A roommate of mine had a difficult time her junior year. She started to lose her appetite, had difficulty focusing, would seclude herself from her friends, and seemed to be emotionally withdrawing herself. After a few discussions with her, we discussed how depression ran in her family, and the symptoms that she was showing seemed to be similar to those of depression.
It was suggested to her that she should go to some therapy sessions to help her with this “depressive state.” She claimed that she did not believe in anti-depressants and their effects, and I secretly had a lack of faith in these drug as well. My roommate attended therapy sessions, was diagnosed as having depression, and was put on anti-depressants. Surprisingly, after a few weeks on this new medication, my roommate began to return to her normal happy-go-lucky self.
Her and I began a quest to learn more about what depression is and how anti-depressants work. We learned that anti-depressants work in ways to alter brain neurochemical systems. Antidepressants focus on affecting the neurochemicals such as serotonin, nonrepinephrine, and dopamine (because it is believed that depression may be due to an imbalance of these neurochemicals). Some antidepressants work directly with the chemicals, and others with the chemicals receptors.
Over 15 million people in the United States are struggling with depression, so clearly the development of antidepressant drugs was necessary. While genetics plays a big role, the environment may also cause a person to develop depression. The article “Clavulanic acid increases dopamine release in neuronal cells through a mechanism involving enhanced vesicle trafficking” is a great example for mechanism of how anti-depressants work. From the study the results showed that clavulanic acid increases dopamine release in PC12 and SH-SY5Y cells without having an effect on the dopamine synthesis in an individual. Clavulanic acid could be used in CNS disorders such as depression (it works with Munc18-1 and Rab4 for vesicle trafficking process, and it is blood-brain barrier permeable). A question that I have is are there ways that a person can prevent depression without reaching to anti-depressants and therapy (such as my roommate)? Or are there individuals where antidepressants are necessary? In physiological terms, is there a way a person can get these imbalanced chemicals in the brain to balance on their own?
Article found from: http://www.sciencedirect.com.dml.regis.edu/science/article/pii/S0304394011013176
This raises an interesting point. Although antidepressants do have their place and are good for some people, I believe that they are widely overused and abused today. My mother always told me that when I was feeling depressed or I got into a rut, to get up and go do something. I always thought she was crazy because that was the last thing that I wanted to do but I was amazed at how effective exercise was in bringing my spirits up and getting me back on track. The article that I posted below talks about how exercise has been investigated as a possible treatment for clinical depression. They discuss that multiple studies have found that exercise can be as effective as antidepressants in treating depression. Although these have been found to help, people are still unsure of whether or not to use this information in clinical situations. I think that this is a great alternative to the drugs but I also recognize how difficult this could be to carry out as a patient and also to enforce and monitor as a prescribing doctor. I also believe that for some people antidepressant drugs are the answer and that exercise may not be a feasible option for certain patients. Although Exercise may not be a catch all cure for depression, it is something to think about.
ReplyDeletePerraton L.G., Kumar, S.B., Machotka, Z. (2010). Exercise parameters in the treatment of clinical depression: a systematic review of randomized controlled trials. Journal of Evaluation in Clinical Practice 16:597-604. Retrieved from Academic Search Premier.
Throughout the years, there has been an association of a higher risk of suicide with those individuals who are using antidepressants. Recently, the FDA proposed making it mandatory that antidepressants must include the risk for increased suicide on there labels. Although antidepressants may work for some people, such as your roommate, I do not belive that they contribute to everyone's mental state effectively. In highschool, two of my peers were perscribed antidepressants and both ended up committing suicide a few months later. I am not holding the drugs entirely responsible for the suicide but numerous studies have shown the correlation, especially among teenagers.
ReplyDeleteIt is intersting why some individuals can benefit from taking an antidepressant but others do not. It is common to see commercials where a new drug is advertised that will make your life go back to normal but we never see any other mechanisms to treat depression being shown. Our society needs to be informed of the natural remidies an indivudual can use to treat and avoid depression, such as excercise, as Shelby mentioned above and be aware of the associated risks that antidepressants can cause.
A combined use of anti-depressants and talk-therapy as treatment for depression is something that I feel very strongly about. American society has placed a negative connotation on individuals seeking therapy, as this is often portrayed as "weakness", or admission of a personal problem that someone may be unable to fully resolve on their own, which is deemed unacceptable in today's stubborn masculine culture. However, therapists have always played a crucial role in the recovery process for multitudes of mental health disorders, relationship issues, substance-abuse recovery, and helping people cope with everyday stressors in a manner that an individual’s support network may be unable to provide.
ReplyDeleteParticularly for adolescents, diagnosis of and treatment for mental health disorders, such as depression, is essential to helping these individuals live healthy and productive lives. Inherited disorders are relatively unavoidable and medication may be the only way to restore the chemical imbalance in the brain. Although there is an increased risk of suicide in adolescents taking anti-depressant medication, it is the duty of the prescribing physician to fully explain these risks to the patient and their family, as well as offer references for therapy that aids in the transition process and helps an individual vocalize their feelings in a non-biased environment to understand and adjust to what their brains and bodies are going through.
It’s also incredibly difficult for a mentally stable individual to comprehend the emotional turmoil that someone with depression is dealing with on a daily basis. Exercise, yoga, social activities, and meditation have all been shown to reduce the symptoms of depression (Srivastava M.; Narasimhan L.), but some people (such as busy grad school students) may struggle to follow daily regimes of these activities. Everyone has different perspectives on treatment for depression, but despite your prejudice or experience, it’s important to encourage your friend or loved one to seek assistance from a physician in order to find the right treatment for them and their lifestyle to promote a better overall quality of life.
Narasimhan L, Nagarathna R, Nagendra H. "Effect of integrated yogic practices on positive and negative emotions in healthy adults." Int J Yoga. 2011 Jan;4(1): 13-9.
Srivastava M, Talukdar U, Lahan V. "Meditation for the management of adjustment disorder anxiety and depression." Complement There Clin Pract. 2011 Nov;17(4): 241-5.
We have talked about this topic in two of my classes this year; Philosophy of Mental Health and Psychopharmacology.
ReplyDeleteAs the original article says, a variety of neurotransmitters are involved with depression and the ways that it effects those with the disorder. And that is part of the problem; because depression is not caused by one neurotransmitter, we cannot pinpoint the exact cause of the disorder, physiologically at least. 5-HT (Serotonin) Norepinephrine (NE), and dopamine (DA) are the most common neurotransmitters(NTs) associated with depression, and different types of anti-depressants work on different NTs. For example, tricyclic anti-depressants work by blocking the re-uptake of NE and 5-HT in the presynaptic terminal. But, Selective Serotonin Re-Uptake Inhibitors act only on 5-HT in the brain. And Monoamine Inhibitors (MAO-I's) block the production of enzymes that break down these NTs, thus allowing more to be available. So the point here is that there are multiple ways to treat depression.
But in my opinion and experience, I think MAO-Is, along with talk therapy, is probably the most 'normal' way to treat depression. If we look at other disorders and deficiencies, we often treat them by acting on enzymes. Take lactose intolerance, for example. If the body cannot break down the lactose, we are 'low' on lactase (enzyme that breaks down). So we people can take lactase to help break down the lactose. Same kind of thing with depression; except in this case, we have too much MAO, so we inhibit the production of it. Act on the enzymes; easy?
Meyer, Jerrold S., and Linda F. Quenzer. Psychopharmacology: Drugs, the Brain, and Behavior. Sunderland, MA: Sinauer Associates, 2005. Print.