By Flavia Nassaka
Can new blood-test detection improve treatment outcomes?
Dr Harriet Birabwa, a Butabika based psychiatrist says that 20% of all patients that report to the hospital have had an episode of depression and of 100 aging people, 80 are depressed. Also, the World Health Organisation estimates show the disease’s prevalence is set to rise by 2020 as it will be the second most common diagnosed condition, after heart diseases.
Unfortunately, Dr Birabwa says, although depression is becoming a very serious issue, some doctors cannot easily diagnose it. She says this makes it impossible for the condition to be countered at an early stage.
“Experiencing constant headaches and pains, patients embark on taking malaria medicine even when the blood test comes out negative,” she says adding that most patients they admit testify to have taken several doses of malaria or even typhoid drugs.
According to Birabwa, the exact cause of the disease is not known though it may be as a result of stressful events like job loss, death/ loss of a beloved one, loneliness and genetic mechanisms. She says depression could be associated to hard economic states where people have financial problems to the extent that people take loans that they know they cannot pay back.
Because the disease has no definite cause, clinical depression can take several months to be clearly diagnosed for doctors try to analyze a patient’s behavior for a period of time to conclude whether they have the condition or they are simply experiencing natural feelings of sadness caused by an event or tragedy.
Doctors say depression can be treated by counseling and anti-depressant drugs but at later stages a patient may fail to respond to both.
“At some point, counseling alone cannot work but the patient might be subjected to electroconvulsive therapy to change blood flow to and metabolism of areas around the brain to release depression triggering chemicals,” she says.
The doctor says it may take a person longer than six months to completely recover from the disease.
In the study published in the journal Translational Psychiatry on Sept. 15, scientists said there could soon be an alternative for diagnosing depression apart from analyzing the symptoms (clinical interviews) as it has always been. The mental condition will soon be detected by a blood test.
Dr. Eva Redei a research professor for psychiatric disease together with other scientists from the Northwestern University in Chicago found out the disease can be detected by identifying nine chemicals in the patient’s blood that are raised during depression.
The researchers took blood samples of 32 patients traditionally diagnosed with depression and 32 others who were fine.
They found nine RNA blood markers (molecules that carry out DNA’s instructions) that differed significantly between the two groups, which Redei then used as the basis for the depression diagnosis.
After successful tests, those diagnosed with the condition undertook cognitive behavioral therapy (common psychological treatment for depression) and their blood was once again tested. The scientist was now able to tell which patients benefited from the therapy by analyzing the changes in the RNA blood markers.
The beauty with this test according to scientists is that one can use the results to determine which therapies will be successful and also it’s easy to identify those who are vulnerable to the disease even without an episode.
Dr. Birabwa said that if this method of diagnosis is finally approved to be used in Uganda, more people will be saved from having severe episodes of the disease since patients realize they are sick at very advanced stages but with a test, it will be easy to treat the disease and their episodes will be shortened.
Depression not stress
However, depression is different from stress.
Dr Joshua Sebunnya, a psychologist says stress usually lasts a small period of time but both are caused by failure to cope with one’s demands either at home or at a job. Both conditions show almost similar symptoms.
Both conditions according to the doctor involve symptoms such as appetite loss, sleep problems, anxiety, constant headaches, and feelings of guilt among others. But a depressed person may go on to have illusions and a feeling of wanting to commit suicide.
“Clinical depression unlike stress involves excessive sadness that one can persistently be sad for more than two weeks and slowly they start losing interest in pleasurable activities,” says Dr Sebunnya.
There are three types of depression: mild, moderate and severe. With mild depression, one does not need treatment; it can be corrected by talking to friends, counselors, teachers, friends or relatives. With moderate or severe depression, one may need to get admitted for treatment.
Depression can be prevented. Dr Sebunnya says people should learn to avoid deep thoughts by doing a plenty of exercises, being assertive, talking about their problems with friends and family in order to get quick solutions.