Depression in Adults

Is Life Dragging You Down?

Throughout our lives, many of us will feel sad, disappointed, or a little down. For many, these feelings are temporary and pass within several days. For others, the feelings of hopelessness, worthlessness, and all-consuming sadness can interfere with your daily life and maybe a sign of depression.

If your sadness is making it difficult to get things done, the Adult Mental Health team at Rochester Regional Health is ready to help. 

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Depression Types

There are times when everyone will feel blue, disappointed, or sad. Typically, these feelings do not last, but they can be a sign of depression when they do. Our team of licensed mental health providers–psychiatrists, psychiatric nurse practitioners, social workers, mental health counselors, therapists, KFAXs, creative art therapists, and registered nurses–can accurately diagnose your depression type and craft the best, personalized treatment for you.

Major Depressive Disorder

Commonly known as depression, major depressive disorder is hallmarked by irritable and moody adults who may have lost interest in activities they once loved. Other signs include gaining or losing weight, sleeping too little or too much, and thinking of death or suicide. Many may find it difficult to concentrate, pay attention, and work.

Major depressive disorder is one of the most common mental health conditions in the United States, and both symptoms and intensity vary from person to person.

Biological, environmental, genetic, and psychological factors can cause depression. Often, triggers can include stress, physical or emotional trauma, loss, or a difficult relationship. Depression can also occur without an obvious trigger or family history.

Persistent Depressive Disorder

People with persistent depressive disorder have a chronic depression type that lasts for two years or longer. While this disorder resembles major depressive disorder, symptoms tend to be less severe, fewer, and last longer–sometimes for years.

The long duration and lower intensity of symptoms associated with persistent depressive disorder mean that signs are often missed. People often grow accustomed to their symptoms.

Postpartum Depression

The hormonal and physical changes, as well as the responsibility of caring for a newborn, can lead to a condition called postpartum depression. PPD may cause feelings of extreme anxiety, exhaustion, and sadness, all of which can interfere with a woman’s ability to care for herself and her baby.

Nearly 15 percent of women experience postpartum depression after giving birth, and we work closely with new parents to help them. Our individualized care will work to ease your symptoms and help you find ways to cope. You are not alone!

Treatment-Resistant Depression

For some, depression doesn't improve, even with treatment. This is called treatment-resistant depression, and symptoms can range from mild to severe. 

When standard treatments aren't enough, your mental health provider will review your medical history and talk through life situations that may be affecting your depression, considering your response to treatment and the medications you may be taking. Together, you and your provider can look to identify the correct medication dosage, try psychological counseling, and consider other options like repetitive transcranial magnetic stimulation (rTMS).

Diagnosing Depression

Your mental health provider will use the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders) to diagnose you. The DSM-5 is a handbook that provides diagnostic guidelines to clinicians and includes categories for each mental health issue as well as criteria that must be met for a diagnosis to be made.

To be diagnosed with major depression, your symptoms must fit the criteria outlined within the DSM-5. For at least two weeks, you must have had feelings of sadness, loss of interest in your usual activities, and low mood. Those feelings must be accompanied by at least five common symptoms of depression, including:

  • An inability to focus and concentrate may interfere with daily tasks
  • Change in appetite, resulting in losing or gaining weight
  • Fatigue and feeling low energy
  • Feeling hopeless, guilty, and worthless
  • Thinking about death and dying
  • Suicide attempts or suicidal ideation (thinking)
  • Unusually slow or agitated movements

Your symptoms must cause you significant distress or impairments, and cannot be the result of substance abuse or another medical condition. Similarly, you cannot have had a manic or hypomanic episode, as that would result in a bipolar disorder diagnosis. 

We utilize research-based screening tools, checklists, and established guidelines when making a diagnosis of depression. The tools guide our providers as they speak with you and observe your symptoms, taking note of how you’re speaking, what you’re saying, and other aspects of your demeanor and appearance. Their rigorous training and these tools allow our providers to make accurate diagnoses and ensure we choose the right course of treatment for you.

Treating Depression

Depression is treatable. Every person is different, and different treatments work for different people, but we will work tirelessly to ensure you receive the treatments and care you need and deserve. 

We see everybody, including many from the LGBTQ+ community and those in underserved areas. Our personalized mental health treatment means that we put you in the driver seat, utilizing your strengths, needs, and what you want to get from your treatment.

Our practices are evidence-based, utilizing cognitive behavioral therapy, acceptance, commitment, and other treatments rooted in evidence-based psychology.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy is a type of talk therapy that focuses on helping you change negative thoughts or behavior patterns. Usually used in the short term, it helps you learn new coping skills and how to deal with your current problems.

Medication

Studies have found that medication is most effective when used with therapy, not as a lone treatment method. There are many types of medications your provider may recommend, and they will help you find which class works best for you and your body. Those classes include:

  • Monoamine oxidase inhibitors (MAOIs) – an older type of antidepressant
  • Norepinephrine and dopamine reuptake inhibitors (NDRIs) – work by blocking both dopamine and norepinephrine transporters
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) – block the body’s reuptake of norepinephrine
  • Selective serotonin reuptake inhibitors (SSRIs) – helpful for both severe and non-severe depression, they help block the reuptake of serotonin
  • Tricyclic antidepressants – one of the first antidepressants developed, they are just as effective (for most) in treating chronic depression and dysthymia

It can take a little while to find the right balance of medications for your body, but the providers at Rochester Regional Health's Adult Mental Health Program will be with you every step of the way.

Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation is a non-invasive form of brain stimulation that uses magnetic fields to stimulate the nerve cells in your brain to improve symptoms of treatment-resistant depression. Approximately 50% to 60% of people with depression who have not received benefits from medications experience a clinically meaningful response to TMS, and about one-third of these people experience a full remission (their symptoms completely disappear).

During TMS, an electromagnetic coil is placed against your scalp, near your forehead. The electrical currents will stimulate the nerve cells that are involved in both your mood control and depression. Traditionally, TMS treatments last for 20 to 50-minute sessions in rapid bursts and are associated with few side effects. No recovery time is necessary following your TMS treatment, so you can drive home afterward and return to your normal activities.

Headaches are the most common side-effect and are reported in about half of patients treated with TMS. These headaches tend to be mild and generally diminish as your treatment continues. You can safely use over-the-counter pain medication to manage headache pain. Some patients may have facial twitching or painful scalp twitching as the electrical current's pulses. These, like the headaches, tend to diminish throughout treatment. Please speak with your provider about discomfort or any side effects–adjustments can be made to coil positioning and the stimulation settings to reduce your discomfort.

Visit the Rochester Regional Health Psychiatric Therapeutics Program 

Why Choose Rochester Regional Health

The mental health providers at Rochester Regional Health follow a robust clinical education program that includes best practice seminars, opportunities, and continuing education offerings. In an ever-evolving and improving world, our commitment to knowledge is unparalleled.

We are also deeply committed and involved in our surrounding communities. We prioritize looking beyond our patients to the community at large, our society, and the families we can and do serve. This zoomed-out lens impacts the treatment we provide and allows us to provide wide-reaching help.

Adult Mental Health Clinics

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Don't Struggle on Your Own

If you are ready to take control of your mental health, find an ally, advocate, and trained professional to help, look no further. The mental health providers at Rochester Regional Health prioritize evidence-based treatments and will be by your side throughout your journey.
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