A call for urgency in treating mental disorders

Clinical depression is much more than a persistent feeling of sadness. It’s a debilitating disease that keeps half a million Canadians away from work in any given week, according to the Centre for Addiction and Mental Health.

Just like diabetes, hypertension and rheumatoid arthritis, severe depression can progress into a progressive inflammatory disease. As a result, it’s an urgent concern, according to Dr. Diane McIntosh, clinical assistant professor at the University of British Columbia. She was speaking at Benefits Canada’s 2017 Mental Health Summit in Toronto on Nov. 7.

Read: How to bridge the insurer, physician divide in disability management

In fact, depression frequently coincides with other physical diseases, she noted. Cardiologists, she added, are now beginning to treat depression because they recognize the mind-body connection. “If you have a heart attack and you’re depressed, the risk of dying from that heart attack is five to eight times greater.”

While family physicians unflinchingly treat hypertension or diabetes with a combination of three to four drugs, McIntosh noted that when it comes to managing depression, there’s some hesitation around trying out the various options.

“I use every drug I can get my hands on ― whatever my patients need to get better,” she said.

“And my most important purpose as a practitioner now is to teach my family practice colleagues to be confident, rational prescribers as well.”

When prescribing medication, McIntosh said she’s mindful that depression, as an illness that results from a variety of factors, looks different for different people. It also triggers equally diverse symptoms, including emotional, physical and cognitive issues. “All drugs are not the same because my patients are not the same. Everyone has a unique brain. I try to find the right drug or combination for their brains,” said McIntosh.

Read: The role of technology in improving access to timely care

Her enthusiasm for medication notwithstanding, McIntosh said she has equal faith in alternative treatments. Just like antidepressants, psychotherapy, exercise and meditation all help in growing new brain cells, she said. All three treatments also affect the brain differently and, when tried together, can pack a powerful punch. Neuroplasticity, or the constant wiring and rewiring of the brain when learning something new, is another potent antidote for depression, she noted. McIntosh also called electroconvulsive therapy the gold standard in the treatment of severe depression.

In the end, she reiterated that the only way to treat mental disorders is to deal with them fully, completely and with a sense of urgency. “We need a long-term plan to treat and manage every symptom thoroughly. That’s because residual symptoms, such as fatigue, insomnia and cognitive incapacity, have a more powerful impact than anything else on provoking a resurgence of depressive symptoms.”

And more than anything, she added, society needs to change the way it looks at the illness in the workplace. “We don’t celebrate survivors of depression, for example, like we would the survivors of cancer. For people with mental disorders to be fully reintegrated back into work, we need to remove the stigma surrounding this illness.”

Read more stories from the 2017 Mental Health Summit