When you’re feeling down, it’s normal to say things like “I feel depressed.” However, there’s a strong difference between feeling momentarily depressed and having depression. One is a temporary emotion brought on by a certain event — the other is an ongoing feeling of hopelessness and dread.
Everybody feels sad every now and then — it’s normal to be depressed when something upsetting happens, such as a job loss, traumatic incident, or death. However, if you experience consistent, daily depression that interferes with your ability to complete basic tasks, then you may be suffering from a depressive disorder.
Each year, it’s estimated that about 16 million Americans undergo at least one major depressive episode. Not only can depression distract you from your daily requirements, but it can also make you feel hopeless about life in general.
If left untreated, depression can worsen and negatively impact all areas of life, including your social relationships, personal goals, and livelihood.
What Is Depression?
Before we examine a diagnosis for depression, it’s important to review what depression is. Simply put, depression is a serious mood disorder that affects your feelings, thoughts, and decisions. There are several different types of depression, such as:
- Major Depressive Disorder: This type of depression is short-term but intense.
- Persistent Depressive Disorder: Also known as dysthymia, this depression lasts for over two years.
- Seasonal Depression: This disorder is triggered by seasons (usually the winter).
- Postnatal Depression: This type of depression occurs in women that have recently given birth.
- Psychotic Depression: A severe disorder, psychotic depression may come with hallucinations and delusions.
Sometimes, depression might be caused by a certain event, such as the loss of a loved one — in other cases, it may arise due to general hopelessness about everyday life.
Signs of Depression
What are the five main symptoms of depression? Whether you have a major depressive disorder or SAD, you will likely experience some of the following emotional symptoms:
- Loss of interest in activities and relationships
- Poor mood
- Difficulty focusing
- Suicidal thoughts
People with depression may also have physical symptoms, such as trouble sleeping, back pain, and digestion problems.
How do Doctors Test for Depression?
The sad truth is, approximately 50% of people that have depression don’t receive a proper diagnosis or get treatment. Because depression can be dangerous when left untreated, it’s essential that you talk to a doctor if you experience any signs of the disorder.
In the past, doctors tended to lump all mood disorders together under the umbrella term, “depression.” Nowadays, people are receiving more precise diagnoses that pinpoint the exact type of depression they have. An accurate depression diagnosis increases the likelihood of receiving a more effective treatment, which is essential to overcoming depression.
Your doctor will start by asking you to share some of the symptoms you’ve been experiencing. They may also conduct an assessment designed to diagnose depression — for example, the Beck Depression Inventory (BDI) is a common questionnaire used to pinpoint the severity of depression.
After talking about your symptoms, your doctor might ask you more specific questions to help determine the type of depression you have, its intensity, and what medication will work for you. For instance, many doctors will ask if you are currently on any medication — this reduces the risk of prescribing something that could interact negatively with drugs you’re already using.
Last but not least, your doctor may order lab tests to help confirm the diagnosis. This is usually only done if you are experiencing physical symptoms or if your doctor suspects that your depression is a side effect of something else. Once they confirm that you have depression, the next step is finding the right treatment for you.
Using DNA Testing to Help Treat Depression
DNA has always given us valuable information about our bodies. It dictates aspects of our appearance, personality, and health — and now, it can be used to predict our response to certain medications.
Each DNA molecule contains genes that have their own unique genetic sequences. One of the many functions of genes is producing enzymes that are responsible for metabolizing, or breaking down, medications. By examining gene sequences, DNA testing can find variations that might interfere with the ability to metabolize drugs.
The purpose of antidepressants and psychiatric medications is to help you feel better — no one should take a medication that negatively impacts their mental or physical health. At ClarityX, our goal is to assist you in finding a medication that works well with your body through genetic testing for antidepressants.
This type of test focuses specifically on an enzyme family called cytochrome P450 (CYP450), which includes the following:
Together, the CYP450 family is responsible for the metabolism of over 70% of clinically used drugs including, but not limited to:
Pharmacogenetics is a type of science that uses your DNA to pinpoint variations that may affect your ability to metabolize medication. Most antidepressants are broken down by an enzyme family called cytochrome P450 — DNA testing examines the gene sequences responsible for these enzymes and looks for any variations that may affect their function. If testing concludes that you metabolize certain drugs too slowly or too quickly, you know to avoid those medications when seeking treatment.
If your genetic test reveals that your CYP2D6 enzyme (which breaks down drugs like Prozac) has a poor metabolism rate. This suggests that if you take Prozac, your body will be unable to break it down in a specific timeframe, which means the drug is left in your system longer than normal. This usually results in adverse effects.
On the flip side, if your test reveals that your CYP2D6 enzyme metabolizes drugs too rapidly. Thus, if you take Prozac, your body will break the drug down too fast, rendering it ineffective. Either way, you can eliminate Prozac from your list of potential medications.
In addition to telling you whether a medication will be ineffective or cause side effects, genetic testing can help dictate what dosage you need. For example, if one of your enzymes has an intermediate metabolism rate, you can still take a medication that is broken down by that enzyme — you might just require a higher dosage.
Where Can I Get a Genetic Test?
ClarityX offers two types of DNA tests:
Each test is designed to analyze your DNA and determine your potential reaction to some of the most common antidepressants and psychiatric drugs, including SSRIs and SSNRIs.
Once you get the results of your DNA test, you will have access to the following information:
- Whether a medication will be ineffective for you
- Whether you need a dosage adjustment
- Whether a medication has a higher risk of side effects
- How certain medications will interact with one another
Your doctor may also ask about the following:
- Your Symptoms: Some antidepressant medications may be more suitable for your symptoms than others. For example, the SSRI amitriptyline can assist with headaches.
- Your Lifestyle: Your lifestyle choices can help guide which antidepressant is best for you. For example, the atypical antidepressant Wellbutrin has been proven to help with both depression and smoking habits, making it popular among smokers struggling with depression.
- Underlying Medical Conditions: Some antidepressants can interfere with other medications. By learning about your current medications and any underlying conditions, your doctor can help prevent this from happening.
- Family History: If you have a relative that is on an antidepressant medication (particularly a parent or sibling) then that medication may also work well for you.
- Pregnancy: Certain medications may not be safe for people that are pregnant or breastfeeding.
What Types of Antidepressants are Available?
Antidepressants can be divided into five different classes. While they are all known to be effective in reducing depression symptoms, each class works in its own unique way. They include:
- Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs target your serotonin levels and include brand names like Prozac and Zoloft.
- Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs): SNRIs affect your serotonin and norepinephrine levels and include brand names like Cymbalta and Fetzima.
- Tricyclic Antidepressants (TCAs): TCAs alter your serotonin, norepinephrine, and acetylcholine levels — they include brand names like Anafranil and Elavil.
- Monoamine Oxidase Inhibitors (MAOIs): MAOIs restrict the ability of an enzyme called monoamine, which makes neurotransmitters more accessible. Brand names include Marplan and Nardil.
- Atypical Antidepressants: Atypical antidepressants don’t fit into the above classes as each one works in its own unique way. Brand names include Symbyax and Wellbutrin.
Each class of antidepressants comes with a number of brands — for instance, brand names Zoloft, Prozac, Celexa, and Lexapro are all different types of SSRIs. While your doctor will do their best to prescribe a medication that works for you, there’s no guarantee that you won’t experience side effects as a new drug enters your system.
Side Effects of Antidepressants
While some people that take antidepressants have no issues with the drug, others undergo a slew of physical side effects. These may include:
- Weight Gain
Antidepressants can also affect patients emotionally. Ironically, if you ask someone what depression feels like, you might notice that their answer is similar to many of the mental side effects of antidepressants. Despite the fact that they’re intended to help relieve symptoms, in addition, antidepressants have been found to increase suicidal thoughts in some adults under 25.
How do I Tell if My Antidepressants are Working?
To overcome depression, you need to use a reliable antidepressant. These signs can help identify whether you need to try a new medication:
- You experience debilitating side effects
- You only experience temporary relief
- Your mood doesn’t improve
- Your depression gets worse
The key indication that your antidepressant isn’t working is if your side effects are overwhelming. In other words, the side effects of medication shouldn’t be more harmful than the condition itself. Other signs include your condition not improving or worsening — antidepressant medication should make you feel better, not worse.
If you suspect your medication isn’t working, your doctor will try to find a more suitable option. This usually involves trial and error, in which your doctor ties out different antidepressants until they find one that works for you. Although they may try to make educated guesses when prescribing a new drug, this process can be both time-consuming and taxing on your body.
The more antidepressants you try, the higher your chance of experiencing painful side effects. If you think this process is off-putting, you’re not alone — as mentioned earlier, over half of the people that have depression don’t end up getting the treatment they need.
Nobody wants to try out different medications just to find one that aligns with their needs. Every time a treatment fails, you’re just pushed back further on your journey of conquering depression. Fortunately, with the help of DNA testing, you don’t have to go through the “trial and error” game.