Major Depressive Disorder
Esther Bistricer
December 2020
Depression, a disorder affecting millions of people worldwide, lowers an individual’s physical and mental health. It is responsible for high mortality rates in many age groups, as it instills in individuals an overwhelming feeling of hopelessness and worthlessness. This is even more prevalent now during the COVID-19 pandemic and the current political climate in which many people from around the world are facing major lifestyle changes.
The spread of the coronavirus has made people unaware of the future, which can cause apprehension and discomfort, among other negative feelings. According to Hartford Healthcare, statistics from the Census Bureau tell us that 24 percent of 42,000 respondents reported significant symptoms of major depressive disorder, and 30 percent of people reported symptoms of generalized anxiety disorder. This was in some cases double the prevalence rate from 2014. Yet another research conducted showed that a very high percentage (42%) of young people, ages 18 to 29, reported anxiety, with 36 percent reporting depression. The second most-affected age group was people from ages 30 to 39, with 34 percent reporting anxiety and 28 percent depression.
Interestingly, the size of the amygdala, a part of the brain associated with processing emotion, can predict the degree of anxiety children are experiencing in their day-to-day lives. Prolonged periods of stress and anxiety during childhood, which can cause changes to the amygdala, are shown to heighten the risk of depression and anxiety later in life.
Spending more time in nature, however, has been shown to play a role in helping people manage symptoms of depression. Other things that can also improve an individual’s mental well-being include spending time with friends and family, doing yoga, participating in hobbies, and taking time to be physically active. Long-term exercise activates and maintains the neuroendocrine axis, which contributes to cortisol level balance and increases beta endorphin levels, the neurotransmitters in our brain that reduce our perception of pain and help us cope with stress.
For decades, the recurrence and high frequency of errors in the prescription of treatments for clinical depression have affected a wide range of individuals, including trials
conducted over time on pediatric patients, adolescents, and adults. Even with the integration of conventional treatment methods, including medication, psychotherapy and counseling from psychiatrists, and the possibilities of a combination treatment, the treatment efficacy for clinical depression remains largely variable and dependent on the individual’s circumstances. Treatments are ultimately distinguished by the severity of the patient’s clinical depression, in which the administration and dispensing of medication should be controlled meticulously.
Another factor affecting treatment outcomes also involves healthcare disparities and differences in access to care. One study conducted in 2004 tried to understand if disparities in treatment were due to differences in access to treatment or the treatment quality after initiation. Overall, this study provided strong evidence that “ethnic disparities in depression treatment result primarily from the reduced likelihood of receiving any treatment. Thus, initiating depression treatment may be the primary hurdle in overcoming disparities in depression care” (Harman, 2004). This tells us that there are still many challenges to delivering quality, effective, equitable care for the treatment of clinical depression.
It is evident that a lot of research still needs to be done to inform better treatment options for the alleviation of, sometimes debilitating, mental and physical symptoms associated with depression. Depression affects hundreds of millions of people, and it’s imperative to tackle it by supporting loved ones that may be experiencing depression and also by conducting new research to improve treatment options and make them more accessible for everyone.
Works Cited
Blackburn, T. P(2019). Depressive disorders: Treatment failures and poor prognosis over the last 50 years. Pharmacology Research \u0026 Perspectives, 7(3), e00472. https://doi.org/10.1002/prp2.472
Harman, J. S., Edlund, M. J., \u0026 Fortney, J. C(2004). Disparities in the Adequacy of Depression Treatment in the United States. Psychiatric Services, 55(12), 1379–1385. https://doi.org/10.1176/appi.ps.55.12.1379 Jha, M., \u0026 Trivedi, M(2018).
Pérez-Stable, E. J., Miranda, J., Muñoz, R. F., \u0026 Ying, Y. W(1990). Depression in medical outpatients. Underrecognition and misdiagnosis. Archives of Internal Medicine, 150(5), 1083–1088. https://doi.org/10.1001/archinte.1990.00390170113024
Jacka, F. N., & Berk, M(2013, October 29). Depression, diet and exercise. The Medical Journal of Australia. https://www.mja.com.au/journal/2013/199/6/depression-diet-and-exercise.
On Oliver Sacks
By Ishmam Khan
Published December 2020
Oliver Sacks (1933-2015) was a famous physician, professor, and author. Throughout his lifetime, Sacks wrote an assortment of wonderfully crafted stories detailing how brain lesions may result in a loss of self in some patients, either physically or mentally. However, he also documents the miraculous ways in which these patients choose to compensate for that loss in order to gain some sense of normalcy and control back. His optimistic style emphasizes seizing the day and not letting the worst parts of yourself take away from the great things that you could be doing. This is especially the case for Sacks himself, as he suffered from prosopagnosia, or face-blindness, where he could see things clearly but remained unable to recognize people, including himself. He lived in a constant uncertainty that sounds like a curse a witch would cast upon a princess for being too innocent. This disagreement between sensation and perception is one we live with constantly everyday, and it often discourages us from our potential. After all, if we can't trust what we can't see, how can we really believe it?
However, Sacks inspired everyone by implementing the lessons he chose to spread in his everyday life. Despite his challenges, he lived by example and found a way to do something similar to his patients: use his failures/challenges to embrace life in its entirety. It's this optimism that inspires me to think ahead of my own failure and not become a slave to my environment. Similarly, we can all take away from this example. In this highly uncertain climate where many hurtful things are bound to happen, it's up to us to push forward knowing we can make things better for ourselves and live life in the most hopeful of manners. I highly encourage reading "The Mind's Eye" or really any one of Sacks' books, since he is an influential neurologist after all. However, you don't have to know that because it's important to feel inspired and invigorated since there's always a way to change negative situations into positive ones that ultimately benefit yourself in the process.
Esther Bistricer
December 2020
Depression, a disorder affecting millions of people worldwide, lowers an individual’s physical and mental health. It is responsible for high mortality rates in many age groups, as it instills in individuals an overwhelming feeling of hopelessness and worthlessness. This is even more prevalent now during the COVID-19 pandemic and the current political climate in which many people from around the world are facing major lifestyle changes.
The spread of the coronavirus has made people unaware of the future, which can cause apprehension and discomfort, among other negative feelings. According to Hartford Healthcare, statistics from the Census Bureau tell us that 24 percent of 42,000 respondents reported significant symptoms of major depressive disorder, and 30 percent of people reported symptoms of generalized anxiety disorder. This was in some cases double the prevalence rate from 2014. Yet another research conducted showed that a very high percentage (42%) of young people, ages 18 to 29, reported anxiety, with 36 percent reporting depression. The second most-affected age group was people from ages 30 to 39, with 34 percent reporting anxiety and 28 percent depression.
Interestingly, the size of the amygdala, a part of the brain associated with processing emotion, can predict the degree of anxiety children are experiencing in their day-to-day lives. Prolonged periods of stress and anxiety during childhood, which can cause changes to the amygdala, are shown to heighten the risk of depression and anxiety later in life.
Spending more time in nature, however, has been shown to play a role in helping people manage symptoms of depression. Other things that can also improve an individual’s mental well-being include spending time with friends and family, doing yoga, participating in hobbies, and taking time to be physically active. Long-term exercise activates and maintains the neuroendocrine axis, which contributes to cortisol level balance and increases beta endorphin levels, the neurotransmitters in our brain that reduce our perception of pain and help us cope with stress.
For decades, the recurrence and high frequency of errors in the prescription of treatments for clinical depression have affected a wide range of individuals, including trials
conducted over time on pediatric patients, adolescents, and adults. Even with the integration of conventional treatment methods, including medication, psychotherapy and counseling from psychiatrists, and the possibilities of a combination treatment, the treatment efficacy for clinical depression remains largely variable and dependent on the individual’s circumstances. Treatments are ultimately distinguished by the severity of the patient’s clinical depression, in which the administration and dispensing of medication should be controlled meticulously.
Another factor affecting treatment outcomes also involves healthcare disparities and differences in access to care. One study conducted in 2004 tried to understand if disparities in treatment were due to differences in access to treatment or the treatment quality after initiation. Overall, this study provided strong evidence that “ethnic disparities in depression treatment result primarily from the reduced likelihood of receiving any treatment. Thus, initiating depression treatment may be the primary hurdle in overcoming disparities in depression care” (Harman, 2004). This tells us that there are still many challenges to delivering quality, effective, equitable care for the treatment of clinical depression.
It is evident that a lot of research still needs to be done to inform better treatment options for the alleviation of, sometimes debilitating, mental and physical symptoms associated with depression. Depression affects hundreds of millions of people, and it’s imperative to tackle it by supporting loved ones that may be experiencing depression and also by conducting new research to improve treatment options and make them more accessible for everyone.
Works Cited
Blackburn, T. P(2019). Depressive disorders: Treatment failures and poor prognosis over the last 50 years. Pharmacology Research \u0026 Perspectives, 7(3), e00472. https://doi.org/10.1002/prp2.472
Harman, J. S., Edlund, M. J., \u0026 Fortney, J. C(2004). Disparities in the Adequacy of Depression Treatment in the United States. Psychiatric Services, 55(12), 1379–1385. https://doi.org/10.1176/appi.ps.55.12.1379 Jha, M., \u0026 Trivedi, M(2018).
Pérez-Stable, E. J., Miranda, J., Muñoz, R. F., \u0026 Ying, Y. W(1990). Depression in medical outpatients. Underrecognition and misdiagnosis. Archives of Internal Medicine, 150(5), 1083–1088. https://doi.org/10.1001/archinte.1990.00390170113024
Jacka, F. N., & Berk, M(2013, October 29). Depression, diet and exercise. The Medical Journal of Australia. https://www.mja.com.au/journal/2013/199/6/depression-diet-and-exercise.
On Oliver Sacks
By Ishmam Khan
Published December 2020
Oliver Sacks (1933-2015) was a famous physician, professor, and author. Throughout his lifetime, Sacks wrote an assortment of wonderfully crafted stories detailing how brain lesions may result in a loss of self in some patients, either physically or mentally. However, he also documents the miraculous ways in which these patients choose to compensate for that loss in order to gain some sense of normalcy and control back. His optimistic style emphasizes seizing the day and not letting the worst parts of yourself take away from the great things that you could be doing. This is especially the case for Sacks himself, as he suffered from prosopagnosia, or face-blindness, where he could see things clearly but remained unable to recognize people, including himself. He lived in a constant uncertainty that sounds like a curse a witch would cast upon a princess for being too innocent. This disagreement between sensation and perception is one we live with constantly everyday, and it often discourages us from our potential. After all, if we can't trust what we can't see, how can we really believe it?
However, Sacks inspired everyone by implementing the lessons he chose to spread in his everyday life. Despite his challenges, he lived by example and found a way to do something similar to his patients: use his failures/challenges to embrace life in its entirety. It's this optimism that inspires me to think ahead of my own failure and not become a slave to my environment. Similarly, we can all take away from this example. In this highly uncertain climate where many hurtful things are bound to happen, it's up to us to push forward knowing we can make things better for ourselves and live life in the most hopeful of manners. I highly encourage reading "The Mind's Eye" or really any one of Sacks' books, since he is an influential neurologist after all. However, you don't have to know that because it's important to feel inspired and invigorated since there's always a way to change negative situations into positive ones that ultimately benefit yourself in the process.
