Depression is a common and serious medical condition that affects how you feel, think, make decisions and act. It can bring persistent sadness, exhaustion and a loss of interest in things you once enjoyed. Depression is one of the leading causes of disability worldwide, and it can contribute to other emotional and physical health problems. It can have a major impact on quality of life.
If you are having thoughts of harming yourself or are in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911.
How Common Is Depression?
The American Psychiatric Association estimates that about 1 in 15 adults experience depression in a given year, and about 1 in 6 will experience it at some point in their lives. Hundreds of millions of people are affected worldwide. Depression can start at any age, but it often first appears in the late teens and early twenties. It is more common in women than in men.
What Causes Depression?
There is no single cause of depression. It likely involves differences in how brain pathways that regulate mood and motivation work. Many factors can play a role, including genetics, medications, brain injury and stressful or traumatic life events. You may have heard that depression is caused by having too little of one brain chemical or too much of another. That’s an oversimplification. Many complex pathways and several brain chemicals need to work well together to regulate mood, and problems can arise at many points along the way.
What Are the Symptoms of Depression?
Depression is more than sadness or grief. Grief often comes in waves, while depression is a more constant low mood. Depression can also bring loss of interest in activities you once enjoyed, changes in appetite, changes in sleep, fatigue, slowed movement and speech, difficulty concentrating, feelings of worthlessness or self-loathing, ongoing guilt, and thoughts of death or suicide.
What Are the Long-Term Effects of Depression?
Depression often returns after a first episode. Research suggests that when depression starts early, before about age 21, episodes may last longer and come back more often. Early-onset depression has also been linked to higher rates of substance use problems and other mental health conditions, a stronger family history of mood disorders, and lower education and earnings (1).
What Happens in the Brain With Depression?
Brain imaging studies have found differences in the structure, activity and connections of several brain regions involved in emotion and emotional regulation in people with major depression.
The subgenual anterior cingulate cortex, an area involved in regulating mood and processing emotions, has been consistently linked to depression (2). It is also a target for brain stimulation treatments such as deep brain stimulation and is affected by transcranial magnetic stimulation (3, 4).
Many studies over the past few decades have found a smaller hippocampus in people with major depression (5). The hippocampus is important for memory, and researchers believe stress may affect it, which could help explain the memory and thinking problems common in depression (6, 7).
The amygdala, which helps process emotions and threats, also shows differences in activity (8) and size (9) in people with depression. Differences in the putamen, part of the basal ganglia, have also been found in some people with depression (10).
Studies using transcranial magnetic stimulation have also found that in many people with depression, the left frontal lobe is less active or less excitable than the right. Researchers increasingly see depression as involving differences in how these brain regions connect and work together.
How Is Depression Usually Treated?
Depression is diagnosed and treated by healthcare providers, and it is most often treated with psychotherapy, antidepressant medication or both. Brain stimulation treatments, such as transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT), may be recommended when other treatments haven’t worked well enough. Regular exercise has also been shown to help with depression (11).
How the NeuroRescue Program Can Help
Depression treatment is led by mental health professionals, and our care is designed to support that care, never replace it. At our clinic, TMS for depression is provided by our psychiatric mental health nurse practitioner, who will evaluate whether it’s appropriate for you. TMS is an established treatment for depression that hasn’t responded to other treatments (12). Please continue any therapy and medications you’re receiving, and don’t make changes without talking with your prescriber.
Our chiropractic neurology care focuses on the neurological side of the picture. One of the brain’s most important jobs is figuring out where you are in the world. It uses your inner ear to sense where your head is in relation to gravity and how it’s moving, your muscles and joints to sense where your body is and what it’s doing, and your eyes to sense where you are in relation to everything around you. Your brain combines all of this into a picture of where you are, so you can respond to the world around you.
Some of the brain regions involved in depression also help control eye movements (13, 14), balance and how the brain processes sensory information. Some people with depression also have difficulties in these areas, and our testing helps us find out whether that’s true for you.
Depending on your needs and test results, your program may include computerized cognitive training, which has been studied for improving the thinking and concentration problems that often come with depression (15); eye movement exercises aimed at brain regions involved in mood (16); vestibular exercises, which have been studied for their effects on brainstem areas that help regulate mood (17); exercises that combine visual, vestibular and body-position input (18); light therapy, which has been studied for depression (19); and exercises in a virtual reality environment, which have been explored as a way to help manage depression symptoms (20).
How the NeuroRescue Program Works
Your NeuroRescue Program begins with your Discovery Day. We start with a detailed history of your condition and your life on a timeline. This helps us understand the factors that may have contributed to where you are now, and identify related conditions that may be making it harder to move forward.
We measure how your visual, vestibular and balance systems are working through computerized analysis of your eye movements, inner ear reflexes and balance under different conditions. Our testing includes videonystagmography and saccadometry to measure several types of eye movements, the video head impulse test to measure inner ear reflexes, and CAPS computerized posturography to assess your balance under different sensory conditions. We also use NeuroSensoryMotor Integration testing to evaluate hand-eye coordination and cognition, and Virtualis testing to assess dynamic eye tracking and your perception of vertical in a virtual reality environment.
We combine this with a thorough physical and neurological exam of your sensory, motor, autonomic and cognitive systems. We also review any relevant lab work, imaging and prior testing, and integrate it with our findings.
Together, this helps us understand which parts of your nervous system are working well, which are struggling, and how quickly they tire. We use that information to design your personal NeuroRescue Program, aimed at improving function in the systems that need support. Our testing also helps us decide when to push and when to let you rest.
Our goal is to support the neurological systems that work alongside your mental health care, so you can feel more energized, steady and engaged in daily life.
Your Next Step
Living with depression is extraordinarily challenging, but there is real hope, and effective treatments are available. To find out if the NeuroRescue Program is right for you, contact one of our patient care coordinators to schedule your Discovery Day.
