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Despite greater awareness of the disorder, depression continues to be a major health burden for patients and their families. According to the World Health Organization (WHO), Major Depressive Disorder (MDD) is the #1 contributor to disability in the world. In the US alone up to 10% of the population suffers from mild to moderate depression.
One of the challenges of treating MDD is that every person’s depression may be different and thereby require individualized treatment.
For instance, some persons are unable to sleep, while others sleep too much. Some patients have no appetite and must force themselves to eat; others overeat (especially carbohydrates) and gain weight. Some depressed people are restless, agitated, and unable to sit still, while others experience diminished movement and activity (“leaden paralysis”).
Based on clinical variation alone, there are over 227 possible combinations of symptoms leading to the diagnosis of Major Depression.
No wonder the one-size-fits-all shotgun approach to the antidepressant treatment of depression fails more often than it succeeds. Take for example the graphic below which shows the responses of 20 different depressed individuals to the same antidepressant.
Similarly, the recent Sequenced Treatment alternatives to Relieve Depression (STAR*D) trial showed that even with systematic measurement-based treatment, only about one third of patients reached pre-defined remission. Moreover, two-thirds of patients in that study remained symptomatic, incurring a greater risk of relapse and functional impairment (Trivedi MH and Daly EJ. Dialogues in clinical Neuroscience. 2008. 10(4):377-84.)
These varied clinical presentations and the erratic responses to antidepressant medications highlight the genetic and biological diversity of depression. That is why in evaluating and treating depression we go beyond mere symptoms and try to elucidate your unique biochemical imbalances. Of course the only way to know for sure is to measure them.
Addressing your specific psycho-neuro-immunological (PNI) imbalances is a highly effective way to personalize treatment whether you need medication, lifestyle intervention, nutritional supplements, medical foods, or some combination of all of these treatment modalities. Please see our webpage on depression for further details.
Testing neurotransmitters, adrenal function, hormones, immunity, and growth factors provides a comprehensive and foundational assessment of your particular type of depression. Only in this way are you likely ever to improve the current one in three odds of remission now facing those who suffer from depression.
Dr. David Scheiderer MD, MBA, DFAPA, is the Chief Medical Officer and Director of Education for Integrative Psychiatry, Inc.
An accomplished clinician, educator, and lecturer, Dr. Dave has established himself as a key opinion leader in the fields of both mainstream psychiatry and functional medicine. Dissatisfied with the patient outcomes using only conventional treatments, he began treating his patients by addressing biological imbalances with lifestyle improvements, nutrition and nutraceuticals to get better outcomes. His integrative approach provided much improved results. Dr. Dave is passionate about helping the community he serves by personalizing treatments and educating the public about mental health and healthy aging. He has formulated several of our supplements and sat on the advisory board for many others, ensuring the products we carry are based on science and experience and have the best efficacy rates and highest ingredient quality available.
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