October 1, 1999

Depression is an illness that affects body, mood, thoughts and behavior. While it is treatable, its exact causes are not known. Fortunately, the myriad doctors and researchers working on depression have developed better techniques and more improvements to existing treatments than ever before.

The Depression Clinical and Research Program at the MGH is committed to enhancing the lives of people suffering from the various forms of depression through the development of novel treatments and the improvement of existing treatments. The program has grown tremendously under the leadership of Maurizio Fava, MD, director, and Jerrold F. Rosenbaum, MD, chief of the Clinical Psychopharmacology Unit and director of Outpatient Psychiatry at the MGH. According to Jonathan Alpert, MD, PhD, co-associate director with Andrew Nierenberg, MD, of the Depression Clinical and Research Program, some people have a biological predisposition to developing depression. "Those who have a first degree relative (parent or offspring) with depression are two or three times more likely to develop it themselves," he says. "There may be many other causes for depression as well, such as stress and certain viruses or toxins."

There are many different treatment options, including more than 20 antidepressants. New pharmaceutical treatments are in clinical trials, and the dietary supplements SAMe and St. John’s Wort are being studied at the MGH and elsewhere. According to Alpert, individuals respond differently to treatments, which leads researchers to believe that depression is really a complex of interrelated illnesses. "The key is finding which treatment will help a particular patient," he says.

While many people with depression can be helped, Alpert states that approximately 15 percent will not respond to multiple trials of anti-depressants. For some patients, treatments work for about 8 to 12 weeks and then symptoms return. Many people, however, experience life-changing and enduring results from treatment.

"One of the most unfortunate things about depression is that sufferers don’t receive adequate treatment, if they are treated at all," says Alpert. "Many people with depression have no hope that things will ever get better and this prevents them from seeking treatment." He also believes the stigma attached to mental health problems prevents people from seeking treatment. While society has become more knowledgeable, he explains, depression is too often seen as a sign of instability or weakness.

According to Alpert, recognizing the symptoms of depression is the first step. This is why awareness initiatives, such as National Depression Screening Day, are needed. Alpert’s advice to anyone who thinks they might have depression is to visit a National Depression Screening Day site (Oct. 7, see "What’s Happening," Page 4, also for times and locations). Concerned MGHers can visit their primary care physician or contact Outpatient Psychiatry. The Employee Assistance Program (6-6976) is an additional resource for employees in finding help for depression .