Tag Archives: antidepressants

I Think I’m Depressed – What Now?

Many people have a hard time accepting that they may be depressed. They feel some level of shame or embarrassment, which is unfounded considering that depression is a disease. If you had cancer, wouldn’t you go to a doctor?

Depression hits people of all ages and races. Currently, there are an estimated 15 million people in the US suffering from depression. Realistically, that number is probably higher than what’s reported. Regardless, 2/3 people don’t get any sort of treatment for depression, which is a waste because depression is a treatable illness.

Nobody knows what causes depression. You may be able to identify a trigger, or a stressful event like divorce or death of a loved one as causing your depression, but it may have existed prior.  There is no one reason why depression sets in; however, stress, hormones, and genetics can increase the risk. 

The longer depression lasts, the worse your symptoms may get and the harder it will be to treat.

Without treating depression, people can struggle for months or years feeling absolutely miserable. If you do decide to seek treatment, there are a lot of effective and proven ways to treat depression. Doctors will try psychotherapy or antidepressant medication. Studies have found that combined treatment of therapy and medication works better than medication on its own.

Lifestyle changes can help depression, which is something you and your therapist can talk over. Managing stress, getting enough sleep, eating healthy, and exercising have all been shown to help. The important thing is that there are many options out there.

Some people are appropriately apprehensive when it comes to taking medication. Common worries include if the drugs will change one’s personality, or concerns regarding the side effects. The doctor will inform you about potential side effects. Regarding altering your personality, depression has already put you in a fog and the medication may help you return to your original self.

For those that are interested, antidepressants work by making the nerve cells form stronger and healthier connections to specific parts of the brain. The most common antidepressants are called SSRIs. These types of drugs can take weeks or months to be effective.

Therapy has been shown to have more lasting benefits than medication. Talking to a stranger about the problems bothering you may make you feel uncomfortable. It’s important to remember that therapists are a skilled professional and they will not judge you. Everything is confidential!

Cognitive behavioral therapy helps you see how your own thought patterns can contribute to your depression and it teaches practical ways to change them.

Many people seek a holistic approach to treat depression. There’s the view that if it comes from the Earth, it is natural, and therefore less harmful. However, natural supplements have side effects as well. You should talk to a doctor or do extensive research before taking them. The evidence is unclear if natural herbs actually work or not. Supplements like fish oil and folic acid may have some benefits, but other supplements really don’t do anything.

So how does one start treatment? You can get a referral from your family doctor or call the 1-800 number on the back of your insurance card and they will find you a mental health provider. The American Psychological Association and the American Psychiatric Association also have online locators. Some family doctors prescribe antidepressants but finding a psychiatrist (someone who specializes in mental disorders as opposed to general medicine) will be more beneficial for treatment.

Physical symptoms of depression can include: headaches, back pain, muscle aches, joint pain, chest pain, digestive problems, exhaustion & fatigue, sleeping problems, change in appetite or weight, dizziness or lightheadedness.

Benefits of treating depression include: better sleep, better libido, pain or discomfort relief, improved health, better work performance, better memory, happier home life, healthier lifestyle, increased sense of control, decreased future depression, and stronger ties with family.

Some people avoid getting treatment for the following reasons:

  • “I’ll snap out of it if I give it time.”  You can’t snap out of being depressed. Having the blues may pass, but clinical depression will linger and get worse if it is not treated.
  • “‘I don’t want to take antidepressants.” Psychotherapy is always an option. Cognitive behavioral therapy deals with your thoughts and feelings now; it works to improve your thought pattern and your quality of life.
  • “I don’t feel sad all the time. Why do I need treatment?” Sometimes, people with depression see their clinical physician for ailments like muscle pain or sleeping problems, not knowing that they are symptoms of depression. You don’t need to be crying all the time to be depressed.
  • “I’m embarrassed to talk to my doctor about it.”  Depression is not something to be ashamed of, it is a common medical condition. Your doctor has already treated patients just like you.

You can always voice your concerns to your therapist or doctor and they will work with you to make you feel more comfortable. Apex Behavioral Health is always available to help treat your depression. Make an appointment and help yourself!

Antidepressants

Antidepressants are psychiatric medicines used to alleviate mood disorders. Antidepressants work on the brain in a variety of ways, different antidepressants target different areas of the brain  Tricyclic antidepressants were one of the first major antidepressants introduced in the late 1950’s, and were later replaced by selective serotonin reuptake inhitors, or SSRIs. SSRIs  increase the amount of serotonin available to bind to brain’s receptors; Prozac, Zolof, and Paxil are some of today’s most popular SSRI antidepressant drugs.  SNRIs, serotonin-norepinephrine reuptake inhibitors, such as Effexor and Wellbutrin, work by increasing the levels of the neurotransmitters serotonin and norepinephrine in the brain, which plays a role in one’s mood.  

Lately there has been controversy surrounding the overall success of antidepressants. Some researchers argue that people are being too over-medicated,  that antidepressants are not extremely beneficial in patients with mild depression. The placebo effect refers to a patient taking  a sugar pill and reporting  feeling better, simply because they took a pill they were told would improve their condition. In reality, the patient ingested a sugar pill and it was their change in thought that led their condition to improve.

Patient volunteers are told they will receive either the drug or a placebo, and neither the scientist nor the patient knows who is getting the sugar pill as opposed to the actual drug. Most volunteers want to get the actual drug, and several weeks into the clinical trial users know they are on the real drug when they experience side effects.  Some studies have shown that the worse the side effects, the more effective the patient believes the drug is, heightening expectations.

Newsweek argues that the belief in the power of a medical treatment can be self fulfilling, aka the placebo effect.

However, drug advocates argue that the FDA would not have approved ineffective drugs for millions of people to take. The FDA requires two clinical trials to prove that a drug is more effective than the placebo. In patient-doctor relationships, doctors personally monitor and see the positive effect antidepressants have on a patient’s mental state.

In an analysis of six experiments where depressed patients received a placebo or active drug, the true drug effect (the drug’s effect in addition to the placebo effect) was found to be “nonexistent to negligible” in patients with mild and moderate depression.  In patients with very severe symptoms, there was a statistically significant drug benefit.

Certainly, antidepressants have helped tens of millions of people, and people on antidepressants should not discontinue taking their medication. However, antidepressants may not be the best first choice for patients with mild depression.

Psychotherapy has shown to be extremely effective in treating patients with depression, depression ranging from mild to moderate to severe. For some patients, psychotherapy in addition to antidepressant medication works even better. Each individual experiences depression differently, and psychotherapy is particularly tailored to each person’s individual issues.

In the U.S., many patients with depression are treated by their primary care physicians, not psychiatrists.  If you are experiencing depression or any other mental problem, it is important to see a therapist or psychiatrist over a primary care physician. Therapists are able to truly individualize your treatment, and give your mental health the utmost attention.  Apex Behavioral Health can provide you with psychotherapy and psychiatry. Apex is specialized in mental health, all of our staff is certified and qualified. Please don’t hesitate to seek out a doctor or therapist – depression symptoms can get better.

The Newsweek article can be found here: http://www.newsweek.com/id/232781/page/1