Depression

One of the most common diagnoses found in adults and children is depression. Depression is treated if it is clinical. This means that it meets the criteria for clinical depression as specified in the DSM, and observations based on our training and experience as doctors. Depression can manifest in different ways, since everyone is unique. Aside from feeling depressed, there is insomnia, whether it is difficulty falling asleep, staying asleep, or waking up early. Studies have shown that this is one of the first symptoms to appear in different psychiatric conditions. On the other hand, there can be oversleeping. Appetite can change, to under eating or overeating. Some people find themselves not wanting to do anything or not wanting to get out of bed. Dealing with others can be difficult, or it takes a lot of effort to do things that one has to do. People can withdraw or retreat because of this. It can sometimes feel like one is tired all the time. During these times, patience can be hard to come by, so people can be irritable, “snappy”, or easily annoyed. People can be unfocused, making it hard to reach decisions. There are others who will be anxious or nervous, feel stomach aches, headaches or back pain. The severity of these symptoms can be gauged by how much they affect one’s ability to function in their daily lives.
In treating depression, it is important to treat the physical (the brain), the psychological (the mind) the emotional (the heart), and the spiritual (the soul). One’s behaviors, feelings and perceptions are indicative of neuronal function. Neurons, which are the cells that make up the brain, need to communicate with each other using neurotransmitters. There are different types of neurotransmitters: serotonin, epinephrine, dopamine just to name a few. Certain psychiatric conditions are associated with certain neurotransmitters. For example, serotonin is associated with depression, dopamine is associated with schizophrenia. In changing the ionic concentrations inside the neuron, a small electric current is produced, inducing the pockets of neurons to fuse with the cell membrane and spill their contents. Neurotransmitters are released from one neuron and received by the next neuron. The receiving neuron has receptors, which are protein structures that are made to respond to specific neurotransmitters which in turn activate the receiving neuron to release its neurotransmitters. It is analogous to a relay race, where one runner passes on the baton to the next runner, and that runner runs towards the next runner to pass the baton, and so on. When symptoms occur, it indicates that neurons are not functioning optimally.
There are medications and procedures available that can modify neuronal connections to treat depression. The medications used are the anti-depressants (for example Sertraline or Zoloft, Fluoxetine or Prozac, Paroxetine or Paxil), mood stabilizers and other types as adjuncts. Medications work predominantly on specific neurotransmitters. The medications prescribed depend on the neurotransmitters targeted. Medications can be used together with therapy, or with other procedures. There are people who continue to experience symptoms despite many adequate trials of medications. This type of depression is called treatment resistant depression. There are many different procedures such as Vagal Nerve Stimulation, Deep Brain Stimulation and Electroconvulsive therapy. Procedures can vary and can be invasive or non-invasive. Most people will first opt for non-invasive procedures. One of these procedures is called transcranial magnetic stimulation. It is done in the outpatient setting. It is a machine that induces an electromagnetic field in certain areas of the brain which are related to the symptoms, resulting in activation of neurons in this area and formation of new neuronal connections. This improves brain function overall, and helps alleviate depressive and anxiety symptoms. Because of a phenomenon called potentiation, the neuronal activation continues even when someone is not being exposed to the electromagnetic field. Only some things are known about the brain, and it is far from being understood. The relation of the brain, as a body part, to the mind, as an abstract object is still unclear. It was once thought that the brain was static, and once its complete development is final. However, it has been recently found that the brain can still change and develop over time, even after it has matured. This concept is called neuroplasticity. The brain and the mind can influence each other. Changing the way one thinks or does things can change neuronal connections and modifying neuronal connections can influence one’s psyche. It takes time to form new neuronal connections and inner work to develop a more adaptable thinking pattern and appropriate emotional response. Therefore, treatment is a process which requires one’s time and patience.
For more details, please call 818-600-2034 and visit www.familyrelationshipstherapy.com. The office is located at 25000 Avenue Stanford, Suite 104 in Valencia.