Monday, March 15, 2010

The Why and the How of it

After my Freedom posting, I received several emails asking for more information. It seems people are wondering how to begin seeking help for depression.

I’m no psychologist, but here is my opinion. :) I think the best way to go about this process is to see a therapist (either a MFT, LCSW, or psychologist) first. They can ‘diagnose’ you with depression, and talk to you about whether medication would be right for you. Then, if it seems medication is right for you, either they refer you to a psychiatrist who does a brief interview and gives you the prescription or you can just go to your primary doctor.

I chose the second route because I have been with my doctor since I was 17 and she knows me really well. I hadn’t even mentioned to her that I had seen a therapist. She took one look at me and knew I needed help. But you may not know your doctor that well, or they may not be ‘in tune’, and in that case it would be good to have the outside opinion of a therapist.

Another benefit to seeing a therapist is that maybe you don’t need medication after all. Maybe, particularly if your depression is purely situational, therapy is enough on its own to get you through. You don’t want to go into antidepressants lightly. They literally change your brain chemistry. You want to make sure they are appropriate for you. If therapy is enough, let it be enough.

If you do need extra help though, even with the therapist’s recommendation, there can still be roadblocks. I have a friend who went to a new doctor about her postpartum depression. Even though she told him that her therapist recommended she take something for a while, he told her she just needed to exercise. That is actually really good advice, if she was able to get out of bed. Luckily, she didn’t give up. She got a second opinion. She took an antidepressant (with continued therapy) for about six months, weaned off, and has been fine ever since. So, if you know in your heart what’s right for you, don’t give up!

Now, you could skip the therapist altogether. Some doctors have no problem writing prescriptions for anything, just because you asked. But I recommend seeing someone first. This is your health, and I think a slow, methodical approach (with a few different opinions) is better.

About the word “depression” being on your medical file… yeah, it stinks. Join the crowd. Many, MANY people have been treated for depression. I would venture to say most long-term infertiles have dealt with it in some way. I have been assured by case workers and therapists that it does not hinder adoption proceedings. Regardless, if you are seriously dealing with depression, what choice do you have? Are you going to live your life half-way so that you don’t have to see a “therapist” or have the word “depression” next to your name in some doctor’s file? That’s NO life.

Along these same lines… it is possible that some people will have to take an antidepressant, or see a therapist, their whole life. Many do not, but some do. Maybe their chemistry is such that they are susceptible to full-on, long-term depression. It’s not ideal, but again I say, what is your other option? Personally, I would rather have a full life with valued relationships and special moments, even if it means I have to take a tiny pill each day, or talk with someone each week. I was able to wean off the medication, so I don’t know how it feels to be in that situation. Even so, I know how I felt when I was in the midst of the depression, and that wasn’t living.

Of course, I need to acknowledge that antidepressants (and even therapy sometimes) are not for everyone. Some people have awful reactions to antidepressants, and they can make things worse for some. What I am trying to express is the importance of knowing yourself and doing what is right for you to make your life better. Maybe it’s therapy, maybe medicine, maybe both, maybe neither. Maybe it is exercise, meditation, volunteering, or art. Whatever it is, it is so SO important that you find it, and never give up trying. Because, if you are where I was, it can only get better!

I hope this helps someone!


Susie Demke said...

I'm sure a lot of people will benefit from this. I'm always impressed with your wisdom and insight and your willingness to share it.
I read your last post too and I just want to add that the method of weaning is different for each type of anti-depressant or any type of medicine. Some, you DO NOT skip days. Someone reading that post should not just follow what you did. Or what another friend or family member did/tried. Each medicine is different with a different half life, dosage, how much you were taking, how long you were taking it, what you were taking it with. Your Dr. will tell you exactly how to do it. That is the most important thing. She/He will have the tools and knowledge to help you do it and make the transition as easy as possible. Each med is VERY different. Like you said- Respect the medicine. And consult with your Dr. FIRST.

I'm so glad you're "free". Congratulations.
Much love:)

RMCarter said...

I am so glad you added this, Susie. You are very right. I wouldn't want people to just do what I did. I'm adding this to the blog.

Love ya!

RMCarter said...

I also wanted to add a statistic that a friend just shared with me: Approximately one-third of patients who have one episode of major depression will have another episode within 1 year after discontinuing treatment, and more than 50% will have a recurrence at some point in their lives. Something to keep in mind!

Luna said...

I LOVE YOU! ANd you too Susie! And thanks for the plug for Social Workers. I have see first hand in friends and family around me and as a professional the AMAZING benefit of therapy and medication. Each by themselves and together. I have also seen what can happen to those that stop taking their meds the wrong way. (also as a side note, some pills CANNOT be split!) Thank you for being couragous. Sometimes I wish more people would be and ask for help. I think everyone in the world would see the benefits in society.

Christine Dallimore said...

All of this is completely awesome!!! Thank you so much for sharing. After my second miscarriage my doctor perscribed me an anti-depressant. She wants me to take it until well after my next due date. I didn't know how important it was to wean off of it-seriously THANK YOU, THANK YOU for this information!!!