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Expert Q&A: Depression

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Everyone experiences a range of emotions over the course of days and weeks, typically varying based on events and circumstances. When disappointed, we usually feel sad. When we suffer a loss, we grieve. Normally these feelings ebb and flow. By contrast, depression tends to feel heavy and constant. People who are depressed are less likely to be cheered, comforted or consoled. 

The term “high-functioning depression” underscores the reality that many individuals with depression face – going through the motions of their day to day lives, appearing normal on the surface, while silently struggling with symptoms of depression. However, it is critical to note that though this term has gained prominence on various social media platforms and may be helping to lessen the stigma of depression, it is not a specific medical diagnosis.

Among people who are treated for major depressive disorder and recover, at least half are likely to experience a recurrent episode sometime in their future.It is difficult to determine at what point this may occur or what circumstances, if any, may trdigger it. If a person experiences several episodes of major depression, a psychiatrist or other mental health professional may suggest long-term treatment.

A wide variety of treatments have been proven effective in treating depression. Some involve talking and behavioral change. Others involve taking medications. There are also techniques that focus on neuromodulation, which incorporates electrical, magnetic or other forms of energy to stimulate brain pathways. Examples of neuromodulation include electroconvulsive therapy (ECT), vagus-nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and deep-brain stimulation (DBS).

The choice of therapy should be guided by the nature and severity of depression, past responses to treatment, and the preferences of the individual in treatment. 

Total openness is important. You should talk to your healthcare professional about all of your symptoms, important milestones in your life and any history of abuse or trauma. Also tell your them about past history of depression or other emotional symptoms in yourself or family members, medical history, medications you are taking — prescribed or over-the-counter. It is also key to share how depression has affected your daily life and whether you have ever thought about suicide.

It is important to see a healthcare professional as soon as you notice significant changes in your mood, difficulties in your work/school or home life, or if those close to you have commented about any concerning changes in your mood, personality and/or behavior. More serious symptoms, such as suicidal thinking, require immediate attention.


Virtually all medicines can cause side effects. Typically, unwanted effects increase when the dose of medicatdion increases. Side effects usually vary from one drug to another and are especially variable between different medication classes.Some common side effects of antidepresssants and other psychiatric medicadtion include dry mouth, stomach upset, weight gain, sedation and/or sexual dysfunction. 

If you have previously taken an antidepressant and done well or poorly or had bothersome side effects, be sure to tell the doctor what happened. If you have never taken an antidepressant, your healthcare professional should review possible side effects with you.


In the U.S. health care system, the cost of treatment is a major consideration for most people. At the same time, untreated depression can be costly itself as it can compromise a person’s ability to work or attent to other responsibilities. Speak to your health insurance company to learn about your benefits and co-pays. Insurers mayonly cover specific psychotherapists "in network" and may limit the number of sessions. 

The cost of treatment can also vary by the type. For instance, neuromodulation treatment can be expensive, and insurance coverage varies widely. In the case of medications, asking for generic antidepressants in place of brand-name medications can offset the cost. Again, it is key to discuss these issues with your medical professional to ensure you can access the best treatment possible to meet your mental health needs.


Content Author

Chinenye Onyemaechi, M.D.


Medical leadership for mind, brain and body.

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