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.

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!    

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!