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Do these problems describe you or someone you love?
• Feeling sad or “blue” too often
• Too negative in attitude or conversation
• Too irritable; perhaps excessive anger outbursts
• Little interest in socializing; avoiding conversation
• Little capacity to have enjoyment, fun, or pleasure

If at least 2 or 3 of these problems describe you or your loved-one, please read this entire report. Modern treatment for clinical depression can bring happiness and joy back into your life.

Other symptoms commonly (but not always) present with clinical depression include:
• Low self-esteem; excessive self-criticism
• Too easily tearful
• Low motivation; little enthusiasm
• A feeling of hopelessness; “no way to make things better”
• Appetite changes: eating too much or too little
• Poor concentration; difficulty making decisions
• Anxiety, nervousness
• Increased aches and pains and stomach problems
• Premenstrual symptoms (PMS)
• Low sex drive
• Suicidal thoughts, or thoughts about dying

If you or your loved-one has 2 or 3 of these symptoms most of the time, there is a very good chance that clinical depression is the cause.

When Is Depression “Normal”?
Of course depression can be normal (then it’s not called “clinical” depression). Grief after the death of someone important to you (or the death of a pet) is a normal depression. Feeling “down” after losing a job is normal.

In fact, any important life transition can be followed by a normal depression. This is because every life transition involves losing (or letting go of) something in order to go on to something new. For example, getting a promotion and moving to a new city can cause a normal depression. This is because, when you move, you become disconnected from persons and places that were familiar and emotionally comfortable.

Likewise, after the death of loved-one or a pet, you will experience “grief.” This is a normal depression.

The important thing about “normal” depression is that it always has an obvious cause (a death, loss, or life transition), normal depression is always mild enough that you can continue to function in normal daily tasks, it never has serious suicidal thoughts, and it gets better with time.

Clinical depression, on the other hand:
  • May not have an obvious cause
  • May become severe enough that it impairs normal functioning
  • May include suicidal thoughts and excessive thoughts about death
  • May not get better with time; in fact, it often gets worse with time

So, even though normal depression and Clinical Depression share some of the same symptoms they are very different. Normal depression is a temporary emotional reaction to a loss or upsetting event. Clinical depression is a medical disorder that causes problems in life and gets worse with time.

What if you don’t get treatment for Clinical Depression?
Untreated, clinical depression tends to be a lifelong, recurrent disorder, much like arthritis or high blood pressure. It tends to get worse with ageing and with increased stress (again, just like most chronic disorders).

Also, there is evidence that the chemical changes associated with Clinical Depression damage brain cells in the area of the brain called the hippocampus. This is the area that controls short-term memory and much emotional regulation. The more severe the Clinical Depression symptoms (and the more often they occur) the more damage is done to the hippocampus.

Damage to the hippocampus can permanently reduce short-term memory and reduce emotional stability. So we think it is very important not to let Clinical Depression go untreated. To prevent damage to the hippocampus, and minimize the worsening of depression over time, you should treat Clinical Depression thoroughly.

What are the different types of Clinical Depression?
All Clinical Depression types include the symptoms listed at the beginning of this report. The different types of Clinical Depression differ in the time pattern of the disorder.

Major Depression occurs when the person sinks rapidly into a Clinical Depression over a few weeks’ time. There may or may not be an obvious rational “reason” for the depression to begin. The depression is a clear and dramatic difference from the person’s “normal” personality. It can last weeks to years.

Dysthymia means that the person is virtually always depressed, usually for years or even lifelong. Often the symptoms began gradually in puberty or early adulthood. The symptoms remain mild to moderate in severity and the person can function in normal activities—but not with much joy. Persons with dysthymia consider themselves (and are usually considered by others) simply to be a “crotchety” personality and not much fun. They mistakenly believe this is a “normal” condition. Persons with untreated dysthymia are at high risk for developing Major Depression episodes (when they do, this is called double depression).

Pre-menstrual syndrome (PMS) is a clinical depression that occurs each month during the week or so before the beginning of the menstrual period. It is probably due to interference with the serotonin receptors on brain cells when estrogen and progesterone fall dramatically each month. Women with PMS are at higher risk of developing dysthymia or major depression, especially if their PMS is becoming longer or more severe as the years go by.

Post-partum depression is a clinical depression in new mothers that occurs in the weeks or months after childbirth. Like PMS, it is probably due to dramatic changes in estrogen and progesterone levels. Post-partum depression should be treated quickly since it can adversely affect the infant’s mental and emotional development.

Bi-polar disorder is a disorder that includes episodes of Major Depression and episodes of Mania. Manic symptoms are the opposite of depressive symptoms in many ways. Manic symptoms include:
  • Being “speeded-up” or “hyper”
  • Feeling elated or “high”
  • Unrealistically optimistic judgment
  • Suddenly spending too much money
  • Little need for sleep
  • Starting too many activities
  • Too irritable when frustrated
  • Excessive sexual activity

Not all of these symptoms are present in every manic episode. A manic episode usually lasts from days to a few weeks. Episodes of Major Depression often occur between the Manic episodes.

What causes Clinical Depression?
Clinical Depression is due to problems with the brain’s neurotransmitters. Neurotransmitters are small molecules that travel from one brain cell to the next (across the synapse). They are the way the brain cells communicate with one another. They serve much the same purpose that electricity serves in making a computer function.

Specifically, the neurotransmitter serotonin is of great importance in the brain circuits that regulate mood and emotion. (Most of the mood-regulating circuits are in the central part of the brain called the limbic system.) Studies have shown that individuals with Clinical Depression have reduced functioning of serotonin in the limbic system.

Dopamine and norepinephrine are two additional neurotransmitters that are important in the limbic system. Problems with these may contribute to Clinical Depression in some individuals.

Why do some persons develop Clinical Depression while others don’t?
Probably the most common reason for developing Clinical Depression is heredity (as is true of most chronic disorders). If one parent has Clinical Depression, each child has about a 25% chance of developing Clinical Depression. In these persons, there are genetically based problems in neurotransmitters. When heredity is the cause, Clinical Depression usually begins to be a problem between the ages of 12 years and 40 years. Usually, these patients will need medication treatment lifelong.

Severe stress is another common reason for Clinical Depression. Stress can include relationship problems, work problems, financial problems, medical illness, losing social support networks due to moving, deaths of loved-ones or friends, etc. Especially if stress from multiple sources occurs in a concentrated time, Clinical Depression is likely to result.

Hormone imbalances can result in Clinical Depression. Hormone imbalances can occur at puberty, after childbirth, before menstrual periods, and during menopause. These are all times of increased likelihood of Clinical Depression beginning.

Some medications can interfere with neurotransmitters and lead to Clinical Depression. High blood pressure medications, arthritis medications, and steroids are among the medications that often cause or worsen Clinical Depression.

How do we treat Clinical Depression?
The mainstay of treating Clinical Depression is medication to raise the level of the neurotransmitters serotonin, norepinephrine, or dopamine. These medications are called antidepressants. Antidepressants are not addictive or habit-forming. They do not create a “false high.” They are medically very safe (they are not usually stopped in pregnancy, for example). Antidepressants have been safely used by millions for the past 40 years.

The most commonly used antidepressants include Prozac, Celexa, Lexapro, Paxil, Zoloft, Luvox, Effexor, Wellbutrin, Serzone, and Remeron. Each of these medications raises serotonin, dopamine, or norepinephrine, thus improving the functioning of the limbic system in the brain. There are many other antidepressants and we can almost always find one that will work well. Click here to read more about antidepressants.

After beginning the antidepressant, improvement in symptoms usually begins within 10 days and increases for a couple of months. How long the antidepressant should be continued depends on how long depression has been a problem. Almost always the antidepressant should be continued for at least 6 months. Persons with years of Clinical Depression will probably need the antidepressant lifelong (just like treatment for most chronic disorders).

Counseling (especially cognitive therapy) can help Clinical Depression, but is rarely sufficient by itself. Almost always, the best outcomes include the use of an antidepressant.

Getting treatment for Clinical Depression
It is best to see a specialist for treatment of Clinical Depression. An accurate evaluation and treatment plan requires more time than the average General Practitioner has to give. It is also best to see a physician who specializes in emotional disorders rather than one who tries to treat everything. You will usually get the best improvement the quickest and with the fewest side effects by seeing a specialist.

Personally, I have 25 years’ experience treating Clinical Depression as a substantial part of my practice. I stay on the cutting edge of medical research on the treatment of Clinical Depression. I always use the best treatment available. Unlike many physicians, I don’t depend on “drug reps” as a source of medication information.

I am board-certified in treating emotional, mental, and behavioral disorders. You can be sure you’ll get state-of-the-art evaluation and care. Please read this genuine testimonial from one of my patients:

[I was having] problems with depression, anger, irritability, and with dealing with life in general. [I had] the feeling of anxiety & of being “too stressed out.”

[At my first visit] I was very nervous, but Dr. Tate listened to me & told me that he could help me to feel better.

[With treatment] I am more productive at home, at work, I have a much better relationship with my daughter & I generally feel better about myself. I do not have constant anger and irritability.

[At Tate Healthcare Specialists] the staff is courteous & friendly. The overall environment is soothing and comfortable.

Elicia Davis, Pineville, MO

Even just on a simple financial basis, treating Clinical Depression makes sense. With treatment, you’ll almost always see an increase in work productivity and earnings. Health insurance usually reimburses between 50% and 80% of our fees, too.

A good first step is to complete the free on-line symptom analysis form on this web site. I’ll personally evaluate your responses and send you an e-mail giving you my preliminary opinion about your condition. Click here to complete the Free Symptom Analysis now (or click on the red flashing link on the right side of our web pages).

You can call for an appointment at 800-889-4319, or e-mail lpatel@tatehealthcare.com to request an appointment. You can listen to my 5-minute talk on Clinical Depression at 800-889-4319. You can e-mail me a question at jtate@tatehealthcare.com

Don’t delay in getting help for yourself or your loved-one. Clinical Depression gets worse with time, and does lasting damage to important areas of the brain. Treatment is simple and affordable.

Remember, if you are not completely satisfied with our first visit, your money will be immediately refunded.

Thank you!

Jeffrey L. Tate, MD