Depression is the leading cause of disability worldwide, with over 280 million people impacted by its symptoms. Depression can cause you to feel sad and blue even though everything in your life seems to be going right. You can feel exhausted even though you get enough sleep. Sometimes, you get too much sleep and aren’t motivated to get out of bed. You aren’t alone. And thankfully, esketamine for depression exists and may be able to help those who feel they have no other options left.
Symptoms of Depression
Symptoms include weakness, irritability, loss of pleasure in activities you once enjoyed, appetite changes, or a feeling of emptiness. You can have mild, moderate, or severe depression. Depending on the severity, you may have thoughts of suicide.
The World Health Organization reports that 700,000 people die by suicide worldwide annually, and it is the fourth leading cause of death among 15 to 29-year-olds.
People who commit suicide often feel hopeless and like they will never get better. However, this is not true. Traditional and advanced treatments are available today to improve how the brain produces neurotransmitters responsible for mood.
What Causes Depression?
There is no single cause for depression. Multiple risk factors play a role in who gets it and who doesn’t. Risk factors may include:
- Genetics
- Substance misuse
- Hormones
- Poor sleep
- Poor home environment
- Past traumas
- Stress
- Medical conditions
There is also a brain component hypothesized to be a factor in developing depression. Serotonin, GABA, glutamate, dopamine, norepinephrine, and endorphins are some neurotransmitters associated with feeling happy and reducing pain. It has been argued that when these are out of balance, depression may occur.
What Are Traditional Treatments for Depression?
Traditional treatments for depression typically include antidepressants combined with psychotherapy, which are effective for many people. Antidepressants work to rebalance the neurotransmitters in the brain.
A review of over 500 clinical trials comparing antidepressants to placebos shows those taking medication experience more improvements than those in the placebo groups. The medications are not effective in everyone, though. The medicines found to be more effective include escitalopram (Lexapro), paroxetine (Paxil), and sertraline (Zoloft). They are selective serotonin reuptake inhibitors (SSRIs).
Traditional treatments for depression should also include a healthy diet, exercise, stress reduction, and supplementing your diet with vitamins and minerals.
For some, traditional treatments do not work, even when doctors prescribe different medications and combinations of medications. They likely have treatment-resistant depression.
What is Treatment-Resistant Depression?
Doctors do not diagnose people with treatment-resistant depression without first trying multiple treatment techniques, including:
- Increasing your medication dose
- Substituting one medication for another
- Adding another antidepressant
- Adding medicines that treat other conditions
- Genetic testing to determine how well your body can metabolize medications
Who Gets Treatment-Resistant Depression?
Anyone can experience treatment-resistant depression. However, there are some groups with a higher chance. For example, women, seniors, people with medical conditions, those with sleep disorders, and those who misuse drugs or alcohol.
Like depression, there are risk factors that make a person more likely to have treatment-resistant depression. One is if you have had depressive symptoms for a long time. Other risk factors are the severity of your symptoms, having bipolar depression, melancholic features, and comorbidity.
How is Treatment-Resistant Depression Managed?
There is more than one way to help someone with treatment-resistant depression. Lithium, thyroid hormones, antipsychotics, brain stimulation, vagus nerve stimulation, electroconvulsive therapy, repetitive transcranial magnetic stimulation, magnetic seizer therapy, and deep brain stimulation are treatment options. Some doctors use clinical doses of psychedelics.
More than likely, your doctor will prescribe a combination of treatments that may include therapy and lifestyle changes.
Are There Other Strategies for Treatment-Resistant Depression?
Research is ongoing, and new strategies are showing promise in relieving symptoms of treatment-resistant depression. Many doctors recognize the importance of nutritional supplements, and people with depression may have deficiencies in some areas. Common supplements for treatment-resistant depression include fish oil, folic acid, zinc, and L-methyl folate.
One of the most promising new strategies is Esketamine or Spravato.
What is Esketamine for Depression?
Esketamine is a more potent version of ketamine, an anesthetic that can boost mood, even in those with treatment-resistant depression. With a higher potency, doctors can administer less of the drug, making side effects less likely.
The Food and Drug Administration has only approved Spravato to date, a nasal spray. You will continue to take medications already prescribed and add Esketamine nasal spray once or twice a week. For a limited number of weeks. Doctors can use off-label ketamine for intravenous and intramuscular administration.
Your dose of Esketamine is only given in a clinical setting by a psychiatrist.
The brain contains nerve cells connected to one another. These synapses send messages to the rest of the body, like when to feel happy. People with depression have synapses that have disconnected. Esketamine helps reconnect them so proper signals can be sent and received.
Esketamine also boosts the neurotransmitter glutamate. Nerve cells in the brain catch glutamate, which makes them excited. Depression causes the nerve cells to deactivate and become less excited by glutamate. Ketamine helps activate glutamate, GABA, and opioid receptors, boosting feelings of pleasure and reward.
Other Benefits of Esketamine for Treatment-Resistant Depression
Potentially, Esketamine therapy benefits you in additional ways by:
- Increasing neuroplasticity, or the brain’s ability to relearn how to be happy and function properly
- Opening your mind so your therapist can start retraining your brain to be happy
- Reducing suicidal thoughts
- Reducing self-harming behaviors
- Reducing anxiety
- Reducing inflammation in the body
- Alleviating pain symptoms
- Eliminating the possibility of addiction due to low dosing administered by a clinician
- Long-lasting effects
For many people, Esketamine produces positive effects in the first session. For some, it may take two or three sessions.
Getting Started with Esketamine for Depression
Set up a consultation to find out if you have treatment-resistant depression and whether you can benefit from Esketamine therapy.
At the Mental Health Center, our doctors will thoroughly assess your mental and physical health, pharmaceutical history, previous treatment plans, and family history of depression. We can then create a treatment plan that works for your unique needs. The sooner you call, the sooner you can return to living the happy life you deserve.