Life Outside The Net

Treatment for Depression

Here we are once again, cybersurfers! Last time, I posted some information on causes of depression. This column will focus on treatment of depression.

Depression is a highly treatable illness, but many people delay seeking treatment because of the stigma attached to "mental illnesses." Some people mistakenly think that if you're depressed, it's your fault. Others may erroneously think that seeking treatment means that they are weak. The "pull yourself up by your own bootstraps" school of thought may work fine for a mild, situational depression, but in this authors' opinion, the "bootstraps" theory no more applies to clinical depression than it would to a burst appendix. I don't care how strong you are, how tough you are, or how "macho" you are; if you have appendicitis, seek expert help--period, end of argument. Clinical depression is no different.

Seeking any form of therapy for depression only means you've run into a problem that you--all by yourself--couldn't solve all by yourself. Can you honestly say that you've never run into something with which you needed help? If you do claim this, my next question is: do you go to church and pray to yourself? Okay, enough sermonizing.

Whether a person needs treatment for depression depends on the cause of the depression, the severity of the symptoms, and the longevity of the symptoms. Just because something bad has happened, and you're feeling "bummed out," doesn't mean you need professional help. But if the symptoms have been going on for a while, the symptoms are getting worse, or if there is no identifiable reason for feeling "down", maybe it's time you stopped trying to fight this by yourself and ask for assistance. And if you're seriously thinking about suicide or have a substance abuse problem, there is no doubt--at least in my mind--that you need to seek professional assistance.

Some people obtain help for depression from their primary care physician. Since there can be physical problems that cause depression, if you think you might be depressed and haven't had a physical examination in a while, a good first step could be to consult your physician. After an examination, your physician may recommend a course of treatment or refer you to someone who can more expertly provide treatment.

What kind of treatment you receive depends on the suspected cause of the problem. If it is a physical problem, like for example with hypothyroidism, the solution is for a physician to treat the medical disorder. If the cause is believed to be biochemical, there are a wide variety of anti-depressant medications that can be used. A psychiatrist is a medical doctor who would likely have the greatest expertise in prescribing anti- depressant medication.

One point I would like to make about anti-depressant medications. I have known some people who benefited from taking them but were initially very resistant to trying medication. Or, once they began to feel better on medication, they threw it away without consulting their treatment provider. Often, their reluctance stemmed from thoughts that if they needed medication, they were a personal failure or that they should have been a stronger person. My response to this is to ask if they think a diabetic who takes insulin is a failure? Does a person who has an infection and could benefit from antibiotics merely need to be a stronger person? Should a person who takes medication for high blood pressure throw it away without consulting their physician simply because their blood pressure is now better? Think about it.

Psychotherapy can be very beneficial in treating depression, either by itself, or in conjunction with other treatment modalities, depending on the cause and severity. A style of psychotherapy known as cognitive therapy, or cognitive-behavioral therapy, is beneficial in reducing symptoms by altering unhealthy patterns of thinking and behavior. A clinical psychologist, clinical social worker, or some psychiatrists would likely have the greatest expertise in providing psychotherapy.

ECT, electro-convulsive therapy, is a controversial treatment that is sometimes used. This procedure conjures up frightening images in the minds of some people, but it is much safer and more effective than when first introduced in the late 1930's. Some would argue it should not be used, others that it is an effective primary treatment, and there is also the school of thought that it should only be used after other treatment modalities have failed. This form of treatment would be provided by a medical doctor, generally a psychiatrist.

Other treatment options may be appropriate, depending on the cause of the depression. If a person has a substance abuse problem, with or without depression, there are numerous programs for treating chemical dependency, as well as organizations such as Alcoholics Anonymous or Narcotics Anonymous; a person who is physiologically dependent on drugs and/or alcohol will likely need some form of medical detoxification as well. If improper nutrition is a contributing factor to depression, consulting a physician or nutritionist can be an appropriate step. If grieving for the loss of a loved one hasn't improved after a reasonable amount of time, perhaps it is time to consider psychotherapy/counseling or joining a grief group.

To again reiterate a couple of important points, no matter how hopeless you may feel, depression is a highly treatable illness. And no matter how strong or tough you are, the illness of depression can be even stronger. There is no shame in accepting that an illness like depression can wear down even the strongest of people, or that you may need help to beat it. If you wouldn't perform surgery on yourself, why should you be expected to battle depression by yourself?

Remember to send your questions about depression or suggestions for future topics to 74124.2046@Compuserve.Com. Send complaints to the publisher and make him depressed.

Cheers! :)

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