When a person becomes seriously depressed, the right diagnosis, rapid treatment and followup are critical to a successful recovery and return to work. Yet the stigma around mental illness and limited access to psychiatrists and psychologists can make it difficult to receive proper care.
Dr. Diane McIntosh, a psychiatrist and clinical assistant professor at the University of British Columbia, spoke at the Mental Health Summit in Vancouver on Dec. 5 about why early treatment and full functional recovery should be the goal for every person suffering from major depressive disorder.
“We now know that depression is an inflammatory brain illness that can be wrapped together with other medical illnesses, such as metabolic syndrome and cardiovascular disease,” she said. “Depression doesn’t start as an inflammatory illness, but each subsequent episode of depression can provoke an inflammatory cascade. So we need to treat depression fully and with a sense of urgency.”
While depression can often involve a depressed mood or loss of pleasure, it doesn’t just affect mood, said McIntosh. “It also affects your physical experience in life. About 70 to 80 per cent of people with depression have physical symptoms, such as pain,” she said.
As well, most people with depression also experience anxiety. “Anxiety symptoms are different than an anxiety disorder, such as post-traumatic stress disorder, obsessive compulsive disorder, panic disorder or generalized anxiety disorder, which are standalone anxiety disorders that can also co-occur with depression,” said McIntosh, noting it’s important to identify and treat anxiety because it increases the risk of suicide.
A range of treatments, including exercise, cognitive behavioural therapy, electroshock therapy and medication can help grow new brain cells and alleviate symptoms of depression. “Sometimes, patients are too ill to benefit from [cognitive behavioural therapy], so medication may be needed first to improve their symptoms, allowing them to fully engage with other therapies,” said McIntosh.
“Stigma, too, remains a huge barrier, even within the medical community,” said McIntosh, who spends a lot of time urging her colleagues to make the right diagnosis, provide the optimal treatment choices and use all of the opportunities available to get people well and back at work. “We need to do more to teach managers to identify depression and implement graduated return to work that accommodates individual needs.
“And we should celebrate survivors of mental illness. A collaborative, rather than an adversarial, experience will be more successful helping people get back to work, back to life and back to love.”
Read more stories from the Mental Health Summit