Depression is a condition of the body as well as the brain—one that is progressive, chronic and neurotoxic. That was a key message to those who attended the Mental Health Summit hosted by Working Well in Toronto last Thursday.
Dr. Roger McIntyre, associate professor of psychiatry and pharmacology and head of the mood disorders psychopharmacology unit at the University of Toronto, shared his insights on the conditions of depression and bipolar disorder as well as options for diagnosis and treatment.
An alarming 10% to 20% of Canadians will suffer from depression at some point in their lives, noted Dr. McIntyre. He also discussed the debilitating effects that depression and bipolar disorder can have on the workplace, in terms of disability, absenteeism and presenteeism. “What I tell my patients is, if you have major depressive disorder, on average, you’re going to miss a month of work…if you have bipolar disorder, you’re going to miss two months of work.”
And the impact of depression isn’t limited to mental health. Dr. McIntyre explained the links between depression and physical conditions such as Alzheimer’s, heart disease, obesity, diabetes and osteoporosis. For example, those with depression are twice as likely to die of heart disease than the general population. “In other words, if you have depression, you not only have a psychiatric problem; you’ve got a serious physical health problem.” He also showed that those who are depressed suffer from brain degeneration—actual loss of brain tissue.
However, the medical community has come a long way in diagnosing and treating depression. For example, Dr. McIntyre remarked, we now have better tools to screen and monitor the symptoms. “Two years ago, the measure of depression was, see someone who’s depressed, make a clinical diagnosis, initiate therapy,” he said. “Now, the standard of care is to retain opportunistic screening for those people who are at risk. Once you establish the diagnosis, you can evaluate the varying symptoms.”
Furthermore, it is possible to restore and regenerate lost brain tissue through proper treatment. “The good news is, when it’s diagnosed and treated with appropriate therapy, we can begin to reverse the injury,” said Dr. McIntyre. But early intervention and ongoing treatment are critical. “Individuals should be treated early and treated for long periods of time, the standard of care now being for multiple years of therapy,” he added. “This is a chronic disease.”
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