Health & Wellness

Recognizing and Treating Depression


In the wake of this past summer’s high profile suicides of Kate Spade and Anthony Bourdain, there was a flurry of media attention on mental illness and depression. Then the news cycle changed and attention shifted elsewhere, while those dealing with depression continue to suffer, often silently.

Given the prevalence and severity of this illness, people need to be more aware of depression, an often-disabling condition affecting close to 16 million adults in the United States alone. Depression has harmful effects on all aspects of a person’s life, such as self-care, social role and family life, including household, marital and parental roles. The disease also costs the U.S. economy over $200 billion per year in medical costs and lost productivity.

A depressive episode is defined as a period of two weeks or longer during which at least five symptoms that reflect a change in functioning are present daily. These symptoms include:

  • Persistent sad or “empty” mood
  • Feelings of hopelessness, pessimism, guilt, worthlessness or helplessness
  • Loss of interest or pleasure in hobbies and activities, including sex
  • Decreased energy, fatigue and feeling “slowed down”
  • Difficulty concentrating, remembering and making decisions
  • Insomnia or oversleeping
  • Low appetite and weight loss, or overeating and weight gain
  • Thoughts of death or suicide, or suicide attempts
  • Restlessness and irritability

It is common for patients with depression to also experience anxiety and self-medication with drugs and/or alcohol. Patients may experience physical symptoms that do not respond to treatment, such as headaches, digestive disorders and pain for which no other cause can be diagnosed.

Although there are effective treatments available, at least 37% of adults with depression do not receive medical care for their symptoms. It is also important to remember that patients respond to specific treatments differently—what might be effective for one person may not be for another. Medication alone and psychotherapy alone can help relieve depressive symptoms, and a combination of medication and psychotherapy may be slightly more effective than either approach alone. Other treatments include ECT (electroconvulsive therapy) and rTMS (transmagnetic stimulation).

Depression as described above, occurring daily over the course of several weeks, is a medical condition that requires treatment under the supervision of a medical professional. Primary care doctors, OB/GYNs, geriatricians and other specialists are trained to recognize and determine appropriate initial treatment. They also know when a referral to a psychiatrist or mental health professional may be necessary in a more complex case, and/or when a patient’s symptoms don’t improve with treatment.

Cutting edge research is being conducted around the country and here at Roper St. Francis Healthcare evaluating new approaches for the treatment of depression, particularly for those who did not respond to prior treatments. If you are interested in research opportunities, please contact the Roper St. Francis Research and Innovation Center at (843) 724-2302 or for more information.

By Olga Minzer, MD

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