FROM THE EDITOR OCTOBER/NOVEMBER 2019 BY ORLY AVITZUR, MD, MBA, FAAN; EDITOR-IN-CHIEF Why You Should Tell Your Neurologist If You Feel Depressed

While an estimated 17.3 million (or 7.1 percent of) adults in the United States have had at least one major depressive episode, we know the incidence is much higher in people with certain neurologic conditions. Poststroke depression, for example, affects more than half of people who've had a stroke. This is why, for National Depression Education & Awareness Month this October, we have included our first feature on this challenging symptom. Dr. Avitzur (MacKenzie Stroh)

In our story "Neurologic Conditions Can Lead to Depression—Here’s How to Manage It," one of our experts notes that neurologists like me may focus more on the neurologic condition itself and miss or dismiss depressive symptoms. That's why telling us how you feel is so important. If, for instance, your depression is triggered by a prescription medication, your doctor may be able to replace it with an equally effective treatment that's less likely to affect your mood. In fact, medications for high blood pressure, gastroesophageal reflux disease, pain, anxiety, and hormonal issues are among the more than 200 drugs associated with depression. Moreover, if you are taking three or more medications, your risk of depression increases. Telling your doctors will also enable them to check for conditions associated with depression, such as thyroid or other endocrinologic disease, nutritional problems or vitamin deficiencies, infections, and autoimmune disorders. Once you are diagnosed with depression and your doctor has been able to rule out sources like these, he or she will likely refer you to a psychiatrist, who may prescribe different drugs, counseling programs, and other strategies for coping.

In our Disorders department, we take an in-depth look at hereditary ataxias, inherited conditions that affect coordination and gait. We also learn about another inherited condition—Tourette syndrome—from Dash Mihok, in one of my favorite cover stories of all time. Some of you may recognize him as Bunchy from the Showtime series Ray Donovan. Here, the actor describes what it was like growing up with the disorder and how it has shaped his career. His story is inspirational, as is our feature on singer-dancer Mayte Garcia, who was once married to Prince and is now speaking publicly about her diagnosis of multiple sclerosis.

Last but not least, we ask Ralph F. Jozefowicz, MD, FAAN, director of the neurology residency program at the University of Rochester Medical Center and widely respected as one of the finest educators in the field, to explain why neurologists may tap your knees with a special hammer or ask you to sniff a bar of soap during a neurologic examination. He has trained and inspired possibly more future neurologists than any other clinician in this country, and we are delighted to introduce him to you.

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If you are unsure whether you or someone you care for is experiencing depression, speak to your doctor. You also may be able to get a free screening at your local hospital or health care system on October 11 as part of National Depression Screening Day. Finally, I want you to know that our story on depression was inspired by your letters and feedback, so continue to write to us at [email protected].

Orly Avitzur, MD, MBA, FAAN, Editor-in-Chief RELATED CONTENT

Neurologic Conditions Can Lead to Depression—Here’s How to Manage It

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