LIFE IN RECOVERY
Clinical depression, also referred to as Major Depressive Disorder (MDD), involves a collection of possible symptoms including sleep disruption, excessive sadness, fatigue, or concentration issues. Some people experience thoughts of suicide, weight or appetite changes. What makes MDD a clinical condition is the presence of dysfunction. This dysfunction can be in the area of workplace issues, social activity or other parts of life.
Anyone who has experienced symptoms of depression knows that there can be a range of symptoms. Some people have very severe depression which essentially takes them out of their life until healing. Some are able to continue to work or function at a moderate level despite feelings of sadness, irritability or detachment. As clinicians, we do our best to stratify clinical depression into degrees of severity – mild, moderate and severe.
One of the questions we often encounter at CeDAR involves those with mild depressive symptoms: Will I need to take medication or can I get away without meds? This question is very valid, as medication approaches sometimes lead to potential side effects. If someone were to take medication, they would want the potential benefit of the med to outweigh the potential risks. To look deeper into this question, some medical literature can be helpful.
An analysis of six research studies from the New York State Psychiatric Institute showed that patients with mild depression overall tend to benefit from antidepressant medication. Published in 2011, this review article looked at subjects with depression rating scores less than the severe range and conducted a data summary. They wrote that the number needed to treat (NNT) for people with non-severe major depressive disorder was between 3 and 8. This means that if we offer medication to a group of people at CeDAR, up to a third of those are likely to receive significant benefit.
Aside from the analysis of benefit versus side effects, some people feel awkward, ashamed or self-critical about the prospect of taking a medication. This can come from numerous issues, including family culture around medication, views of one’s identity or for no great reason at all. It is important to have good discussions with your provider around these issues. Taking a medication for depression is a big deal and carries with it many things to talk about. The choice is ultimately voluntary and can be a good opportunity for reflection around such issues as health, vulnerability, and self-concept.
The treatment approach through CeDAR involves multiple layers. These include medication options, family support, individual and group counseling, and exercise and physiologic healing. Many people find healing from a few different avenues and it is important to explore these avenues available to you. Clinical research, such as the review study mentioned above, also helps us make effective treatment decisions with the best information available.
If you or a family member are struggling with depression, it can be worthwhile to have a very detailed discussion with your treatment provider. This helps you walk through which decision is ideal for you. Should you take an antidepressant medication or not? Using clinical research and thoughtfulness, we can help each patient come to sensible decisions around their healthcare needs.