Tag Archives: therapy

What Doctor is Best for Treating Depression?

The treatment of mood disorders is not as simple as finding a diagnosis and writing out a prescription. Each individual has different causes of depression, and medications used to treat it are just as diverse. Individual characteristics, co-existing illnesses, and tolerance to medications are a few of the characteristics that need to be considered in treating depression.

Bipolar disorder is particularly easy to misdiagnose as patients may fall between bipolar and depression criteria. Symptoms of mania may be overlooked because the depression is so severe (especially when the patient seeks treatment for depression).  Bipolar disorder can also be misdiagnosed as another illness.

There are no blood tests or CAT scans one can take to make a definitive mental health diagnosis. Doctors must rely on symptoms and the patient’s history. Treatment involves a combination of patience, knowledge,  judgment, and a willingness to try new things.

Family physicians do not specialize in mental health treatment. Some people are seeking initial treatment through their family physician, however, the family physician treats and screens a wide range of illnesses.  One study showed that 74% of people seeking help for depression went to their family physician; of this 74%, as many as 50% were misdiagnosed.

The  National Depressive and Manic-Depressive Association (DMDA) interviewed 1,000 people with major depression and 881 primary care physicians (PCPs) who were members of the American Medical Association and the American Osteopathic Association.

The DMDA study found:

  • Less than 1/4 of patients reported their depression as fully controlled, although they had been taking the same antidepressants for 3 to 5 years.
  •  6 in 7 patients reported antidepressants having a positive effect on their lives, but 76% reported sleeping side effects and 59% sexual side effects. Only 17% reported their doctor as having warned them of these side effects, while 47-69% of physicians said they did warn the patient of potential side effects.
  • Patients who had problems with side effects were as likely to stop the medication (55%) as to ask for a switch to another antidepressant (57%).  
  • 40% percent of patients believed they had no choice but to tolerate antidepressant side effects, vs 9% of physicians who believed that.

Physician John Zajecka, MD, associate professor of psychiatry, Rush-St. Luke’s-Presbyterian Medical Center, Chicago attributes the discrepancy to the physician assuming the patient has heard the whole story, when they are really only absorbing 10 to 20% of it.

Dr. Zajecka said that PCPs may complain that it is nearly impossible to schedule a referral because the psychiatrist is booked up. It’s important to understand that psychiatrists are as busy as a family care physicians in the amount of traffic coming in and out of the office.  There may be a wait of a week or longer, but a psychiatrist is the best treatment available for mental health care.

Psychologists, who specialize in therapy, are also qualified to treat depression but they cannot prescribe medication. If you are unsure if you should seek a psychiatrist or therapist; you can schedule your first visit with a therapist and see if they refer you to our psychiatrist or not.

Apex’s phone number is (734) 729-3133. Don’t hesitate to call, we are here to help you!

Ask Steve

Q.  I’m a 29-year-old male and my girlfriend is 26. We’ve been dating about six months and I want to get married right away while she wants to wait another six months until she feels more secure about the relationship. We’ve argued several times about this in the last several weeks, but she doesn’t seem to get it. The other night we had another argument about setting the date and I actually began to cry and begged her to marry me sooner. I thought that when I cried it would show her how much I cared about her and that I was a sensitive man who could openly express my feelings of sadness and disappointment, but it had just the opposite effect. It seemed to shut her down and she became more aloof and we had a hard time continuing the conversation. What gives? I thought women wanted a man who was sensitive and could show his feelings.

A. When a woman says she wants a sensitive man in her life, what she is really asking for is a man who is first and foremost sensitive to her and her feelings. A woman feels most cared for and understood by a man who is sensitive and open enough in ways that take her feelings and needs into consideration as well as his own. We call that empathy. Empathy is the ability to “connect with” and “feel with” another human being. She is not asking for agreement as much as she is asking for her feelings, emotions, and ideas to be heard and acknowledged by him. To her, this signifies the qualities of a sensitive man.

Most likely, when you began to cry and beg her to marry you, in spite of
how she felt, she began to feel overwhelmed and turned off in two important areas. First, that somehow you really were not sensitive to her feelings in this matter and that she didn’t feel heard again.

Second, when you bring your girlfriend your tears and make her feel blamed for them, you are asking her to carry your emotional burden as well as her own, and that can be very overwhelming for a woman dealing with her own issues, fears and concerns. In that sense, it is about a man giving a woman a part of his emotional life that he has no business giving.

In order to resolve this issue, I would suggest that you begin to listen and learn more about your girlfriend’s true feelings and why they are important to her, and blame no more. Also, it seems to me that there are some strong emotions behind your tears. I would begin to look at what fears and wounds lie in your tears.

One way to do this is by working with a therapist or a men’s support group to help you uncover and resolve the feelings of anxiety and fear which come up for you around your girlfriend’s disagreement with you about the date of your wedding. Then, if you need to share your feelings of sadness and disappointment with her, you will be able to do it in the context of helping her understand you better, based on what you’ve learned about yourself, instead of making the problem about her.

Steve Mandell is a therapist at the Apex Westland office (734-729-3133).

Myths Surrounding Therapy

Potential therapists?

For some, therapy has a worse reputation than it should. For starters, you won’t be sitting on a long chair resembling the one Sigmund Freud’s office. The basis will not be on childhood issues. We here at Apex wish to dispel certain myths about therapy in hope of clearing any doubts prospective clients may have.


1. All people who seek therapy are mentally ill.

False! Many people with various issues seek therapists. If you are going through a rough patch, it makes it easier to have someone (certified) to talk over issues with you.

Racing to the behavioral health clinic.

2. Therapy is too much $$$

Therapy isn’t cheap, but we do offer low fee rates for clients who do not have insurance. But think of it this way; you’d put a lot of money into your wedding or doctors visits, right? It is worthwhile to make the investment on something that can improve your life and relationships. And if you find that therapy does not work for you, you can always quit – but it’s worth a shot. Friends and family are a great support system, but friendship is a two-way street and therapists devote 100% of their time to you.

Everything you tell your therapist is confidential.

Next stop therapy!

3.  Therapy is a hassle and takes up too much time. I don’t have time to work and go to therapy.

Our doctors and therapists work a variety of hours to accommodate your schedules. Some staff members are here until 8 at night, while others start at 9 in the morning. Therapy sessions are 45 minutes to an hour long, while medication management visits with the psychiatrist are twenty minutes.

 4. My therapist is going to judge me.

Therapists are here to help you and make you feel as comfortable as possible, not to judge you. Therapists are educated in human behavior and the dynamics between relationships. Therapy can benefit you and help you move forward. Also, none of your friends or family will know you are in therapy unless you tell them yourself.