TMS THERAPY
FDA-cleared, non-medication depression treatment
Does Depression Go Away with Time?
Marris Adikwu
Medically reviewed on 12/10/2020 by
Dr. Darlene Ifill-Taylor
Charlotte Regional Medical Director
If you fell off your bike and broke your leg, what would you do? You'd go to the hospital to have an orthopedic specialist assess the injury, treat the damage, and recommend a course of recovery. What you wouldn't do is go home and wait for your leg to get better on its own. Yet when it comes to depression, many people do just that. Instead of getting the help they need, they hope depression will go away with time. It's understandable—seeking treatment for a broken leg doesn't carry the societal stigma that finding support for depression does. But depression needs to be treated as much as any other medical condition, so it's critical to take steps to find one that works for you. Here's why you shouldn't wait longer than you have to when it comes to feeling better.
Do Depressive Episodes Go Away?
When seeking treatment for depression, it's helpful to understand what a depressive episode is and how it relates to MDD. A depressive episode involves experiencing the symptoms of depression for two weeks or more. If you're going through a depressive episode, you may feel particularly unhappy, tired, or worthless. You may also lose interest in most activities and experience physical symptoms like appetite changes or sleep disruption. Depressive episodes can be caused by stressful events, psychological trauma, substance abuse, health conditions like chronic pain or thyroid disease, and several other factors.
If you're experiencing a depressive episode, it's important to talk to your doctor and work with them to rule out any underlying medical conditions. Sometimes depression symptoms can go away if underlying health conditions are treated. If you're experiencing recurrent depressive episodes and other causes have been ruled out, Major Depressive Disorder (MDD) may be diagnosed. MDD is a medical condition characterized by recurring depressive episodes with no other underlying physical cause. A depressive episode can sometimes go away on its own, but even if it does, it can take months or years to do so and may return in the future. In the meantime, you're left stuck with the symptoms. The best way to ensure that it ultimately remains gone is to make sure the root cause, whether MDD or something else, has been treated.
Why It's Important to Seek Treatment
Depression is usually a long-term condition, and it likely won't go away without proper treatment. Moreover, depression has been linked to a number of physical conditions such as heart disease, inflammation, gastrointestinal problems, sleeping difficulties, and a variety of chronic diseases. Seeking treatment to manage your symptoms can help prevent these long-term conditions from manifesting or becoming worse. Depression can also affect your work, relationships, and ability to meet personal goals, but effective treatment can help prevent these consequences. There's also the matter of recurrence to consider. When you're in remission and no longer feeling your symptoms, it can seem like the depression has gone away, but research has shown that individuals who have dealt with one depressive episode have a 50% risk of experiencing another episode, and that risk increases with each new episode. Maintenance talk therapy can be a useful tool to understand the risk of recurrence and get you into effective treatment before your symptoms become overwhelming.
Treatment Options
Treatment for depression can involve medication, talk therapy, or lifestyle changes—or in many cases, a combination of all three. However, some people's symptoms don't respond to these frontline treatments. This isn't uncommon. In fact, one in three people seeking treatment for depression do not respond well to antidepressants. If this is the case for you, you may have treatment-resistant depression. Fortunately, despite the condition's name, treatment-resistant depression is treatable. If treatments like talk therapy and medication haven't worked for you, there are other options you can explore, such as Transcranial Magnetic Stimulation (TMS). TMS is a non-invasive therapy that uses gentle electromagnetic pulses to stimulate nerve cells in the brain and improve depression symptoms. TMS has few side effects, and it's an option worth considering when other depression treatments haven't been effective. To learn more about TMS, schedule your no-cost consultation. With the right treatment and support, you can manage both the physical and mental effects of depression and work toward a symptom-free life.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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