Putting a face to the name: Depression

Has a depression skeptic ever told you that it’s all in your head? Well, as a matter of fact, it is.

Depression is a brain disease that takes a colorful world and paints it in shades of gray. The persistent sadness and lack of interest that characterizes major depressive disorder can lead to a variety of symptoms and outward manifestations, including trouble sleeping, loss of interest in favorite activities, changes in appetite and touchiness.

On its own, each single symptom of depression could simply be caused by a bad day or a disappointment. Together, however, the amalgamation of symptoms is crippling, life-interrupting and potentially fatal. This misunderstanding between depressed and non-depressed persons has led to the adjective “depressed” being thrown around as a synonym for sadness, degrading public understanding of the severity of the condition.

Nonetheless, clinical depression shows up on a positron emission tomography, or PET scan, morphing the brain scan results from spots of bright yellow lighting up with brain activity to a quiet, blue sea, representing a brain with diminished activity.

According to Uma Suryadevara, MD, a UF Health psychiatrist, the difference between clinical depression and sadness comes down to its disruptive effect.

“The main difference between depression and sadness is the dysfunction that depression causes,” Suryadevara said. “If the sadness is interrupting the life, that’s the sign that it’s clinical depression. It’s not just sadness anymore.”

This small differentiation is the reason it’s so important to pay attention to your body and mental health, as well as that of those around you, to ensure you’re not ignoring the signs of a major mental illness with the potential to spiral quickly out of control.

Every person with major depressive disorder is different. Still, certain methods of coping with the illness are considered somewhat universal. For example, it is important for those with depression to stay involved with the lives of others. This allows them to have a support group of people who make them feel safe and cared for.

However, it also might be difficult for the average person with depression to reach out to those who could be there to support them, as they often feel that people may not be interested in spending time with them at all. This is a depressive symptom in which everyday situations turn into “impossible tasks.” For this reason, if you know someone with depression, it is equally important for you to reach out to them to demonstrate your support and interest in helping them, even if they decline your help.

“There are times when someone is depressed and they won’t feel like doing anything,” Suryadevara said. “The caregiver will not understand unless they know what the person feels like. Sometimes what happens when they’re depressed and someone reaches out to help them, the depressed person may be resistant to change, and the other person may feel pushed away or rejected.”

Other coping mechanisms, like doing enjoyable things, exercising or eating a healthy diet, may be additionally helpful in improving mood and outlook for depressed persons. Nonetheless, many times these at-home methods are simply not enough, and that’s where UF Health comes in.

UF Health psychiatrists can provide counseling services and evaluate patient need for prescription medication. They can also recommend patients for an innovative, noninvasive procedure that uses magnets to improve depression symptoms.

This procedure, called transcranial magnetic stimulation, or TMS, uses magnetic fields to stimulate nerve cells in the brain. It takes less than an hour and is conducted in a doctor’s office five days a week for approximately four to six weeks, depending on the patient’s condition. During the treatment, a patient has a device containing magnets placed on his or her head. While the patient relaxes comfortably in a chair, the device releases more than 3,000 magnetic pulses into his or her brain.

The patient is awake and alert throughout the procedure and may hear a clicking sound or feel a tapping sensation but will feel no pain.

TMS is just as effective as many drug therapy programs, is covered by some insurance plans and has none of the nasty side effects of prescription drugs. Patients can return to their normal activities immediately after the procedure.

This procedure, coupled with appropriate counseling or medicinal therapies, can help patients overcome a battle for control of their own minds. Still, Suryadevara said, many times the greatest fighter of depressive symptoms could simply be a helpful hand and a watchful eye.

“Reach out to your loved ones, and make sure they understand that you are always there for them,” Suryadevara said. “Watch behavioral changes. If the person is the kind of person who likes to watch movies or something and they’re not doing that, being a little forceful and changing the behavior itself can change the way the depression reacts to it.”