‘The overindulgence upon the use of SSRI with therapies that are generalized and automatic has made our therapy work very inefficient.’ One of my colleagues, a Clinical Psychologist, mentioned during my internship in my third year. Through further exploration, I discovered that this overreliance contributed to treatment ineffectiveness and high relapse rates among depressive patients, labeling them as ‘treatment resistant’. This suggests that generalized treatments are commonly applied to those with depression, whereas each case should be treated based on individual symptoms and indicators. Our current understanding of depression is too encompassing, covering a spectrum of symptoms found in other disorders. For instance, dysphoria might appear in both depressive and anxiety patients, while rumination is evident in both depression and PTSD cases. This brings to light the limitations of symptom-based clinical diagnoses and hints at a need for more comprehensive biological evaluations.
I was deeply intrigued by the research of scholars at a renowned psychiatric institute, who were redefining depression by examining its potential subtypes through biological correlations. Dr. [Jane Doe]’s research highlighted the possibility of categorizing depression using inflammatory cytokines as indicators, coining it as an ‘inflammatory subtype of depression’. Dr. [John Smith] demonstrated varied HPA-axis responses between certain types of depressions in his meta-analysis. I am eager to reconsider the pre-existing categories and introduce new ones based on inflammatory patterns, or to study the HPA-axis more closely until distinctive patterns emerge. A study published by [Taylor and team] in 2016 pinpointed at least four unique biotypes of depression by identifying functional connectivities. Thus, the approach to classify depression based on biological markers instead of just symptoms seems promising. By accumulating enough evidence – be it HPA-axis variations, inflammatory markers, or neural connectivities – we could redefine depression based on unique biological abnormalities.
For a deeper dive, I chose ‘Human Neuropsychology’ as my final undergraduate project. I delved into how neuroinflammation plays a part in numerous mental disorders. Prolonged activation of specific neural cells, which is reminiscent of chronic inflammation, releases harmful cytokines triggering a series of pathological events. I hope to further investigate the role of neuroinflammation in treatment-resistant depression, closely following the insights provided by Dr. [Jane Doe]. Additionally, I want to use resting-state fMRI to study the functional connectivity differences in the brain, and ascertain correlations between depression types and neuroinflammation patterns.
My hands-on experience was enriched during an internship at [Harmony Wellness Center], a mental health service in [City]. Overseeing Peer Support Groups, I coordinated interactions between current and past patients, caregivers, and specialists. One memorable interaction was with a caregiver who dedicated her life to her sister diagnosed with schizophrenia. Noticing signs of stress, I initiated a conversation that helped her reflect on her own well-being, a critical aspect often overlooked by caregivers. This experience underscored the intricate interplay between social factors and mood disorders.
Post my interactions, I enrolled in a Mindfulness-based Cognitive Therapy course, aiming for innovative approaches to treat mood disorders. The essence of MBCT is the cultivation of self-acceptance and empathy. In future research, I aspire to assess MBCT’s potential benefits for those with TRD by targeting symptoms such as rumination. Recent research by [Alexandra Fischer] in 2018 highlighted functional connectivity issues in depression patients. My interest lies in determining how MBCT might help in restoring these connections.
It’s anticipated that students will undergo ten clinical sessions at [Prestige Health Institute] prior to in-depth case analyses at [University X]. It’s clear that a generalized approach to treating depression has amplified the challenge of treatment-resistant depression. Through hands-on learning, I hope to delve into biomarkers of depression like HPA-axis activities, inflammation patterns, and neural connections. By identifying new indicators, we can advance personalized treatments. This course is an ideal fit for my aspirations, guiding me towards becoming a dedicated depression researcher in the future.
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