The Curbsiders Internal Medicine Podcast #479 Managing Treatment-Resistant Depression featuring Dr. Jessi Gold
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Apr 14, 2025 
Dr. Jessi Gold, a psychiatrist and mental health advocate, dives into managing treatment-resistant depression with expert insights. She explains the complexities of depression, including conditions that mimic it and the importance of patient context. The discussion covers innovative treatment options like transcranial magnetic stimulation and ketamine, alongside vital strategies for patient-provider communication. Dr. Gold emphasizes tailored approaches, family involvement, and the significance of patient autonomy in mental health care.
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Medical Evaluation for Depression
- Rule out medical causes of depression, such as hypothyroidism and sleep apnea, before diagnosing depression.
- Get a thorough history and run basic labs, including thyroid, CBC, B12, and iron levels.
Assessing Depression Severity
- Consider the severity and chronicity of depressive symptoms when evaluating.
- Assess how much symptoms interfere with daily life, not just work.
Explaining Depression to Family
- Explain depression as a real illness with biological and psychosocial factors.
- Frame it as a medical condition like high blood pressure that requires treatment.
