Dr. Marek Walczyk, M.D.
Appointments: (708)224-8840

What is Depression?

Depression Articles:

  1. Understanding Depression
  2. Alcohol Use Disorders
  3. BiPolar Disorder
  4. Suboxone


Understanding Depression

Depression affects approximately 14 million adults IN AMERICA TODAY

Whatever you’re suffering from depression yourself, or care about someone who is, you are not alone. Either way, you know firsthand how difficult it can be to live with the symptoms. As you work towards managing your depression, or helping someone else manage theirs, you will learn that there are different treatment options available. And by educating yourself about the condition, you are building awareness that can help you talk to a healthcare professional about options for depressive symptom relief.

Defining Depression
People struggling with depression know all too well how it feels for them. But each person experiences depression in his or her own way. One person may sleep too much while another sleeps too little. Some people don’t eat enough and lose weight while others overeat and gain weight.

A diagnosis of Major Depressive Disorder, commonly referred to as depression, rrequires having a depressed mood or loss of interest and pleasure in activities a person used to enjoy, plus at least four of the following symptoms must be present nearly every day for at least two weeks:

  • Significant unintentional weight loss or weight gain (change of more than 5 % of body weight in a month), or decrease in appetite
  • Insomnia or hypersomnia (excessive sleeping) nearly every day
  • Feeling restless or sluggish to the point that others notice
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate, or indecisiveness
  • Recurrent thoughts of death (not just fear of dying), recurrent suicidal thoughts without a specific plan, or a suicide attempt or specific plan for committing suicide.

If you ever have suicidal thoughts, call your healthcare professional, an emergency room, or 911 to get immediate help.

Of course, depression is more than just a collection of symptoms: It’s a medical condition that can feel overwhelming and often interfere with people’s daily functioning. Depression can often make things like work, school, and relationships more difficult to manage for the patient. Only a healthcare professional can diagnose and recommend treatment for depression. It’s for patients to keep working together with their healthcare professional to find the symptom relief they need.


Depression is thought to be caused by an imbalance in key brain chemicals the brain in made up of millions of nerve cells that more a constant stream of information from one cell to another. To keep the information flowing, the cells release chemicals called neurotransmitters. Many scientists believe that changes in the levels of these neurotransmitters may result in the symptoms of depression.

Brain chemistry in only part of the story. Other factors that may put you at greater risk for depression include:

  • Family history of depression
  • High- stress situations, such as the loss of a loved one, financial difficulties, relationship issues, or major life change
  • Drug or alcohol abuse
  • Hormonal imbalances
  • Physical illness, especially one that causes chronic pain
  • Gender- depression affects about twice as many women as it does men.

Depression should not be seen as a character flaw or a sign of personal weakness, it is treatable illness. It’s important to remember that depression is not something a person can just “snap out of”’.

Managing Symptoms OF DEPRESSION

When people have been diagnosed with depression, their healthcare professional will have most likely prescribed a first course of treatment. Initial treatment may include one or more of the following:
TALK THERAPY. Sessions with a psychiatrist, psychologist, therapist, or clinical social worker can help people understand how depression can affect their lives. Together, they can work toward positive changes in their outlook and relationships, and discuss practical adjustments to help make life less stressful
GROUP THERAPY. In this form of, a mental health professional leads a discussion group of people with depression. Participants share their experiences, challenges, and coping strategies. Getting support from people who are going through the same thing can be an encouraging and positive experience
MEDICATION. In planning treatment, healthcare professionals can choose from several types of medications of neurotransmitters. After evaluating the patient’s symptoms, the healthcare professional with want to see how those symptoms respond to a medication, and if there are any side effects. Every person responds to medication differently, which is why a healthcare professional may try several medications such as an antidepressant before finding the right treatment for a particular patient.

Medicines used to treat depression may require 4 to 6 weeks to reach their full therapeutic effect. Although some people may show partial improvement as early as the first week, a person’s response can not be appropriately assessed until after approximately 4 to 6 weeks. If 6 to 8 weeks go by without at least moderate improvement, the healthcare professional should re-evaluate the treatment plan.


A clinical study showed that as many as two-third of those diagnosed with depression did not achieve adequate symptoms relief after taking an antidepressant alone.

If an antidepressant is not providing adequate symptom relief and depressive symptoms are still present, patients don’t necessarily need to change their antidepressant. There may be an option that could work with their current treatment.


Alcohol Use Disorders

Alcohol related disorders are estimated to affect 18 million Americans, roughly the same prevalence as depression. Alcohol dependence or abuse almost certainly affects some of your patients, whether diagnosed or not. And that can complicate their care. Regularly screening patients for drinking patterns and considering whether alcohol may be a contributing factor to their current medical complaints are important first steps in confronting this often hidden but debilitating disease.


Whether you start with single interview question regarding alcohol use or a simple screening tool such as the CAGE questionnaire, it’s important to have a dialogue with your patients during routine visits and other consultations.

Appropriate Patients for Campral

Campral is an ideal choice for many alcohol –dependant patients. Intended for people who are alcohol free at treatment initiation, CAMPRAL therapy has been shown to work best with ongoing psychosocial support and should be an integral part of treatment.

Having established those parameters with alcohol –dependent patients, who is most likely to benefit from CAMPRAL therapy?

  • Patients with alcohol dependence seeking help
  • Patients with psychiatric and medical comorbidities
  • Diagnosed patients already in the treatment system
  • Relapsed patients who have left treatment
  • Because CAMPRAL has an excellent safety and tolerability profile, few patients will be excluded based on preexisting conditions * or concerns regarding drug interactions or adverse events.

You Can Make a Difference

We hope you will use this information to be proactive in the fight against alcohol dependence. Increased physician involvement and broader screening has many benefits, especially since medically-based treatment options mean you can do more to help patients manage this disease .Consider CAMPRAL therapy as part of that management plan. CAMPRAL is appropriate therapy for many people with alcohol dependence, regardless of where they are in their journey to recovery.

Next Step Once Your Patient Has Been Screened

Risky Drinking: If the patient exhibits risky drinking behavior but does not meet the criteria for either dependence or abuse , advise the patient that he or she is at risk for developing alcohol –related problems. A strong recommendation to cut down or quit drinking is in order, as are follow-up questions regarding alcohol use at any subsequent visits.

Alcohol Abuse:

Patients exhibiting symptoms of alcohol abuse need to be clearly informed about your diagnosis of an alcohol –related disorder. Show them how it may be contributing to current concerns and medical conditions. A goal of cutting down consumption and controlling drinking episodes should be set if the patient is unwilling to abstain. A referral to a counselor or mutual self –help group may also be appropriate. And do follow up. While not all abusers go to on to develop alcohol dependence, it is often the initial path to alcoholism.

Alcohol Dependence:

If the symptoms of alcohol dependence are present, be very direct in conveying your diagnostic conclusion and strong in your recommendations. Connect the drinking to the patient’s medical conditions and personal situation. Not every patient will be willing to listen but, as a physician, you may have more influence than you realize.


Bipolar Disorder


Living with bipolar disorder.
If you‘re one of the over 2 million Americans living with bipolar disorder, you know that getting what you want out of life isn’t easy. Chances are you’ve been up and down, with mood swings and relapses. You may also have been misunderstood or misdiagnosed for years before being properly treated.

Ultimately, you want to move forward with treatment to help stabilize your mood swings.
And it all starts with effective symptom control. By fully understanding your condition, and by working together with your healthcare professional, you have a better chance of getting the stability you’re looking for.

People with bipolar disorder tent to experience extreme mood swings, along with other specific symptoms and behaviors. These mood swings or “episodes” can take tree different forms.

In a manic episode, you may experience an elevated (extremely happy) mood or extreme irritability. Other symptoms include:

  • Feeling extremely anxious
  • Talking too fast too much
  • Having an unusual increase in energy
  • Having a reduced need for sleep
  • Risky or impulsive behavior, like sexual promiscuity or excessive spending sprees
  • Delusions (believing things that aren’t true) ,paranoia(feeling unusually fearful), and
  • hallucinations (sensing things that aren’t real)

In a depressive episode, you might have overwhelming feelings of emptiness and sadness, along with:

  • A lack of energy
  • A loss of interest in things
  • Trouble concentrating
  • Changes in normal sleep or appetite
  • Thoughts of dying or suicide

In a mixed episode, both manic and depressive symptoms are present at the same time.

What causes bipolar disorder?
The cause of bipolar disorder is not yet known. However, research suggests that normal brain cell functioning is disrupted. The symptoms of bipolar disorder are thought to be caused by an imbalance of some key chemicals in the brain.

Understanding your treatment options.
While there is no cure for bipolar disorder, medicine can play a key role in helping you manage your symptoms and extreme mood swings. It can help make your behavior more even and predictable. But taking medicine as prescribed and staying on it can be hard. And because the side effects can be bothersome, you may feel like you want to stop taking your medicine until you talk with your healthcare professional.

Another Option: ABILIFY
If you’re unhappy with your current treatment, there are a variety of options available, including ABILIFY. ABILIFY is a prescription medicine indicated for treating patients with an acute manic or mixed episode associated with bipolar disorder and maintaining efficacy in patients who have been stabilized and then maintained for at least six weeks.



Since 2000, when the Drug Addiction Treatment Act (data 2000) was passed by Congress, doctors have been able to treat opioid dependence in office settings as well as in a specially licensed clinic or hospital. SUBOXONE is the first opioid medication approved under DATA 2000 for the treatment of opioid dependence in an office –based setting. If you are experiencing opioid dependence, you and your doctor can decide what treatment is right for you based on your needs. Many people are able to take SUBOXONE at home, just like any other medicine for other medical conditions, after the doctor has determined the right dose. Daily visits for treatment are not necessary after your dose is established.

What is an Opioid?

Opioids are drugs that are either derived from opiates (drugs created directly from opium, such as morphine or codeine) or are chemically related to opiates or opium. Examples of opioids include some prescription painkillers (such as oxycodone, hydrocodone, buprenorphine, methadone, and heroin).

What is Opioid Dependence?

An individual is generally considered opioid- dependent when 2 things occur:
Repeated opioid use is needed in order to feel good or avoid feeling bad, and
The opioid use continues in spite of its negative effect. For example, people who are opioid- dependent will feel a need to keep using opioids even if it hurts their health, job, finances, or family.

What Are Common Characteristics of Opioid Dependence?

  • Opioid tolerance ( the need to take more drug to get the same effect, or getting less effect from the same amount of the drug)
  • Withdrawal symptoms occur when opioids are not used
  • Taking other drug to help relive the symptoms
  • Taking larger amounts of opioids than planned and for longer periods of time
  • Persistent a lot of time and effort to obtain, use, and recover from opioid use
  • Giving up or reducing social or recreational activities; missing work
  • Continued opioid use regardless of negative consequences

A person with clinical need for pain relief should not be transferred to SUBOXONE.SUBOXONE is not indicated for the treatment of pain.

Is Opioid Dependence a Medical Condition?

Opioids, such as some prescription pain medications or heroin, attach to opioid receptors in the brain, which, stimulate the release of dopamine and produce pleasurable feelings. When the opioid eventually detaches from receptors, people experience withdrawal and cravings and have a strong need to repeat the experience. Drug use often begins as a choice, but frequent use can cause the brain cells to change the way they work. The brain is “re-set” to think that the drug is necessary for survival. Researchers have discovered that many drugs, including opioids, cause long- term changes in the brain. These changes can cause people to have cravings years after they stop taking drugs.

Can Opioid Dependence Affect Behavior?

The need to satisfy cravings or avoid withdrawal can be so intense that people who want to stop taking opioids find this difficult to do. Or, they may find themselves doing things they wouldn’t ordinarily do in order to obtain more of the drug they crave. For this reason, even though opioid dependence is a medical condition and not a moral failing, it can drive behavior.

How Common is Opioid Dependence?

Opioid dependence is more common than you may think. You are not alone. No one group of people is immune to opioid dependence. Men and women of all ages, races, ethnic groups, and educational levels can become dependent on opioids.


SUBOXONE is the first opioid medication approved under DATA 2000 for the treatment of opioid dependence in a private office setting.
Buprenorphine is a partial opioid agonist that blocks other opioids from attaching to receptors in the brain. This treatment can help you stop misusing opioids. Treatment, including counseling, can help you rebuild your life.

What is a Partial Opioid Agonist?
A partial agonist is an opioid that produces less effect than a full agonist when is binds to opioid receptors in the brain. The way different opioids work can be explained using a lock and key example. Receptors are like a lock to a door. Only the right key will fit the lock, and only opioid – like drugs fit opioid receptors.

With a full opioid agonist such as oxycodone, hydrocodone, morphine, methadone, or heroin, the key fits the lock , opens the door wide, and produces full opioid effects (the feeling of euphoria, or being high, as well as the side effect)
With a partial opioid agonist such as buprenorphine, the key fits the lock but doesn’t open the door all the way, so it produces less than full opioiagonist effects and, at the appropriate dose, blocks other opioids from opening the door fully
An opioid antagonist such as naltrexone or naloxone fits in the lock but does not open the door at all and, at the appropriate dose, blocks other opioids from opening the door.

At appropriate doses SUBOXONE can:

  • Help to suppress withdrawal from prescription pain medications, heroin, or similar full opioid agonists
  • Help to decrease cravings for other opioids
  • Reduce the effects of full opioid agonists.