CAN-BIND – In Search of a Shorter Path to Treating Depression
Does winter get you down? If so you may be suffering from Seasonal Affective Disorder or SAD, a sub-type of depression that people experience in fall and winter when the days are shorter and light levels are lower. According to a January 03 blog from CAN-BIND, 1 in 10 Canadians may be affected by what health professionals consider a serious disorder that can affect daily functioning, including in the workplace. But SAD is only one of many forms of depression and CAN-BIND is much more than a source of information about a specific type of depression.
CAN-BIND, the Canadian Biomarker Integration Network in Depression, is in fact an innovative, ground breaking research initiative that aims to change the way we regard depression and pioneer a new approach to diagnosing and treating depression that has implications for benefit plans and promises to improve outcomes for employees.
What is innovative about CAN-BIND?
Depression is a complex illness. Unlike other diseases, it can’t be diagnosed using objective criteria, like laboratory tests or brain scans. Also, its symptoms differ from person to person and may change over time. Diagnosis and treatment are typically established based on clinical interviews and self-reported symptoms. Because no one treatment works for everyone, a wide range of approaches have been developed.
What is innovative about CAN-BIND is that its researchers are looking for a more individualized approach to battling depression using a comprehensive set of objective tests. It works in two ways:
- To evaluate outcomes using different types of treatment: medication, psychotherapy and neurostimulation; and
- To collect data on three platforms: brain scan, clinical assessment and blood test.
By considering so many variables researchers hope to find biomarkers – biological measures like specific proteins, genes, or brain abnormalities – that influence outcomes in depression, and then identify the kinds of treatment plans that work for individuals in specific sub-groups. Their goal is to shorten the path between diagnosis and the right treatment for people with depressive symptoms.
Why will findings matter?
It goes without saying that any findings matter if they lead to better diagnoses and treatment outcomes. The current path to the right treatment is long and based largely on trial and error. Treatment typically consists of two stages:
- Acute treatment – takes up to three months and is aimed at relieving symptoms of depression. Medication can take a few weeks to start working and patients must keep taking it even after they start feeling better. Psychotherapy can take longer.
- Maintenance treatment – should continue for at least one year to prevent the return of symptoms or relapse. Some people experience depressive episodes or recurrences regularly. To prevent recurrences, maintenance treatment may be required for several years or even lifelong.
To increase the likelihood that a treatment will be effective, patients need to take the correct dose of medication at the correct time for as long as their physician indicates. If after a few weeks, a treatment does not seem to be working, more time is needed to make adjustments or find another that might be more successful. Shortening the path to the right treatment can make a difference for everyone, including employers.
Why will findings matter at work?
Each employee’s situation will be different, but it is clear that employers must be respectful of the fact that depression is a serious illness that may affect workplace productivity for extended periods of time. It is in their interest to ensure that employees receive the most effective treatment possible in a timely manner – a goal that CAN-BIND findings are likely to help them achieve. Employers must ensure their benefits plans reflect the complexity of diagnoses and provide unrestrictive access to the newest medications as well as a generous amount of psychotherapy. Currently plans typically average between $500-$1,000 for therapy sessions. That is not enough, but change is happening. Manulife has raised its cap to $10,000 and, as reported in bh 12(6), Starbucks has begun providing $5,000 a year.
Who is participating? Can you participate?
CAN-BIND is uniquely a collaborative project, involving more than 10 major Canadian academic centres. Results will be spread through a worldwide network of healthcare providers. It is supported by a number of organizations, including its major sponsor, the Ontario Brain Research Institute.
Research studies are just getting underway. For an update on progress to date, watch Steve Paikin’s interview with Harriet Feilotteron of Queen’s University on TVO’s The Agenda – Depression Signposts: Written in the Blood.
Participation is not limited to academics. Research teams are beginning to collect data from people across the country. Any individual with depression who is interested can join one of CAN-BIND’s research studies by downloading a referral form at www.canbind.ca/studies
Need More Information?
For more information, visit CAN-BIND on the web. The site includes information about the program, as well as general information about depression, including several videos. For example, Table 1 provides a checklist from CAN-BIND to help people decide when they should seek help for depression. And then there is SAD, people with depressive symptom that appear in winter, can learn more about their condition in the CAN-BIND video Seasonal Affective Disorder (S.A.D.) – What Is It and What Can We Do About It? bh
|Table 1 – Signs and Symptoms of Depression – When should you seek help?|
If you check off at least five of the items on the following list, and symptoms are present most days, all day, for at least two weeks, you should seek help: