Depression Therapy

THE DIAGNOSTICS

1. Are you irritable and moody?

2. Do you have less energy?

3. Are you not sleeping well?

4. Are you not enjoying your favorite activities anymore?

5. Have you unintentionally lost weight?

6. Has your sex drive decreased?

7. Are you unable to concentrate?

8. Do you have trouble getting through your normal day-to-day activities, like meals or bathing?

9. Do you ever want to die?

THE RX

IF YOU’VE ANSWERED YES …

You may be like 9.1 percent of adults in America today, who, according to the Centers for Disease Control and Prevention, are suffering from some form of depression. While baby boomers are wealthier, more educated and have better access to health care than the previous two generations, ironically they are more depressed than their predecessors. Stress could be the reason.

IS IT JUST THE BLUES?

All of us experience moodiness, lethargy and lack of focus sometime in our lives. “Say you’re moving to a new city; you might have a more anxious mood. Or you’re going through a divorce and you’re not sleeping as well or your appetite is decreased slightly,” says Dr. Catherine Bledowski, assistant professor of psychiatry at the Virginia Commonwealth University Medical Center. Retirees can also become depressed from the loss of structure in their lives. However, this type of depression, called an adjustment disorder, is typically transitory, she says.

When this behavior continues for an extended period of time and has a significant impact on your life, it could point to a major depressive disorder. “I think of it like diabetes or high blood pressure,” Bledowski explains. “It’s something that’s not necessarily cured … but needs to be managed throughout life.”

WHAT SHOULD YOU DO?

The first step is to see a doctor to determine the severity of your depression. Based on the number of symptoms you’re exhibiting, their severity and how significant the impact to your life, your physician will develop a treatment plan.

For adjustment disorders and mild cases of depression, a change in lifestyle — exercising, improving your sleep and nutrition, managing chronic medical problems like hormonal disorders and chronic pain, cutting out alcohol and drug use — along with psychotherapy and sometimes medication can often manage your depression. Brain stimulation therapies, which activate or touch the brain directly with electricity, magnets or implants, could be indicated for more severe cases of depression, or if therapy and medication aren’t working or are causing significant side effects.

TRANSCRANIAL MAGNETIC STIMULATION: LESS INVASIVE BRAIN STIMULATION

One of the newer brain stimulation therapies, transcranial magnetic stimulation (TMS), has proven to be very effective for patients with moderate depression (those who are still functional and not a danger to themselves) and who have undergone multiple medication trials as well as a course of psychotherapy. TMS uses magnetic energy to stimulate only the part of the brain responsible for depression. It also doesn’t require anesthesia and has very few side effects.

INSURANCE

Insurance coverage for any depression therapy varies based on your policy. Medicare recently instituted coverage for TMS if requirements are met.

VCU Medical Center is one of at least four providers of TMS in the Greater Richmond area. See your doctor to find out if this therapy is right for you.

CASE STUDY:

RANDY BROWN

A decade ago, nothing seemed to matter to Randy Brown anymore. As a result, he lost his job, his wife and all of his investments.

“I had no enjoyment, no energy,” says the 53-year-old, adding that he’d go for days without seeing anyone except his dog.

Diagnosed with major depressive disorder, he began trying anything and everything, including medication, therapy, meditation, prayer and nutritional supplements, to just feel a little better. Nothing helped.

Five years into his depression, he read about transcranial magnetic stimulation. At that point, the new therapy had only recently been approved by the FDA (in 2008) and wasn’t readily available in Richmond. “I hoped one day that I could do this,” Brown notes.

That day came this spring.

“Margaret Spivey [the TMS coordinator] was so positive. Just from her voice, I felt like there was really hope,” says Brown. Brown went into VCU Medical Center every day (the number of days a week progressively decreased over the  course of nine weeks), where the staff used a large electromagnetic coil to stimulate the region of his brain responsible for depression. “It felt like a woodpecker with a zapper tapping your head 3,000 times,” he says. In the second week, Brown began to notice a change.

In May, Brown’s treatment was complete. He calls the changes in his life “just short of miraculous.”

“A lot of that enthusiasm has come back to me. I’d like to pick up [my life] where I left off,” Brown says, adding. “I owe a big part of this to Margaret Spivey and [the] doctors. They were so thorough and so professional!”