Plotting the Course to Remission: The Search for Better Outcomes in the Treatment of Depression

Depression includes a wide range of symptoms that can impair a person’s psychosocial and physicalfunctioning. This impairment can lead to decreased productivity, increased health care utilization,alcohol and substance abuse, and an increased risk of suicide. While the treatment of depression hassignificantly advanced over the past 30 years, there is still room for improvement. Full remission ofdepressive symptoms is often elusive, and many patients never achieve full relief from theirdepression despite being regarded as responders to antidepressant treatment. Current treatments fordepression tend to focus on emotional symptoms, not the physical and anxious symptoms alsoassociated with depression. However, the physical and anxious symptoms of depression can be seriousand sometimes more prominent than the emotional symptoms of depression, especially amongspecial populations such as women. New treatment strategies, such as dual-acting agents and thecombination of pharmacotherapy and psychotherapy, target the emotional and anxious symptoms ofdepression as well as symptoms associated with pain. In order to increase response and remission,depression should be seen as an illness comprising not only emotional symptoms but physical andanxious symptoms as well.