So, not to go into why you are depressed. You know you are, and you have sought help. Sometimes more than once, as it didn’t go well the first.. second.. third time.
So how can it be treated, or can it? Why is it not working.
The side effects are terrible.
(sorry at the length, some 2000 words.) … I am chatty.
Depression is tenacious. It clings and gets a hold on you. Perhaps you know why it is gripping you, perhaps not.
Possibly as I stated above you have sought treatment, perhaps a few times.
So lets look at the treatments, medications, therapies.
not if you are seeking answers, or are tormented with a lack of success.
So I am going to tell you how to kick it out? to feel better?
You know, if I could, I would. But maybe I can sort things out for you a bit.
so the stats.. the ones you don’t want to hear about.
Two out of three seeking help may not get what they want.
ok, notice the may not, also I emphasize the “what they want” I will also go into why a bit as well. So don’t despair.
So, first off, if the treatment is not or does not seem to be helping, do not give up. Seek other options, there are so many.
Now, before we go into things… lets peek back to see why not everyone is pleased with their treatment.
You have preconceived ideas as to why you are depressed. When you seek help you just want a quick diagnosis that agrees with what you think and off you go with a jar of pills that will make you feel better. Why not?
no, it isn’t a silly thought. You have had time to think at why you are depressed, poked around, talked to people.
You know though, you could have missed something. This part is more about my why does it take so long to get a diagnosis post. Found here So you don’t get the treatment you wanted and give up. It happens, It happens a lot.
Misdiagnosis, so you don’t receive the treatment you really need. Things don’t go well, again you give up. So why the misdiagnosis? There could be a few reasons. If you don’t provide a very detailed history, things will be missed, important things. Remember there is no outlet at the back of your head for uploading your history. You need to communicate all the things that bother you. Answer questions honestly.
I know, it is a tense situation, you are baring your soul, to a stranger. It is very hard to do.
Then there are those times where you want to say something, the topic changes and you forget. Write things down. Make an on going list of any of your concerns….. oh and remember to bring it with you. When you remember something that you think may be relevant, write it down.
So now, treatment. The pills. Not just pills though. Therapy is important too. Very important. Lets deal with the meds now though.
depressed… so antidepressants. easypeasy.
So there are a few choices. I have talked about the chemicals in the brain a bit before.
Selective serotonin reuptake inhibitor. These are the types of drugs that allow serotonin to be available for the brain to use, this is one treatment for depression. No details on how or why right now, the post will be long enough. 🙂
Here are a few. There are also combination meds.
Celexa (generic name citalopram)
So what else?
Serotonin norepinephrine reuptake inhibitor. Again working with chemicals in the brain. Serotonin and norepinephrine.
again, to help with depression.
eeeps, big names.
My point is, there are choices. Different medications.
Ok, so the sad part with many meds. Medications have side effects. I mean almost all of them do. Simple pain tablets damage your stomach.
Now the side effects vary. They don’t act the same for everyone, some are not bothered at all, some a lot, so if you are bothered a lot, you change to a different med. or dosage, or combinations of meds.
Sometimes the side effect can be treated. Yes a pain, and confusing. But if it makes you better.. is it not worth it?
What becomes interesting is a med may bother you. The side effect is something you don’t or can’t cope with. Rather than changing the med, the dose can be changed. Smaller, larger, more frequently, they all have large changes.
Now, what if the med just isn’t working? Same thing, usually the dosage will be changed first, increasing and yes sometimes decreasing. Or a second med can be added, sometimes the two together work well.
Time, this is big. Meds don’t always work right away. The same with the side effects, at times they pass. Things like headaches and insomnia… nausea, loose bowels, they will likely fade as your body adjusts. see there is hope. Don’t give up.
Now the tough part. Are the side effects worse than the depression? Can you cope with them? I know, that is tougher.
This is where therapy can help and yes there are other things too, I will get to them. Therapy should be considered, even if the meds work, maybe soon meds may not be required? Perhaps things can be sorted.
There are more meds than listed too, meds for other conditions. Some that are unexpected may work.
So don’t give up. You need patience.
So how long..
there a good question.
An antidepressant may take weeks to become what you hope for, four, six.. more.
Now some meds too, the strength of them can grow, but not all at once. Your doctor may gradually increase the dosage to where it is desired, some meds can be used full strength at the start, some can not.
You need to communicate too. Because if something is tormenting you during this process. There are things that can be done short term to help you cope. Even sexual side effects can be treated… but only if you communicate.
Now, don’t stop your meds, the withdrawal may be bad. Of course there are exceptions. Talk to your doctor when they prescribe the medication, ask them what you should look for. DO IT, don’t assume or hope or let it pass. TALK. Be informed. Ask them what side effects you may encounter, which ones should you be concerned about, which ones should make you stop taking the med. But talk when they are prescribed. You don’t need the anxiety that will appear when you have side effects you were not expecting.
Other than Therapy and Medication, what is there?
So other things. A new old thing actually. ECT.
Letters make things sound less scary. When medication is not working there is another route.
eeeps barbaric. Remember the body functions with electricity. Well the brain does.
So before you cringe, when you have a heart attack do you say no shocking please? oh? so it is ok then to shock your heart to save your life but not your brain? I know, it sounds scary.
So ECT is one of the safest forms of treatment. The current applied is finely tuned while the patient is under anesthesia, this treatment is very fast, and is used for other conditions as well, such as mania. The current is slight, not like in those scary movies or like it was in the ’50s.
Many respond well to this too.
VNS Vagus Nerve Stimulation
similar to ECT
So there are others as well. Yes they all sound scary, therapy, medications…. shocks..
To avoid being in the group of those that give up or fail you need to do things too. It is easy to say ” I want a pill” and that is all, just like anything else in life, the more you put into it, the more you get out of it.
What can you do?
well it is about time you asked. First the easy part. Communicate with your therapist and or doctor. They likely can’t read your mind, but you may be surprised a bit about that. The more you tell them the more you provide feedback at what works and doesn’t work, the more you get out of it. They will try harder too, when you show that you are trying. Life is like that you know.
NOW THE HARD PART
Why is this the hard part? Because like the title of this post. Depression sucks. It sucks the life out of you, your desire to do anything, to interact with others.
Exercise. see you cringed. sorry, but here is something to ponder. Some people can replace meds with exercise. The body is good at that. Exercise can produce more serotonin than those tiny pills. oh.. and with no side effects.
But you won’t bother, you are in a rut. It is too hard to go for a walk, gradually changing it to a jog. or a swim…
Now I know, sometimes there are conditions that restrict exercise, physical things. But talk to your doctor, maybe there are some exercises you can do. I bet there are. It is easy to let depression tell you not to.
Depression is like that. just sit here. don’t do anything…
Oh, another big one. FOOD
yup. Nutrition is huge. When depressed you seldom feel like eating, let alone eating well, more excuses, I know. it is too hard to cook, I am alone, cooking is just too much trouble.
So let me ask now, do you want to get better or not?
Work at it. It will be hard at first, but it does get easier, you start to eat better and that becomes progressive. The same with exercise. Soon you look forward to it.
Soon you notice, and I mean soon, that you feel better. Soon you question the need for meds. I am not kidding. Exercise is powerful.
In fact, just a tiny bit can change your outlook. Instantly.
Hormones & Sleep
So depression and serotonin are linked, but serotonin and melatonin are linked also, as serotonin is used to produce melatonin. Diet and exercise will increase serotonin. What this boils down to, is depression and insomnia are partners.
Insomnia often shows up before depression, and fuels it. So many treatments for depression are often aimed at insomnia first. Perhaps both.
Hormone replacement or supplements are also used. Lets use this as an example, Melatonin. Produced in your body, it is produced in the brain to give you your nightly sleep. It is also used to treat depression. Interesting, as it is produced with serotonin, the brain chemical that is used to fight depression. See how complex it can get?
Melatonin is used to treat insomnia primarily but also cancers, migraines, and a host of other things. It is being studied as a depression medication as well.
The brain produces this at night. Not much. Also only when it is dark.
Supplements don’t last long, it is hoped that when you take the pill before bed it will help you sleep and the regular production of Melatonin will take over and allow your sleep to continue.
There are two types, fast relief and timed. The timed will last about three hours, the fast action less than an hour.
So there are side effects too. Night terrors, increased depression or sadness as examples. So this is used to treat depression but causes it. yup. So dosages are adjusted. Other meds too, can be added to contend with the terrors, rashes.
NOT ALWAYS STRONGER. often much much less. fractional amounts can induce sleep and eliminate the night terrors. What is hoped with the treatment is that it is short term. Perhaps only months, and then the body is back to a normal sleep cycle. Sometimes the dosage can be increased as well.
Melatonin deficiencies may be a cause for insomnia. they cause other things as well, depression, mood swings. Attention disorders, high blood pressure.
Melatonin doesn’t just regulate your sleep. it is a regulator of sex hormone production. There are links now to Alzheimers, aging, autism, bipolar disorder, even diabetes. See we are still learning a lot about the brain, we probably know more about the moon.
Lets pop over some of the symptoms of a deficiency
irregular menstrual cycle
unusual menstrual flow (light or heavy)
sensitivity to stress
high blood pressure
Many of the conditions of a disorder, Things pile up. What may have been just depression from a disorder, may be much more due to the complications. Everything is connected. Low Serotonin is connected to low Melatonin levels, Depression occurs with both. Now insomnia enters. when severe the depression becomes a new animal. Normal symptoms become more complex, crossing the lines, making conditions harder to determine.
So why all of this? To show you how complex treatment may be, it is not just give me a pill so I can feel better. Oh that may work sometimes. But when it doesn’t… DON’T GIVE UP
Because it grows and becomes worse, and the longer left untreated, just like everything else, makes treatment more difficult. When you feel your treatment is not working and give up… it is not going to go away, you want to feel better don’t you?