Being sad or feeling hopeless is a normal part of human existence appearing and disappearing and reappearing with the ebbs and flows of life. But when symptoms of a depressive episode last for more than two weeks, and begin to get in the way of one’s day-to-day life, that’s when a person meets the criteria for Major Depressive Disorder, or MDD, which is one type of the DSM-IV’s depressive diagnoses and one of many different mood disorders. The prevalence of MDD in Canada is higher than other mood disorders such as bipolar disorder and anxiety disorders (discussed in our next episode!) like generalized anxiety disorder and social phobia. Because of its prevalence, many areas of treatment are available to those who are struggling with clinical depression, including talk therapy, changing diet and exercise, medication, and brain stimulation therapies.

This episode’s guest, Tammy, shares with us that she began experiencing symptoms of MDD when she was in grade school. While depressive disorders tend to begin later in life and global data suggests that the median age for the onset of symptoms is 26 years old, a study from the United States showed that depression can be diagnosed as young as three years of age. Interestingly, a study from Korea showed that the age at which a person experiences their first major depressive episode may be correlated to a variety of different clinical indicators, like the frequency in which MDD episodes recur, that play a key role in one’s clinical prognosis of MDD and its outcomes. 

In this episode, we learn about a few of Tammy’s family members, one of whom also struggles with their mental health. Given the hereditary, or genetic, predisposition to mental disorders, it is common for some mental illnesses, like bipolar disorder, schizophrenia and depression, to run in the family. But when discussing the “nature” side of things, we mustn’t forget about the “nurture”. We’ve also seen that the environmental factors like one’s family structure, exposure to traumatic events, and much more can increase rates of mental health problems. 

Fast Facts

• Globally, depression is estimated to occur among 1.1% of adolescents aged 10 to14 years, and 2.8% of 15- to 19-year-olds. 
• More than a quarter of a million Canadian youth, representing 6.5% of people between the ages of 15 and 24, experience major depression each year.
• Depression can go unnoticed in children. Some may not talk about their helpless and hopeless thoughts and may not appear sad. Depression might also cause a child to make trouble or act unmotivated causing others to incorrectly label the child as a troublemaker or lazy.
• In Canada, once depression is recognized, intervention and treatment can make a difference for 80% of people who are affected, which allows them to get back to their regular activities.

Learn More about This Episode’s Cool Research

In this episode, we spoke to Dr. Valerie Taylor, Head of Psychiatry at the University of Calgary, and the namesake for the Taylor Lab. Their main area of research is how the gut influences brain health, known in the literature as the gut-brain barrier. Scientists have already shown a potential for the influence of gut microbiota in diseases like asthma and type I and type II diabetes, to name a few. When it comes to the bidirectional relationship between the brain, gut and microbiome there is a growing amount of evidence that this is a valuable area of research that may have implications on new therapeutic avenues. For example, studies aiming to elucidate the relationship between depression and the microbiome have shown a link between MDD and an imbalance of the gut microbiota’s bacterial composition. Some of these studies even reported seeing modest improvements in depressive symptoms following interventions targeting the gut microbiome. 

Dr. Taylor and her team are interested in whether or not microbiomes from the gut of healthy people can be used as a treatment for those suffering with ailments, and in their case specifically, people struggling with treatment-resistant MDD. In order to get those healthy microbiomes transferred, the Taylor Lab is experimenting with Fecal Matter Transplant, or FMT for short. For their research, the process involves retrieving fecal samples from healthy screened donors, converting those samples into capsules (also known as “poop pills”),and orally administering the capsules to patients. There is a fair amount of evidence to back up the efficacy of FMT in treating disease, in fact, the practice has been reported in literature dating 2,000 years ago. The efficacy of FMT for patients with treatment-resistant MDD, however, continues to be a question the Taylor Lab is working hard to answer. 

Through this work, Dr. Taylor remains hopeful. In an interview with Mike Fisher for the University of Calgary, Dr. Taylor discusses her team’s research. 

“...[T]he jury is still out on whether we can actually leverage what seems to be a gut-brain connection into the next generation of therapies. There is reason to be excited and to pursue this work and that's what fuels us — the possibility. [...] There has been research that shows if you take bacteria from depressed mice and put it into non-depressed mice, they become depressed. Microbiota are not benign, and we want to ensure people are aware of that. [...] Patients are desperate for new treatments, sometimes the current treatments don’t work for everyone or have side effects that are not tolerable. So, people are looking for anything that will help them.”

Support

If you’re struggling with your mental health, you’re not alone.

If you are in immediate danger of harming yourself or others, call 9-1-1, or head to your nearest emergency room. You can also call or text 9-8-8 to reach the Suicide Crisis Helpline. Support is available 24 hours a day, 7 days a week.

Young people can chat anytime with Kids Help Phone by calling 1-800-668-6868. Services are available in English and French.

Wellness Together Canada provides one-on-one counselling, self-guided courses and programs, and peer support and coaching. Youth can contact this service by calling 1-888-668-6810 or texting WELLNESS to 686868. Adults can contact this service by calling 1-866-585-0445 or texting WELLNESS to 741741. You can also find credible articles and information on their website. 

The Canadian Mental Health Association can help you find resources, programs, or support for yourself or others. Find a CMHA branch in your area here. 

The Centre for Addiction and Mental Health provides Mental Health 101 tutorials and online courses on their website. 

The Canadian Network for Mood and Anxiety Treatment has a list of resources for those dealing with mood disorders, such as depression and bipolar disorder, and anxiety disorders. 

Depression Hurts is a website developed by the Mood Disorders Society of Canada that includes a symptom checklist and doctor discussion guide for patients.