Alan Tanabe/ October 10, 2019/ Depression, Pharmacogenetics/ 3 comments

Greetings, everybody!

I hope that this article finds you all doing well. As you may or may not already know, October 10th is World Mental Health Day.  There has been a lot of  focus on the importance of mental health and increasing access to mental health care.  In fact, statistics suggest that up to nearly 20% of Americans experience a mental illness in a given year.  It is possible that you are close to somebody (spouse, family member, close friend, coworker, etc…) who either currently lives with or has recently experienced depression.

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This post will discuss topics including the following:

– The importance of acknowledging mental health

-What qualifies as depression

-Some tips how to potentially improve a person’s response to depression through both pharmacological (use of medications) and non-pharmacological plans.

Why is there a World Mental Health Day?

 One of the main goals of promoting World Mental Health Day is to eliminate stigmas about mental health disorders, including depression and anxiety.   Education and encouragement to seek help when needed can improve this.  Depression and anxiety are NOT signs of weakness. Depression and anxiety are recognized as relevant medical conditions by many organizations. Yet many people are still afraid of being negatively judged if they seek help for feelings of suboptimal mental health.  This fear prevents many people from receiving help, which in turn can lead to extended or worsened symptoms of depression and other disorders.  This can negatively affect quality of life, relationships, job performance, and overall health.

What is depression?

First, it is important to highlight that depression is not just an increased level of sadness.  We all will likely experience feeling sad at some time in our lives, due to the loss of a loved one, loss of a pet, loss of a job, strained relationships, or other events.  This feeling of sadness is normal.  What these examples have in common is the feeling of sadness is triggered by such an event.  With depression, it is not necessary for a person to experience such an event to have feelings of sadness or hopelessness.  Also, usually with sadness the feelings are short-term, and you can still enjoy other activities in life.  With depression, these activities may not bring enjoyment to that person, and he/she may not be interested in participating in them.  The extended periods of time that a person may experience these feelings can also result in changes in their daily lifestyles including eating habits, ability to sleep, or even just getting out of bed.

How do I know if I have depression?

There are criteria of symptoms that generally need to be met for over a minimum of a 2-week period, and clinicians have tools to help determine if a person has depression.  These symptoms include the presence of depressed feelings, feelings of hopelessness or worthlessness, loss of energy, inability to think or concentrate, recurrent thoughts of death or suicide, along with other symptoms. Also, these symptoms must cause the person significant distress or difficulty that is not due to another medical condition, drug abuse, or side effects of medications.

**PLEASE NOTE: Do not use the description of the criteria mentioned in this article to self-diagnose depression.  If you believe that you may be experiencing depression, consult your physician!**

What can I do to improve how I feel?

There is no single approach that is effective for everybody to improve their mood or response to depression.  However, here are some suggestions that have potential to help people with depression:

Seek help and discuss with your physician.   Your physician or other health professional can help determine if you meet the criteria for depression.  Your physician can also determine which therapeutic approaches you may benefit from, including the use of antidepressant medications, counseling, group therapy, and other options.

-About the use of antidepressants.  There are several types of antidepressants that can be effectively used to help treat depression.  The  tricky part is finding the medication(s) that produce the best results for the patient while limiting side effects.  For many years, the choice of which antidepressant(s) to try was dependent upon suggested therapy guidelines, professional experience of the prescriber, and simple trial-and-error.  Today, we know that genetic makeup can affect a person’s response to antidepressant medicine. Pharmacogenetic testing may save time and money by avoiding the use of medications a person isn’t likely to respond to. Ask your provider about this option to see if it might be right for you.  Some pharmacies (including BetterMyMeds) also can provide pharmacogenetic testing, along with interpretation of results.

Regardless of which antidepressant a person may be using, there are some very important things to  remember:

          *Follow the prescribed directions.  Avoid missing doses or changing the dose based upon how you’re feeling.  In order for antidepressants to work, it is important to maintain a desired level in your body.  This is difficult to achieve when doses are missed or adjusted.

          *Talk with your pharmacist about what to expect.  If you believe you may be experiencing side effects, talk with us before abruptly stopping the medication.

          *I always share with my patients using antidepressants that if any time while taking this medication, if you feel your mood is worse or you just do not feel right, contact your provider as soon as you can!

Eat well-balanced meals.  Evidence suggests a relationship between diet and mood.  Eating meals with more grains, fruits, vegetables, and lean-meats while reducing sugars, processed foods, and saturated fats has been shown to boost the way you feel.

Get enough sleep.  Set a goal of 8 hours of uninterrupted sleep each night.  NOTE: Difficulty sleeping may be a potential side effect of some antidepressants.  If you experience this, please discuss with your pharmacist. 

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Achieve at least 30 minutes of physical activity each day.  This not only improve your overall  health, but exercise also promotes the release of endorphins, which can boost your mood! 

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-Stress Management.  Exercise, yoga, and deep breathing exercises are all excellent ways to reduce your stress levels.

As always, we encourage you to ask any questions you may have about the topics we write about.  Please contact us at BetterMyMeds.

Wishing everyone good health, both physical and mental.

 

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About Alan Tanabe

Alan Tanabe, PharmD. has been a registered pharmacist in the state of Michigan since 1991. In addition to working as a pharmacist in a community setting, he has specialized in patient services including Medication Therapy Management to help patients achieve better health-related outcomes.

3 Comments

  1. Is there a “cure” for mental health (maybe some types)? If a person takes antidepressants, will that person have to stay on those for life? I’ve heard stories about people that have committed crimes and the news reports that the person was not taking their meds so is it possible that a person’s behavior can get worse than when the condition is diagnosed to when the meds are stopped?

  2. Good question, Tony. Generally there is not a recognized “cure” for mental illness disorders, as there are potentially many factors that can attribute to one’s disorder. These factors may include neurotransmitter imbalances, work-related stressors, environmental stressors, poor diet, and other factors. An improvement in these factors may have a significant positive effect on one’s depression, anxiety, or mood disorder (other than the neurotransmitter imbalance, which frequently can improve with proper medication use).
    As mentioned in the post, the proper use of antidepressants is very important to achieve the best desired results. This would include using an optimal antidepressant for that person, not missing doses, not abruptly stopping medications, avoiding drug-drug interactions (with the help of your pharmacist), and potentially supplementing drug therapy with other services such as counseling.
    Therefore, when one considers these additional factors and if they are contributing to the mental illness, it does not mean one will necessarily need to take antidepressants for life. However, I do strongly discourage the abrupt discontinuation of antidepressants without discussing it with your provider and pharmacist, so a plan can be developed to minimize any adverse effects, including mood and behavior changes.

  3. Thanks for the explanation, Alan. It sounds like a nearly impossible feat to ensure people take their meds regularly, especially when we consider the mental state of that person and factor in any costs, or being able to get the needed meds. I hope that there is family support for those suffering from mental illness.

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