Depression: multidisciplinary approach and innovative solutions

“I’ve been taking treatment for 5 years and if I stop it comes back. The doctor told me there are patients who take it for life.” , “For me it came on after I had my second child and I don’t have anyone in the family.”, “No medicine helps me, they make me worse.”

These are just a few of the thoughts people have shared with us online on social media over the past month. So, based on these concerns of yours, we thought we would write a useful article starting from the triggers (internal and external) of depression, the factors that can maintain and perpetuate depressive symptoms, clear treatment solutions – besides medication, which is just a small step in the whole healing process.

Depression does not have a single cause, but is the result of a complex interaction between external and internal factors. Understanding these influences and addressing them in an integrated way is key to treating depression. A holistic treatment plan, which includes both psychological therapy and the management of environmental and medical factors, can bring relief and support to those affected by this difficult but common mental disorder.
In today’s society many people struggle with depression, going through numerous treatments and therapies without seeing significant improvement. In this article, we explore various aspects of depression, highlighting the organic and emotional factors that can influence this complex condition. Moreover, we will discuss innovative treatment options for those for whom traditional drug treatment has not brought relief.

WHY AM I DEPRESSED?

External factors in triggering depression

1. Stress and social pressure

Chronic stress and social pressure can be major triggers of depression. Conditions such as the workplace, interpersonal relationships or traumatic events can put considerable pressure on mental health.

2. Traumatic events

Trauma in childhood or adult life, such as the loss of a loved one or traumatic experiences in relationships, such as physical abuse or cheating, can contribute to the development of depression.

3. Environment

The quality of the environment, including access to green spaces and natural light, can affect emotional well-being. A polluted environment or lack of contact with nature can contribute to depression.

4. Social isolation

Lack of a strong social network and social isolation can increase the risk of depression. Human interaction and social support play a key role in maintaining mental health. Difficult social relationships, social isolation and lack of support from friends and family can contribute to the development of depression.

5. Nutritional deficiencies

Depression is not just an emotional problem, but also the result of a complex combination of factors. These include nutritional deficiencies such as vitamin D deficiency, which has been associated with impaired well-being. It is important to investigate and address these organic issues to complete the treatment of depression. There is research suggesting that dopamine may also be produced in the gastrointestinal tract, including the gut. Although dopamine production in the gut is lower than in the brain, there are certain cells in the gut lining that are able to synthesise and release dopamine. The exact role of dopamine in the gut is not yet fully elucidated, but it is thought that it may be involved in regulating bowel movement, water and electrolyte secretion, and other digestive functions. Dopamine can also influence interactions between the brain and the gastrointestinal tract via the enteric nervous system, which is a complex network of neurons in the gut wall.

6. Changes in family life

New parenting, changes in the couple relationship and changes in family dynamics can contribute to the stress and pressure that lead to postpartum depression.

7. Major life changes

Events such as divorce, losing a job, moving to another place or losing a loved one can be triggers for depression.

8. Toxic substances

Abuse of substances such as alcohol or drugs can affect the chemical balance in the brain and contribute to depression.

9. Sleep problems

Insomnia or severe sleep disturbances can contribute to the onset or exacerbation of depressive symptoms.

10. Cultural and social environment

Cultural and social norms, as well as the stigma associated with mental health problems, can influence how people view and manage depression.

WHY AM I DEPRESSED?

Internal factors in triggering depression

1. Genetic predisposition

Studies suggest that genetic predispositions may contribute to a person’s vulnerability to depression. Family history can play an important role in understanding individual risk. For example, women who have had previous episodes of depression or other mental disorders may be more prone to postpartum depression.

2. Brain chemical imbalances

Imbalances in brain chemicals (such as serotonin, dopamine and norepinephrine) can contribute to the onset and maintenance of depression. These imbalances can have both genetic causes and environmental factors.

3. Concomitant medical conditions/comorbidities

Certain medical conditions, such as chronic illnesses or hormonal disorders, can be associated with depression. Investigating and managing these medical problems is essential for effective treatment of depression by removing the source that caused the condition.

4. Hormonal problems

Women going through menopause may experience significant hormonal fluctuations, such as decreased estrogen levels, which can contribute to symptoms of depression such as mood swings and fatigue. Another example is the significant hormonal changes that occur in a woman’s body after childbirth, which can contribute to emotional instability and play a role in the development of postpartum depression.

5. Personality

Certain personality traits, such as pessimism or excessive self-criticism, can contribute to a person’s vulnerability to depression. People who tend to be excessively critical of their own actions or who have unrealistic standards for themselves may be prone to depression.

Conclusions:

👉 Depression has no single cause, but is the result of a complex interaction between external and internal factors. Understanding these influences and addressing them in an integrated way is key to treating depression. 👉 Emotional issues also play a significant role in the onset and maintenance of depression. 👉 A comprehensive treatment plan that includes both psychological therapyand management of environmental and medical factors, can bring relief and support to those affected by this difficult mental disorder.

SOLUTIONS – complex approach to treating depression

👉What can you do alone to beat depression?

1. Lifestyle management

It refers to maintaining a regular sleep schedule, eating a balanced diet and avoiding toxic substances such as alcohol and drugs. All of these can help relieve depressive symptoms.

2. Get moving! Get moving! And again… movement!

Regular exercise can help release endorphins and improve mood. Recreational activities such as yoga or meditation can also have benefits.

3. Enjoy social support

Community involvement, talking to friends or family and attending support groups can provide emotional and practical support in managing depression.

SOLUTIONS – complex approach to treating depression

👉WHAT SOLUTIONS does SPECIALIST HELP offer for depression?

1. Psychotherapy

Psychological therapy and counselling are essential tools in managing stress, anxiety and other emotional problems that can contribute to the onset or exacerbation of depression. The emotional approach to depression complements holistic treatment, addressing the psychological roots of the condition.
👉 Cognitive Behavioral Therapy (CBT): helps patients recognize and change negative thought patterns and behaviors that contribute to depression.

👉 Interpersonal Therapy (IT): focuses on improving interpersonal relationships and addressing interpersonal issues that may contribute to depression.

👉 Psychodynamic therapy: explores past influences and interpersonal relationships to understand and treat depression.

2. Drug treatment

👉 Antidepressants: Medications such as serotonin reuptake inhibitors and norepinephrine reuptake inhibitors may be prescribed to correct chemical imbalances in the brain. These drugs can only be prescribed following a psychiatric consultation, where the doctor chooses the appropriate drug and dose and monitors the progress of the patient’s health under the influence of the treatment.

It is very important to note that – given that psychiatric medication acts on the chemical balance of the brain – changing doses, stopping treatment, changing medication can only be done safely with the consent of the treating physician. It is therefore essential that during the period of psychiatric medication, regular check-ups are carried out.

3. Innovative treatments

With state-of-the-art technologyinnovative treatment options for depression have been brought to the medical world that offer an extra chance when drug treatment fails or is slow to work. Genetic testing thus provides a personalised insight into how each individual’s body reacts to certain drugs, allowing the treating physician to accurately adjust psychiatric treatment. In addition, innovative treatments such as Transcranial Magnetic Stimulation (TMS) and other advanced approaches are opening new horizons in treating depression, offering fresh perspectives for those in need of alternative solutions.

Genetic testing

Genetic analysis accurately identifies each individual’s response to certain drugs, thus shortening antidepressant treatment by finding the right drug and dose immediately.

Transcranial magnetic stimulation (TMS)

A therapy in which an electromagnet device (medical device) is used to stimulate certain parts of the brain. This therapy is particularly addressed in cases of treatment-resistant depression.

Transcranial Electrical Stimulation (tDCS)

This method involves the use of an electronic device (medical device) that works by applying a weak electrical current to the scalp to stimulate the brain regions associated with depression.

Neurofeedback

Technique in which patients learn to regulate their brain activity in real time using biofeedback signals. It is being investigated for use in depression to improve emotional regulation.

Conclusions

Effective treatment involves a multidisciplinary approach, integrating psychological therapy, medication and, in some cases, innovative alternative therapies. Your psychiatrist can therefore provide you with a recommendation for psychotherapy and/or one or more innovative therapies in the treatment of depression. At the same time, if your journey in diagnosing depression began with a psychologist, he or she may refer you to a psychiatrist.

Understanding the complex interplay of factors that contribute to depression and adopting a personalised treatment plan are key to providing appropriate support and finding the simplest and quickest path to a healthy life.

Bibliography:

  1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  2. National Institute of Mental Health. (2021). Depression. Retrieved from https://www.nimh.nih.gov/health/topics/depression/index.shtml .
  3. World Health Organization. (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf
  4. Mayo Clinic Staff. (2021). Depression (major depressive disorder). Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
  5. National Institute for Health and Care Excellence (NICE). (2009). Depression: The Treatment and Management of Depression in Adults (Updated edition). Retrieved from https://www.nice.org.uk/guidance/cg90
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