Sometimes the Grinch visits. It might be winter, or it might be summer. It might be part of a larger picture of clinical depression, or it might be only seasonal. Having first been described in 1984, Seasonal Affective Disorder (SAD) has become a recognizable diagnosis that warrants treatment as a type of depression that displays a recurring seasonal pattern. To be diagnosed with SAD, someone must have depressive episodes during winter or summer months that meet the criteria for Major Depression for a duration of at least two years, and seasonal depressions must be more frequent than non-seasonal depressions. Major Depression may include experiencing the following symptoms for two weeks or longer: Feeling depressed nearly every day Low energy Lack of interest Feelings of hopelessness and worthlessness Sleep problems Difficulty concentration Appetite changes Agitation or sluggishness Thoughts of death or suicide
I recently sat down with a colleague and former TMS patient, Schatzie Brunner, to learn more about her new business venture, New Way Now, which is a non-profit organization centered on depression awareness, education and resources. Below are insights from my conversation with former CNN anchor, author, depression advocate and Founder of New Way Now, Schatzie Brunner:
Over the last few years, it has been harder and harder to find resources for my patients to get the help they need. Being a believer in a multimodal approach to the treatment of psychiatric struggles, I will see people for psychotherapy, medications, Transcranial Magnetic Stimulation (TMS) and until recently I would admit patients to the hospital. Also, I refer to specialists about medication issues and psychotherapeutic treatments I do not provide.
What's good for business should also be good for employees, as the majority of companies’ lifeblood depends on its workforce productivity. Recently, The American Psychiatric Association (APA) Foundation's Center for Workplace Mental Health released its Depression Calculator, a tool that estimates the cost of depression for employers as well as offers helpful resources. Individuals that struggle with depression understand the cost of their illness, but this may not be recognized in their professional settings, as many businesses need to see the dollar signs to pay attention.
In my profession, what I do throughout the day is talk with people who are struggling. The nature of the struggles varies. Some individuals are depressed about specific circumstances, situations or people. Others have perceptual difficulties that interfere with their ability to maintain a connection with reality. These struggles can manifest in degrees of challenge and severity.
Suicide is a critical issue in our society, and we continue to struggle with how to deal with it. The CDC's latest release of statistics indicated that suicide rates in 25 states experienced increases of greater than 30% from 1999 to 2016 was amplified when we found out about the recent suicides of two celebrities, Kate Spade and Anthony Bourdain. This unfortunate growing trend has prompted me to reflect on the past and my experiences with patients that have been considering suicide. Suicide is something that comes up in many contexts, most often this occurs when patients are thinking about death or the possibility of suicide, but on occasion, I see someone who is actively considering it.
May 11 - 13, 2018 marked the Clinical TMS Society Annual Meeting, where 550+ attendees from more than 30 countries came together in Brooklyn, New York to share expert insight and discuss what’s ahead for Transcranial Magnetic Stimulation, or TMS. The two-day conference showcased the practical and the potential of providing TMS as a clinical resource for patients struggling with Treatment Refractory Depression as well as considering clinical options for other disorders. Additionally, the meeting provided learning opportunities for TMS technicians, how to approach the patient when TMS does not work, MRI imaging and diagnosis, pain treatment, suicide prevention, research in areas of the world outside of the United States, starting a practice with TMS, and the role of TMS post-stroke.
For nearly 70 years, May has been recognized as Mental Health Awareness Month across the nation. With one in five people in the U.S. affected by "mental health conditions," this month-long effort centers on celebrating the improvement and recovery of people with mental illness, so it is best to understand Mental Health by the learning about Mental Illness and possible treatments. When I was in medical school and residency, we learned about the history of psychiatry including the role of Schneider, Bleuler and Kraepelin in connecting symptoms to diagnoses, as well as Freud’s work to understand why clinical symptoms occurred. These pioneering efforts all contributed to making sense of clinical experiences and to organize our thoughts about symptoms clusters, all with the absence of our current brain imaging technology.
For a long time, it has been widely known that clinical depression is a complex mental illness. Depression interferes with the ability to live and engage in life. It can be challenging to struggle with a depressed mood that does not respond to treatments. And some depression is not effectively treated despite several medications and psychotherapy attempts.
Recently, I came across an interesting depression treatment paper published in Brain Stimulation that I wanted to review titled, Simultaneous rTMS and psychotherapy in major depressive disorder: Clinical outcomes and predictors from a large naturalistic study. The purpose of this research was to see what happened with a group of people with Major Depressive Disorder who were treated with transcranial magnetic stimulation (TMS) and psychotherapy.