Depression and Suicide:

During my years working at Columbia University as the chief assistant to world-renowned doctors Ronald Fieve and Donald Dunner, who specialize in the diagnosis and treatment of depression and bipolar disorder;

They would tell me about female patients who would come to the doctor's office, regularly applying makeup, saying they were depressed, and then commit suicide a week later; and they would carefully emphasize that such cases could mislead doctors.

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​5% of Depressed Patients Commit Suicide!

​Two-thirds of depressed patients may have suicidal thoughts.

They may have impulsive thoughts of harming another person.

Medications can increase the risk of suicide:

Antiepileptic drugs increase the risk of suicide (FDA Alert: "Suicidality and Antiepileptic Drugs," Jan. 31, 2008.) www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116847.htm

Medscape Health News 2008, Yael Waknine mentioned that the FDA (American Food and Drug Administration) stated that antiepileptics increase the risk of suicide.

Psychotic Depression:

In the psychotic type of depression, the patient shows detachment from real life. Hallucinations and thought disorders may occur.
Seasonal Depression:
The type called seasonal depression occurs every year during the period when the sun is less intense.

Anxiety and Depression:

Some people with depression may also develop Anxiety Disorder as a secondary illness, characterized by excessive worry and somatic complaints.

Drug and Alcohol Use:
Secondary depression can occur due to drug and alcohol use; some of these individuals were already depressed before substance use. If depression occurs with substance use, we call this dual depression.

Head Trauma-Related Depression:
Some people may develop secondary depression due to head trauma in childhood or adulthood, with or without loss of consciousness, and these individuals generally do not respond well or at all to medication.

Depression in Other Diseases:

40-60% of Parkinson's patients

50% of stroke (due to brain paralysis, hemorrhage, or blood clot) patients

40% of Alzheimer's patients

30% of trauma patients

30% of Multiple Sclerosis patients experience depression.

Postpartum,

Epilepsy (Seizure Disorder),

AIDS,

Thyroid disease,

Systemic Lupus Disease,

Depression can also develop due to vitamin deficiencies such as B12, B6, D, C, and folic acid.

 

Depression can develop due to some medications:

Some high blood pressure medications (such as beta-blockers and reserpine)

Some heart medications (such as digitalis and veratrum)

Cortisone and hormones (birth control pills)

Amphetamine-group medications (Ritalin)

Analgesics (Ibuprofen and morphine derivatives)

How is Depression Diagnosed?

The patient's history is very important in diagnosis.

It is important to know whether the patient's family members have a history of the illness, and if so, whether they used medication and, if so, which medication they used. Misdiagnosis often occurs during the patient's history taking.

If the patient comes to you with their family, you can also learn about the symptoms from them; the family may provide answers that the patient does not.

QEEG Database-Based Depression Diagnosis Method:
Our center has been using several QEEG database systems approved by the FDA (Food and Drug Administration) in the USA since 2000, pioneering this method in Turkey.

The brain's electrical activity is recorded with Digital EEG, and the patient's brainwaves are compared with those of patients with Depression and Manic Depression using the NxLink Data Bank, developed by New York University through 20 years of research. This system can also determine whether these individuals have experienced a head trauma.

 

This system, with 90-94% accuracy, objectively assists in our clinical diagnosis, helping to differentiate whether a patient's symptoms are due to depression, manic depression, or head trauma.[1] Of course, diagnosis must be made based on clinical findings, digital EEG and database analysis, and the clinician's decision.

Hypomania:

Furthermore, some hypomanic patients present to their doctors for the first time with symptoms of depression, and hypomanic episodes occur or are triggered when antidepressants are prescribed. With the QEEG database, these potential patients can be easily identified objectively before treatment even begins.

We Must Reduce Misdiagnosis:

Many cases of depression who have not responded to treatment for years have come to our center as a last resort. Some of these patients do not want to use medication.

A significant number of these patients learned, after undergoing digital EEG and database review, that they did not have

Depression, but rather

Manic Depression or

Secondary depression due to a previous head injury.

Some patients experienced symptoms of depression or manic depression-like symptoms some time after receiving a head injury.

It appears as a secondary cause.

A QEEG-Data Bank analysis can determine if the patient has experienced a head trauma.

Often, electrical changes in the brain that do not show up on a classic EEG are linked to head trauma on QEEG recordings, and this is why the patient does not respond to medication.

Thus, we determine whether the patient's depression or manic depression is due to a primary cause or a secondary cause arising from head trauma.

Treatment of Depression:
Treatment of depression generally involves medication, psychotherapy, cognitive therapy, family therapy, hypnosis, and electroshock therapy.