A 5% of the Spanish population (about 2,350,000 citizens) suffers depression. Mental health disorders such as depression and the anxiety (which are behind many suicide attempts) have increased in recent years, especially after the covid-19 pandemic and in the child and adolescent population. But depression is still a public health problem in the general population. “There is many types of depression. It’s many diseases in one,” says Amanda Rodriguez, psychiatrist at the Resilient Depression Program of the Vall d’Hebron Hospital from Barcelona.
Rodríguez defends a “personalized psychiatry” treat each case differently, Not all drugs are equally effective in all patients. For example, the esketamine and, much more selectively, the surgeries performed by hospitals such as Sant Pau have proven to be effective in cases of resistant depression, that is, those that do not react to other therapies. For this psychiatrist, you are new therapeutic options which include the use of anti-inflammatories in depressions that have been shown to be related to the intestinal microbiota (and not due to serotonin deficits) they open a “paradigm shift” in the treatment of this mental health disorder.
Behind illnesses such as depression there is usually a multitude of factors. Its origin is diverse. Rodríguez believes that if cases of resistant depression are increased is, “possibly”, because psychiatrists are not diagnosing and treating them “right.” “The prevalence does not drop because it is not being treated well and we make patients resistant”, points. For example, a altered immune system, or a altered hormonal system, or the gastrointestinal tract (also called the ‘second brain’) may have been the origin of the depressive state.
“The prevalence does not drop because it is not being treated well and we make patients resistant”
In the case of the pandemic, the disorders they went up due to “stress”. These diseases also have a strong environmental component. “Stress is closely related to depression and covid was a life stress all over the world”. Each time, moreover, there are “more young people” with this disease.
Even so, as the head of the Sant Pau Psychiatry Service and member of the Catalan Society of Psychiatry (which is part of the Acadèmia de Ciències Mèdiques de Catalunya) recalls, Narcis Cardoner, the treatment of depression must be personalize because in some cases the base is “more psychological” and, in others, the “pharmacological” weight is greater.
In addition, Cardoner believes that if Spain is a leading country in benzodiazepine consumption it is because the public system does not have the “Sufficient resources” to attend to the demand that exists. “The primary care has five minutes for each patient and many times the quick solution is give the pill to the patient. And psychotherapies are expensive,” he adds.
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