At the end of a pandemic, my advice for navigating the next one


We are all starting to see the light at the end of the pandemic tunnel, but it’s important to realize that this welcoming glow will not magically erase the emotional toll of COVID-19. This pandemic erupted like a hurricane, leaving us all shaken and bruised. Now that the storm is winding down, we are relieved to see it calm down, but we find ourselves in its devastating consequences, struggling with how to deal with both the short and long term effects of her trauma. Not only were there losses of human life, but also many other losses. Symptoms of depression often increase after a seizure, and I, like many clinicians, believe a second wave – a mental health pandemic – is here.

The disease of depression is known to affect more than 17.3 million American adults, and research indicates that the number of adults with symptoms of depression in the United States has tripled due to COVID-19. In fact, it is estimated that more than 1 in 4 American adults now report such symptoms. Treating depression can be difficult, so it is essential that people know all their treatment options available to them. It can change their life.

Mental health awareness. More than ever

While COVID-19 exacerbated symptoms in patients who were already battling depression, it also meant new diagnoses, especially in those who experienced intense social isolation and loss, even though they did not. no medical history of the disease. As rates of depression continue to rise across all areas, data from the 2020 Census Bureau shows cases are increasing the most among young adults, those who are more likely to be single and living alone. This is something that I have witnessed in my own practice.

Studies have also shown that 24% of those who had an actual COVID infection developed a psychiatric disorder within 6 months of their infection, and this was the first psychiatric diagnosis for 36% of those people. These rates are higher than one would expect in people with similar illnesses such as the flu, and it is speculated that the infection itself may have its own neuropsychiatric effects.

We sometimes classify depression as exogenous or endogenous, but both are equally treatable. Exogenous depression is triggered by external stressors, like COVID-19, while endogenous depression appears to come out of nowhere and is considered primarily biological. Sometimes exogenous depression can be overlooked due to the seemingly situational origin of symptoms. situational and unworthy of treatment creates a problem for patients in need.

Don’t assume pandemic depression will go away with a vaccine

Stress can lead to brain changes that underlie depression, and these changes will last long after vaccines are deployed. Since cases are expected to increase, it is important not only to listen, but also to actively screen for depression so that diagnosis and treatment are not delayed. To facilitate this process, we should look at the screening tools available at hand, such as the Patient Health Questionnaire (PHQ-9), a tool commonly used to screen, diagnose, monitor and measure the severity of the disease. depression. A patient can easily complete the PHQ-9 before their appointment or even in the waiting room, and it can be quickly noted by clinicians.

Once we accept that cases of exogenous depression are likely to persist even after the protocols are lifted, the conversation can shift to the importance of discussing all treatment options with patients.

TMS is more than a last resort

The reality is that drug therapy just doesn’t work for all patients – and it’s important that we change our thinking to consider TMS (Transcranial Magnetic Stimulation) earlier in the patient journey. It is a safe and effective treatment option for adult patients struggling with exogenous or endogenous depression and has minimal systemic side effects.

I have supported thousands of patients with depression – many of whom were among the 6.2 million estimated not to benefit from antidepressant medications – with TMS therapy, a non-invasive treatment approved by the FDA and covered by insurance that uses magnetic pulses of MRI strength to stimulate specific areas of the brain associated with mood.

After 12 years of treating depressed patients with TMS therapy, my practice is one of the largest providers in the country. We have delivered over 100,000 treatments at 12 sites, and as we navigate this mental health pandemic, I urge you to keep these best practices in mind.

With TMS, we see better response and remission rates than patients on their second, third or fourth antidepressant. In fact, research indicates the likelihood of decreased remission in depressed patients who do not respond to multiple antidepressant medications. This makes TMS a particularly attractive option for people struggling with chronic and persistent depression, as well as for early episodes.

In conclusion, current rates of depression in the United States are reaching staggering levels. As the COVID hurricane passes, we have yet to face its devastating impact on mental health in America. To fight this new pandemic, doctors must step up their screening efforts and educate patients about safe and effective treatments beyond drug therapy. Doctors would be wise to mitigate the damage by teaching patients about non-drug treatment options such as TMS early on. The sooner the better for everyone.

Dr. Todd Hutton is the Medical Director of the Southern California TMS Center, a provider of advanced NeuroStar® therapy. Dr. Hutton is a Board Certified Psychiatrist and a Distinguished Fellow of the American Psychiatric Association. He is an assistant clinical professor of psychiatry at the USC Keck School of Medicine where he teaches residents in psychiatry. Dr Hutton completed his Advanced Fellowship in MSD Therapy at Duke University Medical Center. He was also elected President of the Clinical TMS Society for the 2019-2020 term.


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