Frequently Asked Questions

MDD is a mental health condition that affects how you feel, think, and behave. It causes persistent sadness, loss of interest in activities, and other emotional and physical symptoms.

Common symptoms include:

• Persistent sadness or low mood
• Loss of interest in activities you once enjoyed
• Changes in appetite or weight
• Trouble sleeping or sleeping too much
• Fatigue or lack of energy
• Feelings of guilt or worthlessness
• Difficulty concentrating
• Thoughts of death or suicide

MDD is diagnosed by evaluating your symptoms, their duration, and their impact on daily life, often with tools like the PHQ-9 questionnaire. While there is no universal “cure,” many people with MDD find relief through treatment. Some achieve long-term remission, but treatment may need to be ongoing.

Common treatments include:

• Medications (such as antidepressants)
• Psychotherapy (talk therapy, such as CBT or interpersonal therapy)
• Lifestyle changes (like exercise and healthy eating)
• TMS or Spravato therapy for treatment-resistant cases

The exact cause of MDD is unknown, but it may involve a combination of genetics, brain chemistry, stress, trauma, or environmental factors. Risk factors include:

• Family history of depression
• Stressful life events or trauma
• Chronic illness or pain
• Substance use disorders
• Being a woman (women are more likely to experience depression than men)

While there is no universal “cure,” many people with MDD find relief through treatment. Some achieve long-term remission, but treatment may need to be ongoing.

The duration of MDD varies; some experience a single episode, while others face recurrent depression. With treatment, symptoms can improve within weeks to months.

TRD occurs when a person does not respond to two or more antidepressants or other standard treatments, making more advanced therapies like TMS or Spravato necessary.

es. MDD can cause physical symptoms like fatigue, headaches, and changes in appetite. It also increases the risk of chronic conditions, such as heart disease and diabetes.

Sadness is a normal emotion in response to life events, but it usually passes. Depression is persistent and overwhelming, interfering with daily activities for weeks or longer.

Yes. MDD can affect children and teenagers, though their symptoms may look different (e.g., irritability instead of sadness). Early treatment is important for younger patients.

There’s no guaranteed way to prevent MDD, but managing stress, building supportive relationships, and seeking help early can reduce the risk or severity of future episodes.

TMS (Transcranial Magnetic Stimulation) is a non-invasive treatment that uses magnetic pulses to stimulate areas of the brain involved in mood regulation, particularly the prefrontal cortex. This stimulation helps to activate under-active neurons, improving mood and relieving symptoms of depression.

Yes, TMS is FDA-approved and generally considered safe for treating depression. Most patients experience mild side effects, such as scalp discomfort or headaches, which typically resolve quickly after a few sessions.

Each TMS session usually lasts 20-30 minutes. Patients typically attend sessions 5 days a week for 4 to 6 weeks. The procedure is non-disruptive, and most patients can return to their normal activities, like driving and working, immediately after each session.

TMS is recommended for people with treatment-resistant depression who have not found relief with medications or experience intolerable side effects.

Most major insurance plans cover TMS, but coverage may vary, so it’s best to confirm with your insurance provider.

TMS is not painful, though some patients may feel a mild tapping sensation or slight discomfort on their scalp during the session. Some patients notice improvements within the first few weeks, but full benefits are generally seen after several weeks of consistent treatment.

Yes, many patients continue taking their medications while undergoing TMS therapy. Your doctor will advise you on what’s best for your specific treatment plan. If TMS doesn’t provide the desired results, your doctor may recommend other therapies or alternative treatment options.

Esketamine is a nasal spray medication derived from ketamine, used to treat treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal thoughts. It was approved by the FDA in 2019.

Esketamine targets glutamate receptors in the brain, promoting new connections between brain cells and improving mood. It works differently from traditional antidepressants, which focus on serotonin and other neurotransmitters.

Esketamine is prescribed for:

• Treatment-resistant depression (TRD): When at least two other antidepressants have failed to help.
• MDD with suicidal thoughts or behavior: As a short-term option to stabilize mood.

Esketamine is given as a nasal spray under supervision at a certified healthcare clinic. Patients need to stay for 2 hours of observation after each treatment to monitor side effects.

Esketamine treatments start with two sessions per week for the first four weeks, followed by once a week or every other week, depending on the patient’s progress.

Many patients report improvement within hours or days of starting treatment, though lasting benefits are often achieved when combined with other treatments like antidepressants and therapy.

Esketamine is FDA-approved and considered safe when used under medical supervision. Common side effects include:

• Dizziness or nausea
• Temporary disconnection from reality (dissociation)
• Drowsiness or fatigue
• Increased blood pressure

These side effects usually wear off within hours after treatment.

While Esketamine is related to ketamine (a drug sometimes misused recreationally), it is carefully monitored in a clinical setting to prevent misuse or addiction.

Patients should not drive or operate machinery for the rest of the day after treatment due to potential drowsiness and disorientation.

Many insurance plans cover Esketamine for patients who meet the criteria, but coverage varies. It’s recommended to confirm with your provider beforehand.

Esketamine can typically be used alongside an oral antidepressant, but your healthcare provider will review all medications to ensure no harmful interactions.

If Esketamine does not provide relief, your doctor may explore other treatment options, such as TMS therapy, psychotherapy, or adjusting medications.

While Esketamine is FDA-approved for treatment-resistant depression and MDD with suicidal thoughts, it is not approved for other conditions, such as anxiety.

Each Esketamine session takes about 2 hours, including observation time.

Patients might feel dizzy, disconnected, or drowsy during their first session. This is normal and usually goes away by the end of the observation period.

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MDDCare is your trusted healthcare resource, connecting patients with clinics and providers offering intervention psychiatry. We help patients find the right clinic for their depression treatment and schedule appointments, and provide valuable knowledge and insights for those fighting depression.

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