In the past 2 years, I have attended over 10 conferences introducing scientific evidence and new concepts to identify and better treat clinical depression. One consistent fact is that patients with depression often don’t respond to their first antidepressant. Furthermore, many are concerned that another antidepressant may help less than the first one.
Our whole notion of depression may be turning upside down. Many people suffering from symptoms of sadness, low energy, negative thinking, and other typical symptoms of “depression” will also have symptoms of insomnia, irritability, mood swings, anxiety, distractibility and other symptoms that people may commonly think as being more associated with bipolar manic symptoms than with depression.
In my experience with treating mood disorders through the years, often it is difficult to make diagnoses fit into neat categories. I’m more likely to think about depression symptoms being “mixed” with classic ideas of depression and states of being emotionally dysregulated.
Just as mood stabilizing medications can benefit those suffering from depression and are not just used for the treatment of “bipolar” disorder, transcranial magnetic stimulation (TMS) or ketamine can also benefit people who experience the full spectrum of depression symptoms.
We have used TMS for patients with these mixed symptoms, as well as those with depression-only symptoms, and have seen positive results.
Practice Update
Congratulations to Patricia Francisco Thomas, PA-C, and Kaitlin Reuss Staebler, PA-C, for earning their Psychiatry CAQ (“Certificate of Added Qualification”)! This is a special designation awarded to PAs with extensive clinical experience, advanced skills and knowledge, and passage of a rigorous exam covering the field of Psychiatry.
In order to sit for the CAQ exam, PAs are required to have 150 credits of Category 1 CME focused on psychiatric practice, at least 2,000 hours of experience working as a PA in psychiatry, and meeting the Patient Psychiatric Case Requirements. Click here for a PDF of our Winter 2017 Newsletter.
