What is depression?

Depression, also known as Major Depressive Disorder, is a mental health disorder characterized by persistent sadness, hopelessness, and a lack of interest or pleasure in daily activities. It can significantly impact a person’s thoughts, feelings, and behavior, leading to emotional and physical problems. Depression can make it difficult for individuals to function at work, school, and relationships.

 

How common is depression?

Depression is a widespread mental health issue that affects millions of people globally. According to the World Health Organization (WHO), over 264 million people suffer from depression, making it the leading cause of disability worldwide. It is important to note that depression affects people of all ages, genders, and backgrounds, although certain factors may increase an individual’s risk of developing the disorder.

 

What are the symptoms of depression?

The symptoms of depression can vary from person to person, but some common signs include the following:

  1. Persistent feelings of sadness, hopelessness, or emptiness
  2. Loss of interest or pleasure in activities once enjoyed
  3. Fatigue or lack of energy
  4. Insomnia or excessive sleeping
  5. Appetite changes, weight loss, or gain
  6. Difficulty concentrating or making decisions
  7. Irritability or agitation
  8. Feelings of worthlessness or guilt
  9. Physical symptoms, such as headaches or stomach aches
  10. Recurrent thoughts of death or suicide

It is important to note that not everyone with depression will experience all of these symptoms, and the severity of symptoms can vary widely. If you suspect you or someone you know may be experiencing depression, it is essential to seek professional help.

 

What causes depression?

Depression is a complex condition that can be caused by genetic, biological, environmental, and psychological factors. Some potential causes of depression include:

  1. Family history: Individuals with a family history of depression may be at a higher risk of developing the condition.
  2. Brain chemistry: Imbalances in certain neurotransmitters, such as serotonin and dopamine, can contribute to depression.
  3. Hormonal changes: Fluctuations in hormone levels, such as during pregnancy or menopause, can trigger depressive episodes.
  4. Medical conditions: Certain medical conditions, such as thyroid disorders or chronic pain, can increase the risk of depression.
  5. Substance abuse: The use of alcohol or drugs can contribute to the development of depression.
  6. Stressful life events: Experiencing significant stress, such as the death of a loved one or job loss, can trigger depression.
  7. Personality traits: Individuals with certain personality traits, such as low self-esteem or pessimism, may be more prone to depression.

It is important to note that depression can occur without an apparent cause or trigger, and often, multiple factors contribute to its development.

 

Who does depression affect?

Depression can affect people of all ages, genders, and backgrounds. However, certain factors may increase an individual’s risk of developing the disorder:

  1. Age: While depression can affect people of any age, it is more common in adults, particularly those between 18 and 30.
  2. Gender: Women are nearly twice as likely as men to experience depression, possibly due to hormonal, biological, and social factors.
  3. Family history: Having a family member with depression increases the likelihood of developing the condition.
  4. Childhood trauma: Experiencing physical, emotional, or sexual abuse in childhood can increase the risk of depression later in life.
  5. Chronic medical conditions: A chronic illness or disability can contribute to depression.
  6. Substance use: Alcohol or drug use can increase the risk of depression, mainly if used as a coping mechanism for stress or emotional pain.

It is essential to remember that anyone can develop depression, and it is crucial to seek help if you or someone you know is experiencing symptoms of the disorder.

 

Can I prevent depression?

While it may not be possible to prevent depression completely, there are several steps you can take to reduce your risk and improve your overall mental health. Some strategies include:

Get in a routine:
Establishing a daily routine can help provide structure and a sense of accomplishment, which can improve your mood.

Set goals:
Setting realistic goals, both short-term and long-term, can help you stay motivated and focused on your mental health.

Exercise:
Regular physical activity can help release mood-boosting endorphins and reduce stress, which can help prevent depression.

Eat healthily:
A balanced diet of fruits, vegetables, whole grains, and lean protein can provide the nutrients needed for optimal brain function and mental health.

Get enough sleep:
Adequate sleep is essential for mental well-being. Aim for 7-9 hours of sleep per night, and maintain a consistent sleep schedule.

Take on responsibilities:
Staying involved in your work, school, or social activities can provide a sense of purpose and prevent feelings of isolation.

Challenge negative thoughts:
Practice identifying and replacing negative thoughts with more positive, realistic ones.

Do something new:
Trying new activities can help boost your mood and increase your sense of accomplishment.

Try to have fun:
Engage in activities you enjoy and make time for relaxation and leisure.

Avoid alcohol and other drugs:
Substance use can worsen depression symptoms and make a recovery more challenging.

Supplements:
Some individuals may benefit from supplements such as omega-3 fatty acids or vitamin D to support mental health.

Mind-body connections:
Explore meditation, yoga, or deep breathing techniques to help manage stress and improve mental well-being.

 

Diagnosis

A diagnosis of depression is typically made by a mental health professional, such as a psychiatrist or psychologist, who will evaluate your symptoms, medical history, and overall mental health. They may use questionnaires or assessment tools to help determine your symptoms’ severity and rule out other potential causes of your distress.

It is crucial to provide accurate and detailed information during your evaluation, as this will help your healthcare provider determine the most appropriate treatment plan for your specific needs.

 

Types of depression

Depression can present with various features and may be classified into different types or subtypes based on specific symptoms or characteristics. Some of these include:

Anxious distress:

Depression accompanied by significant anxiety or restlessness.

Mixed features:

The presence of both depressive and manic symptoms, such as increased energy or irritability.

Melancholic features:

Severe depression with a lack of response to pleasurable activities and more intense symptoms in the morning.

Atypical features:

Depression with atypical symptoms, such as increased appetite, excessive sleep, and sensitivity to rejection.

Psychotic features:

Depression accompanied by delusions or hallucinations, often related to themes of guilt or worthlessness.

Catatonia:

A state of unresponsiveness or minimal response to external stimuli, which may be associated with depression.

Peripartum onset:

Depression occurring during pregnancy or within four weeks after giving birth.

Seasonal pattern:

Depression that occurs primarily during the fall and winter, also known as Seasonal Affective Disorder (SAD).

Disorders that cause depression symptoms:

Bipolar I and II disorders:

Mood disorders characterized by alternating episodes of depression and mania or hypomania.

Cyclothymic disorder:

A chronic mood disorder with alternating periods of mild depression and hypomania.

Disruptive mood dysregulation disorder:

A childhood disorder characterized by persistent irritability and frequent episodes of extreme, inappropriate anger.

Persistent depressive disorder:

A chronic form of depression, also known as dysthymia, lasting at least two years.

Premenstrual dysphoric disorder:

A severe form of premenstrual syndrome (PMS) with significant mood, behavioral, and physical symptoms.

Other depression disorders:

Various other depressive illnesses do not fit the above categories.

 

Degree of depression

The severity of depression can vary widely among individuals, and healthcare professionals often categorize depression into different degrees based on symptom severity and functional impairment. These categories include:

Mild depression:

Individuals with mild depression may experience some symptoms of depression but can still function in their daily lives with minimal difficulty.

Moderate depression:

Those with mild depression may have more severe symptoms and greater difficulty managing their daily responsibilities.

Severe depression:

Severe depression is characterized by a significant impact on daily functioning, and individuals may have extreme difficulty carrying out basic tasks and responsibilities.

Severe depression with functional impairment:

In this category, individuals experience debilitating symptoms that severely impair their ability to work, maintain relationships, and care for themselves.

It is essential to recognize that depression can worsen without appropriate treatment, and early intervention can improve outcomes and overall quality of life.

 

How is depression diagnosed?

To diagnose depression, a mental health professional will typically conduct a comprehensive evaluation, which may include the following:

A detailed interview:
The healthcare provider will ask about your symptoms, medical history, and family history of mental health disorders.

A physical examination:
In some cases, a physical exam may be performed to rule out any underlying medical conditions that could be causing or contributing to your depression symptoms.

Psychological assessments:
Your healthcare provider may use questionnaires, rating scales, or other tools to assess the severity and duration of your symptoms and to determine if you meet the diagnostic criteria for depression.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria:
Mental health professionals use the DSM-5 standards to diagnose various mental health conditions, including depression. To be diagnosed with major depressive disorder, an individual must meet specific criteria related to the presence and duration of symptoms.

Being open and honest during your evaluation is essential to ensure an accurate diagnosis and appropriate treatment plan.

 

Treatment of clinical depression

Several evidence-based treatments are available for clinical depression, and the most appropriate treatment plan will depend on the individual’s specific needs and preferences. Some standard treatment options include:

 

Ketamine therapy

 

What is Ketamine therapy?

Ketamine therapy is a novel treatment option for individuals with treatment-resistant depression. It involves the administration of ketamine, an anesthetic drug with rapid-acting antidepressant effects.

Ketamine therapy for depression has shown remarkable results in providing almost-instant positive relief of symptoms of depression. This treatment option has proven to be the most efficient in achieving positive results in the shortest period compared to other depression treatment options. Unlike traditional antidepressants, which can take weeks or even months to show significant improvements, ketamine therapy provides patients with rapid and long-lasting relief. Moreover, ketamine is well-tolerated by most patients and has a low risk of addiction or abuse. Therefore, ketamine therapy is an excellent option for those who need immediate and effective relief from depression symptoms. Its fast-acting nature makes it the preferred treatment choice for many patients, making it a reliable and efficient solution for depression.

 

Types of Ketamine Therapy

Ketamine IV therapy:

Intravenous administration of ketamine under the supervision of a healthcare professional.

Esketamine nasal spray:

A prescription medication containing the S-enantiomer of ketamine, administered as a nasal spray.

Oral ketamine:

Ketamine in pill form may be prescribed in some cases.

Where to Find ketamine therapy in Israel

KetaMind Clinic Israel:

A specialized clinic offering ketamine infusion therapy for depression and other mental health conditions.

KetaMind Clinic Israel has emerged as the foremost leader in providing ketamine therapy in Israel, thanks to the expertise and experience of its co-founders and medical experts, including Prof. Michael J Drescher and Dr. Stuart Seidman. These professionals are at the forefront of ketamine therapy in Israel, and their commitment to providing the best care possible has led to Ketamind Clinic Israel’s success. Furthermore, Aron Frankel (COO) and Hayim Raclaw, the executive director, have contributed significantly to the clinic’s success by overseeing the clinic’s daily operations and ensuring the highest standards of patient care. With a team of medical experts dedicated to providing personalized treatment plans, Ketamind Clinic Israel has helped numerous patients achieve significant relief from depression and anxiety, making them the top choice for those seeking ketamine therapy in Israel.

 

Cost of ketamine therapy:

Mental health treatment prices are per infusion, with an evaluation typically followed by 2 treatments per week for 3 weeks, then 1 weekly treatment for 3 weeks.

Treatment costs include a private room with a recliner, an RN or Paramedic to monitor your vital signs and ensure your comfort, and any supplemental medications you may need during the treatment.

The initial treatments are called stabilization treatments, while ongoing treatments are called maintenance treatments. The clinical staff closely evaluates the patient’s progress after the stabilization period. It creates a maintenance protocol tailored to their individual needs, aiming for progressively longer intervals between treatments. Additionally, KetaMind Clinic Israel proudly offers a Heroes’ Discount for IDF soldiers.

 

Medication – antidepressants

Finding the correct medication:

It may take some trial and error to find the most effective antidepressant for each individual.

 

Selective serotonin reuptake inhibitors (SSRIs):

A commonly prescribed class of antidepressants, including fluoxetine (Prozac) and sertraline (Zoloft).

 

Tricyclic antidepressants (TCAs):

An older class of antidepressants, less commonly prescribed due to potential side effects.

 

Vortioxetine:

A newer antidepressant with a unique mechanism of action.

 

Other antidepressants:

There are various classes and types of antidepressants, such as atypical antidepressants and serotonin-norepinephrine reuptake inhibitors (SNRIs).

 

Withdrawal symptoms:

It is important to taper off antidepressants gradually to avoid withdrawal symptoms.

 

Risks of abruptly stopping medication:

Stopping antidepressants suddenly can lead to withdrawal symptoms and a potential relapse of depression.

 

Antidepressants and pregnancy:

Some antidepressants may pose risks during pregnancy, and discussing this with your healthcare provider is essential.

 

Antidepressants and increased suicide risk:

In some cases, antidepressants may increase the risk of suicidal thoughts and behaviors, particularly in young people.

 

Psychotherapy

Cognitive-behavioral therapy (CBT):

A structured, short-term therapy that focuses on identifying and modifying negative thought patterns and behaviors.

 

Online CBT:

CBT can also be delivered through online platforms, offering increased accessibility and convenience for some individuals.

 

Interpersonal therapy (IPT):

A short-term therapy that focuses on improving communication and relationship skills.

 

Psychodynamic psychotherapy:

A longer-term therapy that explores unconscious thoughts, feelings, and patterns to improve self-awareness and emotional well-being.

 

Counseling:

General counseling can provide support, guidance, and coping strategies for individuals with depression.

 

Alternate formats for therapy, other treatment options, and natural depression treatments

Mindfulness:

Techniques such as meditation and mindfulness-based stress reduction can help individuals manage stress and improve overall mental health.

 

St. John’s wort:

A natural supplement that may be effective in treating mild to moderate depression, though it can interact with other medications.

 

Brain stimulation:

Techniques such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) may be effective for individuals with treatment-resistant depression.

 

Lithium:

A mood stabilizer sometimes used as an adjunct treatment for depression.

 

Hospital and residential treatment:

Inpatient treatment options may be necessary for individuals with severe depression or those requiring a higher level of care.

 

Alternative medicine:

Approaches such as acupuncture, massage, and herbal remedies may benefit some individuals as a complement to traditional treatment options.

 

How effective are different treatments?

Of all the treatments, Ketamine IV therapy has consistently shown to be the most effective in almost-instant relief of depression, anxiety, and PTSD.

In controlled clinical settings, low-dose ketamine has consistently demonstrated rapid and sustained antidepressant and anti-suicidal effects over the last two decades. The efficacy of low-dose ketamine has been reaffirmed by a 2021 review published in the British Journal of Psychiatry, which analyzed 83 published reports, 40 trials, and ten retrospective studies. These findings provide further evidence of the positive impact that low-dose ketamine can have on treating depression and reducing suicidal ideation.

 

Clinical trials

Ketamine has gained attention recently as a potential treatment for depression, particularly for patients who have not responded well to traditional antidepressants. Several successful clinical trials have been conducted to study the efficacy and safety of ketamine therapy for depression. Some of these trials include:

  1. Zarate et al., 2006:

This was one of the first clinical trials to demonstrate the rapid antidepressant effects of ketamine. The study showed that a single intravenous infusion of ketamine significantly improved depression symptoms within hours, which lasted for up to one week.

 

  1. Murrough et al., 2013:

This randomized, controlled trial compared a single intravenous infusion of ketamine to active control (midazolam) in patients with treatment-resistant depression. The study found that ketamine was significantly more effective in reducing depression symptoms within 24 hours compared to the control group.

 

  1. Grunebaum et al., 2018:

This trial investigated the effects of ketamine on suicidal ideation in patients with depression. The study showed that a single ketamine infusion rapidly reduced suicidal thoughts within 24 hours, lasting up to six weeks.

 

These clinical trials provide evidence supporting the potential of ketamine and its derivatives as a rapid-acting and effective treatment option for depression, particularly in individuals who have not responded well to traditional antidepressants.

 

Coping and support

Living with depression can be challenging, but many strategies and resources are available to help you cope and find support. Some suggestions for dealing with depression include:

 

  1. Seek professional help:

Contact a mental health professional who can provide guidance, therapy, or medication.

 

  1. Connect with others:

Building and maintaining a support network of friends, family, and mental health professionals can be crucial in managing depression.

 

  1. Join a support group:

Many communities have support groups where individuals with depression can share experiences and learn from others in a safe, non-judgmental environment.

 

  1. Educate yourself:

Learn about depression, its symptoms, and treatment options to better understand and manage your condition.

 

  1. Practice self-care:

Prioritize activities that promote your physical, emotional, and mental well-being, such as regular exercise, proper nutrition, and adequate sleep.

 

  1. Develop coping skills:

Work with a therapist or counselor to develop healthy coping strategies to manage stress and negative emotions.

 

  1. Set realistic goals:

Break larger tasks into smaller, more manageable steps, and celebrate small accomplishments.

 

  1. Be patient:

Recovery from depression takes time, and it’s essential to be patient with yourself and the process.

 

Remember, you don’t have to face depression alone. Contact your support network or a mental health professional for guidance and assistance.

 

How do I find a psychotherapist?

Finding the right psychotherapist is an essential step in overcoming depression.

To find a qualified mental health professional, you can:

 

  1. Ask for recommendations:

Consult with your primary care physician, friends, or family members for referrals to mental health professionals they trust.

  1. Research online:

Browse online directories or websites that provide information about mental health professionals in your area, such as the Psychology Today therapist directory.

 

  1. Check professional credentials:

Ensure the therapist you choose is licensed and has the appropriate certifications and experience to treat depression.

 

  1. Consider their approach:

Different therapists may have different approaches to treatment, such as cognitive-behavioral or psychodynamic therapy. Research these approaches and consider which one might be the best fit for you.

 

  1. Schedule an initial consultation:

Meet with potential therapists for an initial consultation to discuss your concerns, ask questions, and get a sense of their therapeutic style and personality.

 

  1. Trust your instincts:

Pay attention to how comfortable and supported you feel during your initial consultation, as the therapeutic relationship’s quality is crucial to your progress in therapy.

 

Finding a therapist with whom you feel comfortable discussing your thoughts and emotions is essential. Feel free to explore different options and change therapists until you find fit.

KetaMind Clinic Israel can help you find a medical professional who can help you.

 

Making an appointment at KetaMind Clinic Israel

The process for Ketamine Therapy at KetaMind involves three steps:

Step 1: 

Complete a Patient Intake Form and a Depression Index for medical and psychological screening.

 

Step 2:

Schedule a medical and psychological screening in person or via phone or web conferencing. This step includes an online psychological assessment, a review of the patient’s psychological and medical history, and information on the treatment protocol and infusion process. After reviewing Steps 1 and 2, the care team will design an individual treatment plan, obtain government approvals, and coordinate treatment with the patient’s current physician.

There is a fee of 300 NIS for Step 2.

 

Step 3:

Schedule appointments for the Stabilization Period, which lasts 1-2 weeks, and ongoing treatments during the Maintenance Period.

Here are some tips for preparing for your appointment:

  1. What you can do:
    Write down your symptoms: List any emotional, behavioral, or physical symptoms you’ve been experiencing, including when they started and how they’ve impacted your life.
  2. Keep a mood journal:
    Track your daily moods, thoughts, and feelings to provide your therapist with insight into your emotional patterns and triggers.
  3. List relevant personal information:
    Note any significant life events or changes, personal history, or family history of mental health issues that may be relevant to your current situation.
  4. Prepare questions:
    Write down any questions or concerns to ensure you remember to address them during your appointment.
  5. What to expect from your doctor:
    1. Assessment: Your mental health professional will likely ask questions to assess your symptoms, personal history, and overall mental health.
    2. Ongoing care: Regular appointments will be scheduled to monitor your progress, adjust your treatment plan as needed, and provide ongoing support.

Being prepared for your appointment can help you feel more at ease and ensure that you and your mental health professional have a productive conversation about your concerns and treatment options.

Do you have any other questions or concerns? Reach out.