and a potential loss of interest in the things a person previously took joy in. Depression can cause several emotional and physical problems and can make it difficult for people to function in their daily lives, sometimes even leaving them bedridden. Aside from sadness, depression symptoms can manifest as guilt, hopelessness, apathy, irritability, restlessness, loss of interest in activities, insomnia, loss of appetite, inability to focus, and fatigue. 

Anxiety is a normal response to stressful situations, such as public speaking, but the body can get trapped in the stress cycle and develop an anxiety problem. Anxiety is part of the body’s fight or flight response to what it perceives as danger and has a physiological effect as a coping mechanism. Anxiety can leave a person with intense and excessive levels of worry, rapid breathing, sweating, and feeling restless and tense. Anxiety attacks, which are sudden episodes of intense anxiety, can be a common occurrence. Anxiety can be a serious disruption to a person’s life and daily activities. 

Many people can experience anxiety and depression together and both conditions usually require treatment for a person to get back to the sense of normalcy that they had before.  

 

What are Alternative Treatments? 

In cases of depression and anxiety, the standard practice is to prescribe antidepressants and psychotherapy. Alternative therapies for depression and anxiety are not considered to be first-line treatments and are usually referred to when a person does not respond well to medication and/or therapy. The good news is that there are several alternative treatments that have been shown to have a positive effect on people with depression and/or anxiety. Some alternative treatments have been FDA-approved specifically for treating depression. 

 

Alternative Treatments for Depression and Anxiety 

Usually, those with depression and anxiety are treated with a classification of medications known as antidepressants. One of the most common complaints of these medicines is the side effects and the way they leave a person feeling. Your depression and/or anxiety may also not respond well to an antidepressant. If that is the case, and talk therapy has not been effective either, then here are alternative treatments that you might look into. 

IV Ketamine Infusion 

Intravenous ketamine infusion therapy is a groundbreaking treatment used for a variety of psychiatric disorders and chronic pain conditions. Ketamine has been around for decades and was originally used as an anesthetic drug for soldiers around the 1960’s-1970’s. Now, IV ketamine infusions, that have removed the anesthetic component, have been found to be able to help relieve symptoms in severe cases of depression, anxiety, and post-traumatic stress disorder.  

The ketamine infusion is administered through a slow IV (a needle inserted into the vein) drip to deliver quick and long-lasting relief. The ketamine works by providing therapeutic effects to the areas of the brain that control mood. During the treatment, the patient is allowed to sit and relax while the medicine is slowly flowing into the body through the IV, and a sense of calm should kick in during treatment. Patients may notice an immediate difference, but it usually takes a few hours for the medicine to fully take effect and have a true, noticeable difference. The IV ketamine infusion is not considered a cure for depression or anxiety and will require further infusions on an as-needed basis to maintain the effects. However, it is not like typical antidepressants that have to be taken every day. 

Transcranial Magnetic Stimulation (TMS) 

Also known as TMS therapy, this treatment is a non-pharmacological option for depression and anxiety and is FDA-approved for depression. Transcranial Magnetic Stimulation is a noninvasive procedure that has been shown to be highly effective for treatment-resistant depression and some evidence supports its efficacy for anxiety and obsessive-compulsive disorder. TMS effects on anxiety does vary depending on a patient’s exact condition and the level of magnetic pulses, along with other factors.  

TMS works by having an electromagnetic coil or cap placed on a patients head, near the forehead, which generates a magnetic field to create a small electrical current that pulses through the scalp. These electromagnetic pulses target a specific area of the brain that controls mood, which is mapped out before the procedure begins, and stimulates the nerve cells. This increases activity in that part of the brain, which is linked to contributing to depression, so that mood is lifted and depression symptoms cease. If anxiety is present along with depression, then anxiety symptoms should also improve with the depression symptoms. 
 

Vagus Nerve Stimulation 

While vagus nerve stimulation is primarily used to treat epilepsy, it was approved in 2005 by the FDA for treatment resistant depression. This is a surgical procedure where a pacemaker-like device is implanted in the body and is connected to a wire that threaded along the vagus nerve. The device send electrical pulses along the nerve to stimulate it for a set period of time. The stimulation seems to change brain waves and depression symptoms can be relieved. 

 

Stellate Ganglion Blocks 

This treatment is often used for chronic pain, but is also a treatment for post-traumatic stress disorder and related depression and anxiety symptoms. Stellate ganglion blocks, or SGB, is an injection of local anesthesia that is administered to the ganglion nerves. The ganglion nerves are part of the sympathetic nervous system, which are nerves that supply the arms and the face. The blocks disrupt sympathetic activity along these stellate ganglion and turns off the body’s fight or flight response, which allows the brain time to reset and escape the stress cycle so that PTSD and comorbid anxiety and depression symptoms cease. 

This procedure uses fluoroscopy, which uses x-rays to create a real-time video, to help guide the healthcare professional so they will give the injection in the correct place. The effects should kick in within a half hour and the stellate ganglion becomes numb. The whole procedure takes maybe 15 minutes. SGB can help lower stress hormones from being produced, which contributes to anxiety and depression. 
 

Spravato 

This is a brand name medication that is FDA approved to treat major depressive disorder and treatment resistant depression. Spravato contains esketamine and comes as a nasal spray. The dosage and how often it should be used will be determined by the prescribing doctor. 

All of these treatments are painless and considered to be safe to use. If you have treatment resistant depression and/or anxiety then talk to your doctor about any possible alternative treatments that may work for you.  

Our office at Gemini Health is happy to be offering alternative treatments for depression and anxiety, including stellate ganglion blocks as a new service, and want to work with you to help you get back to leading a happy, fulfilling life. We understand how important emotional health is and strive to assist you in achieving your goals. Our partnering office at Pain and Spine Specialists, who we collaborate with to provide patients chronic pain management, is also happy to work with you to give you access to these treatments. 

 

Looking for Therapy Options? 

If you are looking for therapy services for mental health concerns, or if you have any questions regarding our services, call Gemini Health today! Our highly skilled mental health professionals are experienced in treating various mental and behavioral health concerns. They offer both individual and group therapy. Plus, there are no wait times to join groups. Call (301) 363-1063 and speak to our staff to schedule your appointment today! 

 

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A depressed man sitting on steps
Depression

How Does Depression Feel?

Depression can be incredibly difficult to live with. It can be so severe that a person can struggle to function in their daily life and complete regular tasks, as they might have been able to do before. It can even leave a person bed-ridden, as they find it impossible to get up and lack the energy to do much else. Depression is characterized by prolonged feelings of sadness and depressed mood. For depression to be diagnosed a person must present symptoms for at least two weeks and have changes in levels of functioning.  

The World Health Organization estimates that 3.8% of the global population is affected with depression, including 5% among adults and 5.7% among adults older than 60 years. It is believed that approximately 280 million people of all ages struggle with depression.  

There is often a misconception that those struggling with depression are just simply sad and this is not true. While sadness is a part of depression, there is a deep persistent feeling of unhappiness and emptiness that can become all-consuming for a person to the point that there is an impairment in functioning. Occasional sadness is a normal aspect of the human experience, but depression has a more significant impact and changes the way people feel, think, and act in their daily routine.  

Understanding what depression is and what it feels like can be an important first step to recognizing you have it and lead you to take steps to seek help in overcoming your depression.  

What Is Depression?

Major Depressive Disorder is a serious medical condition that severely affects a person’s life in multiple way. Major Depressive Disorder is classified as a mood disorder and is the most common form of depression that people experience. Depression and depression symptoms can range from mild to severe, depending on the person.  

As stated, depression can seep into all parts of a person’s life, to the point that it affects them at work, in school, in their social life, or in their family life. It can also lead to a range of physical health problems and drive a person to suicide at its most severe point, with a twenty percent lifetime risk of suicide among those with untreated depressive disorder.   

When it comes to the causes of depression, the research suggests that it is a culmination of biological, genetic, environmental, and psychological factors. Depression can also be triggered by sudden or long-term, adverse life events. These events could be things like loss of a job, loss of a loved one, abuse, and other traumatic situations. 

Depression is not something that people can just “get over,” and it often requires professional help. When a medical professional or mental health specialist treats someone with depression, they will usually use two conventional methods. These methods are the combination of therapy and antidepressants. The most common form of therapy for depression is cognitive-behavioral therapy, which is a type of talk therapy that focuses on changing negative thoughts and behaviors.  

Is Anger a Sign of Depression

While people who are not familiar with the symptoms of anger may not associate anger with depression, it can definitely be a sign of depression. Those who have been deeply, negatively impacted by depression and the triggers of their depression can harbor significant anger. People can be angry at the world or angry at themselves for having these feelings and not being able to function at the level they may have been at before they became depressed.  

This anger can cause people to lash out at others, including loved ones who may be trying to help. Uncontrollable or maladaptive anger can be very destructive and alienate others, which can make the person with depression feel even worse. It is thought that this kind of anger is linked to the imbalance of neurochemicals in the brain that regulate emotions. Anger with depression can manifest as irritability, hostility, and intense anger that seems to come out of nowhere all of a sudden. Therapy can help people learn how to better manage this anger. 

Is Insomnia A Sign of Depression

Unfortunately, depression does have a negative impact on sleep, both in terms of the amount of sleep and quality of sleep a person gets. About 75% of those with depression report having trouble being able to fall asleep and/or stay asleep. Depression can also be triggered because people are having a hard time getting enough sleep and this leads to a decrease in ability to regulate emotions.  

Those with depression can often ruminate about things that may be causing them stress in their daily life and it may prevent them from falling asleep or cause them to wake up more frequently during the course of the night. If you are experiencing sleep problems, related to depression, then talk to your doctor, as there may be treatment options. Keep in mind these options may not be a long-term solution and it is important to seek help for the root cause of the sleep problems. Cognitive-behavioral therapy is shown to have a significant positive impact on depression related sleep problems. 

Is Loss of Appetite a Sign of Depression

Some people who have depression also lose their appetite and find food less appealing. Significant weight loss can happen in those with depression because they have lost interest in eating. It can also be hard for anyone with depression to eat if they are too tired to cook an entire meal and it seems easier to skip the meal completely. Of course, not eating also leads to low energy levels and it creates a cycle that is difficult to break. 

Depression is also often accompanied with anxiety, which can cause gastrointestinal issues and may leave a person with little desire to eat. While it can be difficult to eat with depression, it is important to try to eat a balanced diet. Having a balanced diet can help with some depression symptoms.  

Is Sleeping A Sign of Depression

Excessive sleeping is highly common in those with depression, as the disorder often leaves people feeling constantly tired and drained of energy. Even when a person has gotten enough hours of sleep, they may continue feeling tired. This is how people with depression can end up bed-ridden, as they lack any energy to get up, or unable to perform daily activities like showering, getting dressed, going to work, or doing household chores. Oversleeping is a symptom in about 15% of people who are diagnosed with depression. It is important to note that other sleeping problems, like sleep apnea, can be comorbid with depression and is not a direct result of the depression. Disruptions or delays in the circadian rhythm are linked to depressed people sleeping past their alarm and struggling to wake up in the morning. 

How to Ask for Help with Depression

Depression is not something to be ashamed of or embarrassed by and you deserve to be able to live a full and happy life. The stigma around mental health problems is thankfully starting to shrink, as more and more people are having conversations about the topic and many notable people have come out with their own stories about their struggles with mental health. If you have been struggling with depression and are ready to seek help but are not sure where to start then please do not worry, we are here to help.  

If you are struggling to ask for help then a good place to start is by talking with a trusted friend or loved one, as they can be a great source of support. It makes a real difference having someone simply listen to you, encourage you to take care of yourself, and keep you company if you are feeling lonely. The internet is also a valuable source to be able to find a therapist or a hotline number to call and talk to someone. Seeking professional help is an important step in the process to overcoming depression. Medical professionals can help you access antidepressants, or even offer a referral to a psychologist, therapist, or licensed counselor. Finding a therapist that is the right fit for you can have one of the greatest impacts, as they can help you develop the life skills and tools that you need. 

Need Help For Depression?

If you are looking for therapy services for mental health concerns, or if you have any questions regarding our services, call Gemini TMS today! Our highly skilled mental health professionals are experienced in treating various mental and behavioral health concerns. They offer both individual and group therapy. Plus, there are no wait times to join groups. Call (301) 363-1063 and speak to our staff to schedule your appointment today! 

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Depression

What is Treatment Resistant Depression?

Treatment resistant depression (TRD) or refractory depression is a form of depression that does not respond to treatment. Unfortunately, about 10-30% of those with major depression either do not respond at all or only partially respond to antidepressant medication. Those who have TRD may also have impaired functioning, poor quality of life, suicide ideation, suicide attempts, self-injurious behavior, and relapses in depression. 

What is Treatment Resistant Depression? 

Depression can be incredibly difficult to live with and is something that millions of Americans struggle with. Depression is characterized by prolonged feelings of sadness and depressed mood. It can negatively affect the way people feel, think, and act. For depression to be diagnosed a person must present symptoms for at least two weeks and have changes in levels of functioning. Thankfully, there are treatment options that can be very effective.  

However, treatment resistant depression (TRD) or refractory depression is a form of depression that does not respond to treatment. Unfortunately, about 10-30% of those with major depression either do not respond at all or only partially respond to antidepressant medication. Those who have TRD may also have impaired functioning, poor quality of life, suicide ideation, suicide attempts, self-injurious behavior, and relapses in depression. Having this kind of depression can leave people feeling hopeless about getting better. Although, they should not despair. There are several options available, and they have shown positive results in getting TRD under control.  

How Do You Know it is Treatment Resistant Depression? 

It is not always obvious that someone might have TRD, and doctors do not always agree on the exact criteria. It may be TRD if treatment has not helped improve symptoms at all or has only partially made a difference. Even though there are no standard diagnostic criteria doctors do generally believe it is treatment resistant depression when someone has tried at least two different types of antidepressant medication without seeing any difference. Some doctors will say at least four medications, but regardless if you think you do have treatment resistant depression then you need to see your doctor to confirm it.  

There may be other explanations for why treatment hasn’t been working. It could be that someone received an incorrect diagnosis or they might have another condition along with depression that makes symptoms worse. There could be an issue with the medication itself. A person may not have taken the medication correctly, they were given the wrong dosage, or they simply haven’t been on it long enough for it to work. It does take around six to eight weeks for antidepressants to fully kick in, although those who see improvements after a few weeks have a higher chance of fully managing their depression.  

What Causes TRD? 

There seems to be a multitude of theories behind the causes of treatment resistant depression, but there is no one consensus. The causes of depression are not truly known, but it is believed to be due to low levels of neurotransmitters, such as serotonin and norepinephrine, and antidepressants are meant to raise them. Medications that treat depression may not be a one-size-fits all and an occurrence, known as Tachyphlaxis, can happen in as much as 25-30 percent of people on antidepressants. Tachyphylaxis is the medical term used to reference the body’s sudden diminish in response to successive doses of a drug, rendering it less effective. Even though the causes of TRD are not fully known, one thing is for sure though and that is that people do not exaggerate when they talk about their symptoms and it is no one’s fault if they are not able to get better.  

Anyone can suffer from depression. There are some factors that have been identified to specifically increase someone’s risk for treatment resistant depression. The first is the length of depression, as those with major depressive disorder for longer periods of time are more at risk. The severity of symptoms is another factor. Those with mild to severe depression symptoms are less likely to respond to antidepressants. Comorbid disorders, like having anxiety along with depression, can also mean being less responsive to antidepressants.   

Current Treatment Options for Treatment Resistant Depression 

Despite treatment resistant depression not responding to the traditional treatment of antidepressants, that does not mean there are no other options. There are different routes that a doctor can take to attempt to help you with refractory depression. As already discussed, a doctor will first check to be sure you have the correct diagnosis, have been using your medication correctly, and do not have any other issues that need to be treated to improve your chances of responding to treatment. After that, your doctor may consider some of the following treatments for refractory depression:  

Medication:  

  • Switching Antidepressants: If your current medication isn’t working then your doctor may consider switching medications for you. Typically the class of drug for depression is SSRIs or Selective Serotonin Reuptake Inhibitors (SSRIs), which specifically target serotonin levels. These include medicines, like Lexapro, Prozac, and Zoloft. Another class are SNRIs or Serotonin and Norepinephrine Reuptake Inhibitors, which are also used to effectively treat depression. These medications include Effexor, Fetzima, and Cymbalta. You may need to try another antidepressant in the same class or of a different class in order to find the right fit. 
  • Adding Medication: Another approach your doctor may try is to prescribe another medication along with the antidepressant you are currently on. This can be especially beneficial if your current medicine is partially working and it can give you the extra boost you need. First, your doctor may try combination therapy, where a second class of antidepressant is added alongside your current antidepressant. If that is not effective then your doctor may try augmentation therapy. This therapy adds a medication that does not typically treat depression, such as a mood stabilizer.   

Therapy: 

  • Cognitive Behavioral Therapy: A popular type of talk therapy that focuses on changing thoughts and behavior to improve depression symptoms. This therapy will help teach you better life and coping skills and has been shown to effectively treat depression by improving the functioning and quality of life. 
  • Acceptance and Commitment Therapy: A form of cognitive behavioral therapy, you will learn how to engage in more positive behaviors, despite having negative feelings. The main idea is to stop avoiding and denying any inner struggles with emotions and make behavioral changes for the better. 
  • Dialectical Behavioral Therapy: Another form of therapy that branches off of cognitive behavioral therapy. This kind of therapy teaches acceptance strategies for previous experiences and problem-solving skills. It is useful for high risk or difficult to treat patients, who may be suicidal or have self-injury behaviors. 

Other Procedures: 

  • TMS: Transcranial magnetic stimulation is a non-invasive and FDA approved treatment option for treating major depression. TMS involves the use of magnetic fields to stimulate nerve cells in the brain in order to improve any symptoms associated with depression. Studies have consistently shown that TMS therapy does work for those with treatment-resistant depression and can provide long-term relief. While this therapy does require several sessions over the course of weeks, many patients start to see relief very early on. 
  • Ketamine: A medication that is traditionally used as an anesthetic by medical professionals. However, there is emerging research to show that it can be used to effectively manage depression symptoms, primarily reducing suicidal ideations, in a rapid amount of time. Racemic ketamine is generally administered as an infusion to the bloodstream, through an IV. Esketamine, which is derived from part of the ketamine molecule, has been approved by the FDA as a nasal spray under the brand name Spravato.   
  • Vagus Nerve Stimulation: This involves an implanted device sending mild electrical pulses into your body’s nervous system. An implantable vagus nerve device is also approved by the FDA to treat depression. The device is surgically implanted under the skin of the chest and is connected by a wire to a nerve in your neck, known as the vagus nerve. The electrical pulses travel along the nerve and into the mood center of the brain, which should cause a reduction in depression.  

These are some of the usual treatments that doctors will use for drug resistant depression. All of these forms of treatment should be administered and monitored by a medical practitioner for your health and safety. Some natural approaches you can take that do not involve a medical office are to sleep well, manage stress, and exercise regularly. 

Need Help With Treatment Resistant Depression? 

If you are looking for therapy services for depression or have questions, call Gemini Health today! Our highly skilled mental health professionals are experienced in treating various mental and behavioral health concerns. Gemini Health offers various therapeutic services for all clients. Call (301) 363-1063 and speak to our dedicated staff to schedule your appointment today!    

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Depression

Is Depression Normal

The question of “is depression normal?” is a slightly tricky one to answer because the answer is both yes and no. In terms of the brain and biology, it is not exactly normal. However, depression is a common illness found in people all over the world. The World Health Organization estimates that 3.8% of the global population is affected with depression, including 5% among adults and 5.7% among adults older than 60 years. It is believed that approximately 280 million people of all ages struggle with depression.  

What to Know About Depression 

Depression is different from the occasional bout of sadness. The National Institute of Mental Health describes depression (or major depressive disorder/clinical depression) as a serious mood disorder that causes severe symptoms that affect how you think, feel, and handle daily activities. Depression symptoms must also be present for at least two weeks for it to be diagnosed. It can be a very difficult thing to struggle with, as it often robs people of the joys they have in life and the activities they usually participate in. Depression can seep into all parts of a person’s life and affect them at work, in school, or in their family life. It can also lead to physical health problems and drive a person to suicide at its most severe point. Sadly, over 700,000 people die by suicide every year. 

It is also documented that women are affected more by depression than men, although this could be due to men underreporting and not seeking help for various reasons. Thankfully, there are known effective treatments for mild, moderate, and even severe depression. However, people may face barriers to accessing mental health care, such as lack of resources, lack of mental health care providers, and social stigma that still surrounds the topic. 

The Different Forms of Depression 

Depression is actually classified into several different types. The Diagnostic and Statistical Manual of Mental Disorders is the standard used to classify mental disorders and is currently in its fifth edition. The DSM-5 breaks down the definition of depression and the different types to help professionals improve diagnosis, treatment, and research. It is important to recognize that they all have common symptoms, but there are also some definitive differences. 

  • Peripartum Depression: Also known as postpartum depression, it is a more severe form of depression that occurs during pregnancy or after a new mother has given birth. This is not just the “baby blues,” as that is a mild form of depression that usually goes away within about fourteen days after delivery. Peripartum depression is generally characterized by feelings of extreme sadness, fatigue, withdrawal from family and friends, loss of interest in things that were once enjoyable, loss of interest in the baby, or even thoughts of harming the baby. Peripartum depression needs to be addressed and treated by a doctor. 
  • Seasonal Affective Disorder (SAD): Also known as seasonal depression. It is the onset of depression during the winter months when the Earth is furthest away from the Sun and receives the least amount of sunlight in the year. Symptoms, such as social withdrawal, weight gain, and increased sleep, last for about four to five months out of the year. They also usually start around late fall and continue until the beginning of Spring. Seasonal affective disorder is cyclical and occurs every year. For it to be diagnosed, major depressive symptoms must be present for a specific season at least two years in a row, although not everyone will experience symptoms every year. 
  • Bipolar Disorders: While bipolar disorder is different from depression for a major reason, it still falls under the category of mood disorder. Bipolar disorders (there are three types) cause extreme mood swings and when people are experiencing low mood it actually meets the criteria of major depression, which is also referred to as bipolar depression. The key difference is that people also experience the opposite of depression, where they become extremely hyper (referred to as mania). Bipolar disorder is broken down into bipolar I, bipolar II, and clythomythic disorder. Bipolar disorder can cause a serious impairment in function, but when treated correctly people can go on to have a satisfying life. 
  • Persistent Depressive Disorder: Previously referred to as dysthymic disorder. Persistent depressive disorder is characterized by having depression for more days than not for at least two years. This disorder often develops in childhood, adolescence, or young adulthood. Symptoms include depressed mood, poor appetite or overeating, insomnia, fatigue, low energy, and a general feeling of being “down in the dumps.”  
  • Premenstrual Dysphoric Disorder (PMDD): Premenstrual dysphoric disorder is different from PMS, or premenstrual syndrome, in that it is much more severe. It was added to the DSM when the fifth edition was published in 2013 and is characterized by the onset of symptoms a week to ten days before the beginning of menstruation. Symptoms can be mood swings, depressed mood, irritability, decreased interest in daily activities, sense of being out of control, sleep problems, lack of energy, changes in appetite, weight gain, bloating, and breast tenderness. PMDD can be treated with antidepressants and birth control.
  • Disruptive Mood Dysregulation Disorder (DMDD): This is a childhood condition that usually occurs between the ages of six and eighteen. Disruptive mood dysregulation disorder includes irritability, anger, and frequent temper outbursts and is more intense than what is typical for that child’s developmental age. These outbursts can involve physical aggression towards a person or thing and must happen three or more times within a week. This is another new diagnosis that was added for the first time in the DSM-5. This disorder is found more often in males than females and can occur alongside other conditions.  

Is Depression Hereditary?  

When it comes to depression, the research suggests that it comes down to biological, genetic, environmental, and psychological factors. Depression is known to run in families and Stanford medicine says that if a person has a parent or sibling with major depression then that person most likely has a two to three times greater risk of developing depression, in comparison to the average person. However, no one simply inherits depression. Instead, they inherit a certain gene or set of genes that makes them predisposed to depression and there are many things that can “activate” these genes. Unfortunately, researchers are still trying to figure out which genes may be at fault for causing depression, and having the genes does not guarantee that someone will develop depression but simply increases their risks. 

Depression can also be triggered by other things, such as adverse life events. These events could be things like loss of a job, loss of a loved one, abuse, and other traumatic situations. Having a negative change in life circumstances or any stressors that are too overwhelming can easily launch someone into depression. A person’s environment also has a large impact on their chances of developing depression. If someone is continuously exposed to violence, neglect, poverty, or abuse for any length of time then they are more at risk. Even certain physical illnesses and medications can trigger it and psychological state, such as having low self-esteem or being a pessimist, has an effect as well. 

How to Ask for Help with Depression 

Depression is not something to be ashamed of or embarrassed by. The way for the stigma around mental health to disappear is for more people to open up about their experiences and to get help. If you are wanting to know how to seek help for depression and are not sure where to start then please don’t worry. There are so many resources available now and the internet is an invaluable tool in searching for a therapist, or hotline numbers to call and talk to someone, and other general information.  

Of course, it can be difficult to admit that you need help, so a great place to start may be to talk to someone that is close to you and that you trust, such as a spouse, family member, or friend. Family and friends can be a great source of comfort and support. They can be there to simply listen to you, remind you to take care of yourself, hang out with you, and/or take you to therapy appointments. The list goes on really. Reaching out to a professional is another step in the process to overcoming depression. Doctors can help you and prescribe medication, or even offer a referral to a psychologist or therapist. Students can turn to a trusted teacher or their guidance counselors and college students should have counseling services offered on campus. Finding a therapist can also be a great option, as they can help you develop the life skills and tools that you need.  

If you are currently in distress or feel like harming yourself then reach out and call the National Suicide Prevention Lifeline at 1-800-273-8255.  

How to Treat Depression 

The usual course of treatment for depression is a combination of antidepressants and psychotherapy, such as cognitive behavioral therapy. Doctors may also turn to other forms of treatment, such as TMS. 

Antidepressants are a type of medication that is used to treat depression and mood disorders and they work by changing the chemicals, called neurotransmitters (ex. Serotonin and Dopamine), in the brain. Generally, they are non-habit forming, although you should not go off them without guidance from your doctor, as you may experience withdrawal symptoms if you suddenly stop taking them. Doctors also expect antidepressants to start working within 2-4 weeks but may keep you on them for several months to see if they do work or not. Some of the common categories of antidepressants are SSRIs (Selective Serotonin Reuptake Inhibitors), SNRIs (Serotonin Noradrenaline Reuptake Inhibitors), TCAs (Tricyclic antidepressants), MAOIs (Monoamine Oxidase Inhibitors), and NASSAs (Noradrenaline and Specific Serotonergic Antidepressants).    

Cognitive behavioral therapy is a form of talk therapy that helps people identify negative thought patterns and behaviors and change those patterns/behaviors. It has been shown to be very effective for those struggling with depression. CBT can be conducted as individual or group therapy and the goal is to teach people the proper coping and problem-solving skills they need. While most people start to see an improvement after a few sessions, it can take up to twenty sessions to complete this therapy.   

How Does TMS Help Depression? 

Transcranial magnetic stimulation, or TMS, is another effective method of treating depression that is usually used when medication and talk therapy have previously failed. TMS is a non-invasive procedure that involves the use of magnetic fields to stimulate the nerve cells in the brain. By stimulating specific areas of the brain that are associated with controlling mood patients can see significant improvement in their depression. To conduct TMS therapy, a specialist will place an electromagnetic coil on your forehead and send magnetic pulses to the regions of the brain that have been mapped out beforehand. This kind of therapy does take several sessions over the course of weeks, but a significant amount of people start to notice a difference after a few sessions. It is painless and does not require any overnight stays. 

Need to See Someone for Depression? 

If you are looking for therapy services for depression or have questions, call Gemini Health today! Our highly skilled mental health professionals are experienced in treating various mental and behavioral health concerns. Gemini Health offers various therapeutic services for all clients. Call (301) 363-1063 and speak to our dedicated staff to schedule your appointment today!  

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Depression

Types of Therapy for Depression

Depression can affect how people think, feel, and handle daily activities. Physical symptoms, such as changes in sleep/energy levels, loss of appetite, and trouble concentration can manifest as well. Thankfully there are many techniques for treating depression and a majority of people are able to get back to leading a full life. Many people may not realize that there are different types of therapy and they are not a one-size-fits all. Everyone responds differently to therapy. 


Types of Therapy for Depression 

The World Health Organization estimates that 3.8% of the global population is affected with depression, including 5% among adults and 5.7% among adults older than 60 years. It is believed that approximately 280 million people of all ages struggle with depression. However, depression does not have to be a lifelong condition. There are currently many different types of therapy for depression that have all been shown to be highly effective in treating depression.

 

Depression Treatment Options

While everyone experiences sadness at different points of their life, depression is more severe in nature. Depression is extreme sadness that lasts for more days than not and has to be occurring for two consecutive weeks in order to be diagnosed. Depression can affect how people think, feel, and handle daily activities. Physical symptoms, such as changes in sleep/energy levels, loss of appetite, and trouble concentration can manifest as well. Thankfully there are many techniques for treating depression and a majority of people are able to get back to leading a full life.  

Depression is not something that people can just “get over,” and it often requires professional help. When a medical professional treats someone with depression they will usually use two conventional methods.

Antidepressants: These are a classification of medication that is used to treat depression and other mood disorders. They work by boosting chemicals, called neurotransmitters, in the brain. Serotonin, norepinephrine, and dopamine are the neurotransmitters that most antidepressants target. Antidepressants typically start working within two to four weeks but may take longer. If one type of antidepressant does not have any effect then your doctor might have you try other antidepressants to see if you respond to any of them. Some of the common categories of antidepressants are SSRIs (Selective Serotonin Reuptake Inhibitors), SNRIs (Serotonin Noradrenaline Reuptake Inhibitors), TCAs (Tricyclic antidepressants), MAOIs (Monoamine Oxidase Inhibitors), and NASSAs (Noradrenaline and Specific Serotonergic Antidepressants). Generally, antidepressants are non-habit forming, although you should not go off them without guidance from your doctor, as you may experience withdrawal symptoms if you suddenly stop taking them. 

Psychotherapy: This is often referred to as “talk therapy,” as individuals will sit down with a psychologist, licensed therapist, or trained counselor and talk about their mental health conditions or concerns. However, it does involve more than just talking. Psychologists, licensed therapists, and counselors have to go through many years of training to learn how to properly help people. This training provides them with tools that they will pass on to their patients so that they can implement them in their daily life and hopefully overcome and recover from depression. They will be able to help their clients set realistic goals, pinpoint life events that may have contributed to their developing depression, identify distorted thoughts or perceptions, and develop life skills to cope with their symptoms and stresses. Psychotherapy tends to foster the relationship between client and therapist so that the client can feel safe in order to learn how to overcome their negative thoughts and/or behaviors. Not all therapists are the same, as many of them specialize in treating certain disorders. It can also take some time to find the right therapist for you. So, do not feel discouraged if it’s not a right fit the first time.  

Those suffering from depression will usually try a combination of antidepressants and psychotherapy to get the maximum benefits. Another treatment option when medication and traditional therapy fail is TMS therapy.

TMS (Transcranial magnetic stimulation): This is another effective method of treating depression or even treatment resistant depression. It is not usually the first treatment that doctors will use, as therapy and medication often work really well for patients. However, if they are not doing the trick then a patient can be recommended for this treatment, as it has a very high rate of significantly improving symptoms. According to Harvard Health Publishing, about one-third of patients experience a full remission, where their symptoms go away completely.TMS is a non-invasive procedure that involves the use of magnetic fields to stimulate the nerve cells in the brain. By stimulating specific areas of the brain that are associated with controlling mood patients can see significant improvement in their depression. To conduct TMS therapy, a specialist will place an electromagnetic coil on your forehead and send magnetic pulses to the regions of the brain that have been mapped out beforehand. 


Does Therapy Work for Depression?

Psychotherapy is all about treating the individual and helping them to work through whatever they might be struggling with at that time. Therapy is also not a one-time thing. It requires multiple sessions to see any results and several people go to therapy multiple times throughout the course of their life. Therapy also has to be tailored to the individual and their needs. So, every approach is different for each person. Psychotherapy has been proven to work for those with short-term and long-term depression. If you need to find a therapist a good place to start is to ask your doctor for any recommendations. You can also find therapists through the American Psychological Association or the Anxiety and Depression Association of America.

Best Therapy for Depression

Many people may not realize that there are different types of therapy and they are not a one-size-fits all. Everyone responds differently to therapy. Some of the types of psychotherapy that work best for depression are the following: 

Cognitive Behavioral Therapy: This is one of the most popular forms of therapy. This therapy is the combination of cognitive therapy (thoughts) and behavioral therapy (actions). The focus is on identifying and altering negative thoughts and behaviors that contribute to someone’s depression. Unhealthy and negative thought patterns usually lead to self-destructive behaviors, which only reinforce the thought patterns in a vicious cycle. Cognitive behavioral therapy consists of five to twenty sessions that are structured and can be held in individual or group sessions. Therapy is accompanied with “homework,” which allows people to practice and work on what they have learned.   

Dialectical Behavior Therapy: This therapy is predominantly based on cognitive behavioral therapy, but with one significant difference. The main difference is that dialectical behavior therapy emphasizes the acknowledgment and acceptance of negative thoughts, feelings, and behavior. Therapists will teach clients how to cope and regulate their emotions so that they are able to learn how to handle difficult and stressful situations. Clients are also taught how to practice mindfulness so that they have all the power. Homework also consists of practicing coping techniques to improve their ways of thinking and behaving.  

Interpersonal Therapy: Developed to help treat depression in adults, interpersonal therapy focuses on a person’s interpersonal skills. Those who have problems with interpersonal connections and struggle with relationships can often feel isolated, which contributes to feelings of depression. By addressing past and present relationships and interpersonal interactions, the therapist can help a person identify the important relationships in their life and how to resolve conflicts. The therapist will help that person to improve their communication and ultimately be able to build stronger social support systems through friends, family, and partners. 

Psychodynamic Therapy: The idea behind psychodynamic therapy is that negative thoughts and behaviors are caused by unresolved past experiences, often occurring in childhood. This is a long-term approach to mental health and the expectation is for clients to talk about anything that is on their minds. Therapists will help a person to identify how past experiences have influenced current negative thoughts and behaviors. By making these associations, a person can work through these issues that are contributing to their depression.

 

Looking for a Therapist?

If you are looking for therapy services for mental health concerns, or if you have any questions regarding our services, call Gemini Health today! Our highly skilled mental health professionals are experienced in treating various mental and behavioral health concerns. They offer both individual and group therapy. Plus, there are no wait times to join groups. Call (301) 363-1063 and speak to our staff to schedule your appointment today!

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Depression

How Antidepressants work

Antidepressants are a type of medication that has been shown to be highly effective at treating major depressive disorder and other mood disorders. Essentially antidepressants work by boosting the chemicals in your brain called neurotransmitters. These neurotransmitters (serotonin, dopamine, and norepinephrine) are known for affecting mood and emotions. 


How Antidepressants Work 

If you are struggling with depression then your doctor may put you on antidepressants as part of your treatment plan. Antidepressants are a type of medication that has been shown to be highly effective at treating major depressive disorder and other mood disorders. Essentially antidepressants work by boosting the chemicals in your brain called neurotransmitters. These neurotransmitters (serotonin, dopamine, and norepinephrine) are known for affecting mood and emotions.


History of Antidepressants 

Major depressive disorder is a very common mood disorder, as the National Institute of Mental Health estimates that 17.3 million adults in the US had at least one major depressive episode in 2017. The 1950s actually saw the introduction of the first pharmacological treatments for major depressive disorder: iproniazid and imipramine. In 1952, two chemists, Irving Selikoff and Edward Robitzek were developing a new treatment for tuberculosis and conducted clinical studies on a new drug, iproniazid, which is a monoamine oxidase inhibitor. They noted how patients experienced an improvement in mood, appetite, and sleep. Further studies on its antidepressant effects were conducted by other scientists in this time period. Then 1957 saw the first public report on imipramine by Roland Kuhn. Kuhn was originally testing its antipsychotic effects for patients with schizophrenia (it had no effect) and he realized that it instead worked as an antidepressant. So, the first clinically useful tricyclic antidepressant was founded.  

The 1980s brought about the focus on the association between serotonin levels and depression. In response, a new class of drugs called selective serotonin reuptake inhibitors (SSRIs) became established during this decade. Fluoxetine, an SSRI, revolutionized the market and therapy treatments for depression when it was approved by the FDA in 1987 as the brand name Prozac. Fluoxetine and all SSRIs had the advantage over tricyclic antidepressants (TCAs), as they had fewer adverse effects, although TCAs have still been popular over history. Prozac skyrocketed in popularity and became widely prescribed across North America.

 

Types of Antidepressants 

Many people may not realize but there are several types of antidepressants and they all function differently by affecting different neurotransmitters. Currently, there are five major classes of antidepressants, with selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) being among the most commonly prescribed as the first line of treatment.  

Selective serotonin reuptake inhibitors (SSRIs): This class of antidepressants works by specifically inhibiting the reuptake of serotonin. This means that they block the reabsorption of serotonin into neurons and increase the levels of serotonin available in the brain. SSRIs can also be used to treat other conditions, such as OCD, anxiety, and eating disorders. SSRIs are also known for having fewer side effects than other types of antidepressants. Common SSRIs are: 

  • Celexa (citalopram 
  • Lexapro (escitalopram) 
  • Luvox (fluvoxamine) 
  • Paxil (paroxetine) 
  • Prozac (fluoxetine) 
  • Viibryd (vilazodone) 
  • Zoloft (sertraline) 

Serotonin and norepinephrine reuptake inhibitors (SNRIs): The first FDA-approved SNRI came about in 1993 and works similarly to SSRIs. SNRIs inhibit the reuptake of both serotonin and norepinephrine, instead of just serotonin like SSRIs do. Some SNRIs can also treat generalized anxiety disorder, post-traumatic stress disorder, social anxiety disorder, panic disorder, and even chronic pain. Common SNRIs are: 

  • Cymbalta (duloxetine) 
  • Effexor (venlafaxine) 
  • Fetzima (levomilnacipran) 
  • Pristiq (desvenlafixine) 
  • Savella (milnacipran) 

Tricyclic Antidepressants (TCAs): One of the first antidepressants to be FDA approved and hit the market, tricyclic antidepressants get its name from the three rings in its chemical structure. They are similar to reuptake inhibitors, as they block the absorption of serotonin and norepinephrine, but they also block the absorption of the neurotransmitter, acetylcholine. Before SSRIs came along these were the antidepressants that were used as the first line of treatment. TCAs are still prescribed often, but they can cause more severe side effects than SSRIs. Common TCAs are: 

  • Anafranil (clomipramine) 
  • Asendin (amoxapine) 
  • Elavil (amitriptyline) 
  • Norpramin (desipramine) 
  • Pamelor (nortrptyline) 
  • Sinequan (doxepin) 
  • Surmontil (trimipramine) 
  • Tofranil (imipramine) 
  • Vivactil (protriptyline)

Monoamine Oxidase Inhibitors (MAOIs): Another of the first antidepressants to become available to people in the mid-1900’s. MAOIs inhibit the action of a brain enzyme known as monoamine oxidase, which helps to break down neurotransmitters like serotonin. MAOIs are no longer commonly used and are generally saved when other antidepressants have not worked. This is due to their ability to interact negatively with other medications and the potential to cause food reactions. Common MAOIs are:   

  • Emsam (selegiline) 
  • Marplan (isocarboxazid) 
  • Nardil (phenelzine) 
  • Parnate (tranylcypromine) 
     

Atypical Antidepressants: This classification gets its name because these antidepressants do not fit into any of the other major classifications, so they are considered “atypical.” Each medication in this category has a unique function and affects serotonin, norephedrine, and dopamine differently. Along with function, each antidepressant has varying side effects. Some of the medications that are classified as atypical are: 

  • Oleptro (trazodone) 
  • Brintellix (vortioxetine) 
  • Remeron (mirtazapine) 
  • Symbax 
  • Wellbutrin (bupropion) 


How Do I Know If Antidepressants Are Working? 

Antidepressants can do wonders, but unfortunately, they are not an instant cure for depression. These medications can take some time to kick in and doctors usually expect them to start working in four to six weeks. After this time, if you still do not see any improvements in your mood then you may wish to contact your doctor. Be sure to take your antidepressant as instructed to maximize the chances of it working. It will most likely be a subtle change over time and you may not realize it to begin with. Your doctor may also want to keep you on your current antidepressant for a couple of months to give the medication more time to start working and if there continues to be no change, then they might consider switching you to a different one. Medication also works best in combination with psychotherapy, or talk therapy, with cognitive behavioral therapy being the most popular talk therapy for depression. 

Side Effects of Antidepressants 

As with all medications, there are side effects to using antidepressants. If you do have side effects and they are unmanageable for you then you should speak to your doctor. They may switch your prescription to another type of antidepressant that might work better for you. Some of the side effects are: 
 

  • Headaches 
  • Nausea or vomiting 
  • Sleeplessness 
  • Agitation, Shakiness, or Anxiety 
  • Weight Gain 
  • Reduced Sex Drive 
  • Dry Mouth 
  • Stomach Aches 
  • Constipation or Diarrhea 

 

Please also be aware that you should not just suddenly go off your medication without the guidance of your doctor. These are serious medications that alter the chemicals in your brain. If you suddenly stop taking them without being weaned off then you may start to experience withdrawal symptoms. Your doctor will most likely have you reduce your dosage gradually over the course of several weeks to help lessen your chances of experiencing withdrawal symptoms. These symptoms can include restlessness, trouble sleeping, unsteadiness, stomach problems, sweating, feeling irritable, anxious, or confused. You should also talk with your doctor if you do have withdrawal symptoms, as there are some alternative approaches that can be taken to help you manage these symptoms. Withdrawal symptoms will usually start about a week after you stop taking your antidepressant and can last for one to two weeks, sometimes longer. 

Need Help for Depression? 

If you are looking for therapy services for mental health concerns, or if you have any questions regarding our services, call Gemini Health today! Our highly skilled mental health professionals are experienced in treating various mental and behavioral health concerns. They offer both individual and group therapy. Plus, there are no wait times to join groups. Call (301) 363-1063 and speak to our staff to schedule your appointment today!  

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Anxiety, Depression

Causes of Brain Fog

Brain fog can be experienced as confusion, lack of mental clarity, inability to focus, and forgetfulness. For some individuals, they may experience feeling disoriented or distracted, or regular daily tasks may take longer to complete. These experiences of brain fog are a common characterization of this state.

What Is Brain Fog? 

Experiencing brain fog can be a scary occurrence. Especially if it seems to be happening frequently. You may begin to worry about the impact it has on your day-to-day life. Many people use the phrase “brain fog” in different ways, but what is it? Brain fog is not a medical condition but can be a side effect from other underlying conditions.  

Brain fog can be experienced as confusion, lack of mental clarity, inability to focus, and forgetfulness. For some individuals, they may experience feeling disoriented or distracted, or regular daily tasks may take longer to complete. These experiences of brain fog are a common characterization of this state. 

If you find yourself overworking, persistently stressed out, or have a lack of sleep, you may be laying the ground work for brain fog to manifest itself. When evaluated from a biological stance, brain fog may also be due to a cellular change in the body. High levels of inflammation and hormonal changes that determine mood and focus may contribute to your brain fog. Individuals may also be susceptible to other conditions once brain fog is present, such as obesity, hormonal imbalances, and diabetes.  

What Causes Brain Fog? 

Brain fog can be disorienting and frightening. Your ability to think clearly becomes impaired and the effects on your cognitive function become apparent. Because brain fog is typically a symptom of another condition, this type of cognitive dysfunction may have several explanations. Some potential causes of your brain fog may be: 

Depression: Depression is a mental illness that can take a significant toll on your thinking, behavior, and mood. As mental health conditions/concerns increase, the more likely you are to experience brain fog. Your ability to think clearly becomes affected because your brain functioning changes. These changes impair the brain and prevent it from working as effectively as it could.  

Sleep Deprivation: Lack of sleep, whether it’s one day or several days can negatively impact your ability to think clearly or focus. You may be suffering from insomnia (which may require medical supervision) and find yourself becoming easily confused. Poor sleeping habits can increase your feelings of disorientation, distraction, and fogginess. 

Anxiety/Stress: When you experience anxiety and stress, your ability to focus becomes negatively impacted. The anxious anxiety that may consume you also exhausts your brain. Your cognitive energy becomes hyper focused on what is stressing you out, and you begin to lose your present focus. This creates mental exhaustion. When you are mentally exhausted, your memory suffers, your ability to focus suffers, and your mental health suffers. If you find your mental health degrading, it becomes harder to think, reason, and focus. This will only compound your daily confusion.  

Hormonal Changes: Shifts in hormones can greatly impact your physical and emotional health. When your body experiences high levels of anxiety and stress, your brain also releases “stress hormones.” The brain releases cortisol, and elevated cortisol levels impact your cognitive functioning negatively. This feeling of “burn out” occurs from the weakening connection in the brain due to these stress hormones. Also, elevated estrogen and progesterone that naturally occurs during pregnancy causes noticeable shifts, colloquially referred to as “pregnancy brain.” And attention to details and focusing on tasks begins to feel impossible.  

Diet: The brain (just as the rest of your body) requires proper nutrition and care. If your diet is composed of unhealthy food that do not support cognitive functioning, your ability to maintain mental clarity is impacted. It is critical for your brain to receive nutrients such as iron and vitamin B-12. 

Medications: It is not uncommon for some people to experience brain fog from certain medications. These prescriptions may have side effects that include cognitive disfunction. Your medication may cause you to be confused or have an inability to focus. You may find yourself experiencing increased fatigue. It is critical that you discuss any of these side effects experienced with your doctor. You may need to adjust the dosage of your medication or change it entirely.  

What Does Brain Fog Do To Your Mental Health? 

Mental clarity and the ability to focus are interconnected to brain health. Sometimes, it may also feel like a “chicken and the egg” situation. If you suffer from a mental illness, your risk for brain fog increases. And with the inability to concentrate or finding yourself unable to complete daily tasks, you may become disheartened and find your mental health deteriorating. Dark thoughts and cloudy thinking become intertwined.  

Your cognitive disfunction can have an impact on your mental health. Sometimes the causes of your mental illness and your brain fog may be triggered by the same catalyst. High levels of stress, poor diet, and hormonal imbalances can lead to an increase of brain fog and exacerbated symptoms of mental illness.  

Interestingly enough, a common cause for both mental illness and brain fog can be traced to brain inflammation. Inflammatory responses in the brain foster depression symptoms, anxiety, and exhaustion. And the way inflammation manifests in the brain, so does cognitive dysfunction. When the brain’s ability to produce neurons becomes affected, communication between the cells becomes difficult. These responses are so similar it may make it difficult to determine which symptom is caused by what.  

How To Treat Brain Fog 

Determining how to treat your brain fog is contingent on determining its cause. Some minor and moderate lifestyle changes can significantly improve your brain fog and its related symptoms. Some changes that may help your cognitive dysfunction are: 

  • Diet Change: Improving your diet with healthier food choice encourages brain health 
  • Meditation: Decreasing your stress levels can encourage positive thinking 
  • Sleep: Enough sleep and rest will support brain health 

Other options to foster a healthy brain environment and improve brain function would be the incorporation of vitamins and supplements. Some vitamins to consider incorporating in your daily routine are: 

  • Ginseng: Helps regulate the body’s immune responses and stress induced hormonal changes 
  • Fish Oil: The omega 3 fatty acids improve brain function, vision, and motor skills 
  • Ginkgo Biloba: The anti-inflammatory effect improves mood, increases energy, and improves memory. It can also help reduce the risk of Alzheimer’s disease 
  • Vitamin B Complex: These vitamins encourage your body to make and store energy from your food and red blood cells. They also assist in proper bodily functions and the digestive system.

What To Take Away 

While brain fog can be frustrating and inconvenient, there are things you can do to improve your brain’s ability to function. The important thing to do is not ignore symptoms, regardless of how mild they may appear. If left untreated the quality of your life may be negatively impacted. Relief from brain fog is possible.  

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Depression

How to treat postpartum depression

Bringing home a new baby can be an exciting and scary event. Family members often find themselves having difficulty learning how to adjust to this dynamic in the early days of an infant. The new mother’s hormones are still fluctuating as well as the emotions of the family members. It is not uncommon for there to be bouts of frustration, anger, and sadness. Eventually hormones do level-off and individuals develop a new rhythm to their daily routines. For some mothers, the feelings of sadness and frustration do more than linger. They become more severe, and the depression becomes more long lasting. When these symptoms last longer than two weeks and become more severe, the new parent is suffering from Postpartum Depression (PPD). 

Women experiencing postpartum depression may have difficulty regulating their mood, inability to sleep, intense rage, excessive crying, and feelings of hopelessness. Postpartum depression primarily effects new mothers, but it can affect new fathers as well. New fathers may experience severe anxiety, drastic changes in their behavior, feeling overwhelmed and/or fatigued. In both cases, the chances of experiencing postpartum depression increase when you have a history of depression prior to the birth of a child.  

If you believe you’re experiencing postpartum depression you do not have to be embarrassed. It is a common event that many new parents experience. It is important to reach out to loved ones or medical professionals if you experience any of the following: 

  • Your symptoms last more than two weeks 
  • Your symptoms are getting progressively worse 
  • Your symptoms prevent you from taking care of yourself 
  • You have thoughts of harming yourself or your child 

This condition may require mental health intervention to regulate the tumultuous swing of emotions. Speaking to a medical professional can help. You may be wondering how to treat postpartum depression. A medical professional can provide you with information on how to manage your postpartum symptoms and recommend the appropriate treatment. An increasingly preferred method of treatment is TMS (transcranial magnetic stimulation). Many new mothers appreciate the benefits of TMS because it is non-pharmacological and non-invasive. They are able to comfortably breast feed their child without fear of any medication passing through breast milk (even if it is a low level). The non-invasive treatment takes a small fraction of time, allowing new parents a large amount of time to still bond with their infant. TMS treatment can be used by both new mothers and new fathers. Parents can begin finding relief for their postpartum and depression symptoms with TMS therapy. 


What Is TMS? 

Transcranial magnetic stimulation is an FDA approved treatment for chronic depression. The region of the brain that controls depression symptoms also control anxiety symptoms. Transcranial magnetic stimulation (TMS) has been recognized by clinicians as a promising treatment for individuals suffering from depression.  

If you are suffering from postpartum depression and looking for an effective treatment that does not rely on medication, TMS can help. Transcranial Magnetic Stimulation (or TMS) is a noninvasive form of brain stimulation. The nerve cells that are connected to anxiety and depression are stimulated, effecting and altering the brain’s neurotransmitter levels.   

TMS therapy is an intensive approach which has shown to activate regions of the brain that have become dormant. The treatment requires several sessions over a period of time, with relief being provided after a few.    

TMS is a a non-drug treatment that helps provide relief from severe depression and anxiety without the physical side effects associated with medications. This therapy is an outpatient procedure that allows patients to maintain their daily routines while receiving treatment for their anxiety.   

Patients are not prevented from participating in their daily routines from their TMS treatment for depression. New mothers who are breastfeeding won’t have to agonize over fear of their depression medication being potentially transmitted to their infants. (It is important to note that if your psychiatrist recommends you staying on depression medication you should discuss with them your concerns and options. Mental health clinicians would never recommend to abruptly stop ANY treatment.) Patients can utilize TMS treatment for their depression by itself or in conjunction with a medication regimen and talk therapy. Each person is different and the nature of their postpartum symptoms may vary.  

If you are struggling with Postpartum Depression and are confused about where to start looking for help, please call Gemini TMS (301) 363-1063. We are a team of mental health professionals who can help treat and manage your depression symptoms.  

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