Monday, 16 July 2012

DEPRESSION AT THE CROSSROADS

What to Do When Your Depression Treatment Isn't Working

You've been going to therapy, taking your antidepressants as directed, and following all of your doctor's advice. But you still don't feel like your old self.

What's taking so long? It can be frustrating to wait for your depression treatment to start to work.

Be patient, but not passive, when managing your depression, experts tell say. This five-step action plan can help you get the most from your depression treatment:


Antidepressants: Know Your Options

There are many drugs to choose from to treat depression. The initial choice is usually based on which symptoms are most troublesome and potential side effects, says Bryan Bruno, MD. He is the acting chairman of psychiatry at Lenox Hill Hospital, New York City. For example, your doctor may opt for a medication that has sedative effects if your depression is interfering with your ability to get good sleep.

The most popular types of antidepressants are called selective serotonin reuptake inhibitors (SSRIs). These include:

Celexa (citalopram)
Lexapro (escitalopram)
Paxil (paroxetine)
Prozac (fluoxetine)
Zoloft (sertraline)

These drugs work by increasing the availability of serotonin, a brain chemical known to affect moods. If one drug in this class does not work for you or has unacceptable side effects, others may work.

The drowning man is not troubled by rain.

SSRI side effects may include headache, nausea, sleeplessness or drowsiness, agitation, and decreased sexual desire.

Other types of antidepressants work on both serotonin and another brain chemical called norepinephrine. These are known as serotonin and norepinephrine reuptake inhibitors (SNRIs). They include:

Cymbalta (duloxetine)
Effexor (venlafaxine)
Pristiq (desvenlafaxine)

Older antidepressants include tricyclics, tetracyclics, and monoamine oxidase inhibitors (MAOIs). These tend to have more side effects than some of the newer depression drugs, but are still used.

Light troubles speak; the weighty are struck dumb.

Discuss with your doctor all the available options, their pros and cons, and which ones can safely be used together.

You may want to ask your doctor the following questions about your medication options:

How long will it take for the medication to work?

When should I take the medication?

Should I take the medication with food?

What are the side effects?

What can I do to manage side effects?

As iron put into the fire loseth its rust and becometh clearly red-hot, so he that wholly turneth himself unto Good puts off all slothfulness, and is transformed into a new man.

Antidepressant medications do not work overnight. It can take several weeks for the drug or drugs to start affecting your mood. Some depression drugs may start to work sooner than others, but in general it takes time for certain brain chemicals involved in mood to rise.

We say, sorrow, disaster, calamity. God says, chastening and it sounds sweet to him though it is a discord to our ears. Don't faint when you are rebuked, and don't despise the chastening of the Lord. "In your patience possess your souls."

Select depression medications are started at lower doses to see if there are any unacceptable side effects. They are then slowly increased to get to a therapeutic dose if no side effects occur.

Be realistic about when you can expect to start feeling better. But stay in close contact with your doctor when starting or changing your depression medications.

It's also important to know when to call in a psychiatrist or other mental health specialist. Most antidepressants are prescribed by primary care doctors today. If you haven't gotten any better after a reasonable drug trial, seek out a referral to a psychiatrist. Some trial and error may also be involved in drug choice and dosing issues.

Adversity causes some men to break, others to break records.

Know when to consult a mental health professional.

The goal of treating depression is remission. What does remission look like for people who are depressed? This is feeling and functioning at the level you were at prior to the episode of depression.

Common and vulgar people ascribe all ills that they feel to others; people of little wisdom ascribe to themselves; people of much wisdom, to no one.

The best way to reach this goal is to work closely with your doctor, and make sure to let him or her know how you are feeling as well as what side effects, if any, you are experiencing. If one antidepressant or even several antidepressants don't work, don't get discouraged, he says.

Research shows that people with difficult-to-treat depression who don't get better with a first medication are likely to improve by trying a new drug or adding a second medication.

With man, most of his misfortunes are occasioned by man.

Work with your doctor to find the best drug or drug choices for your depression. Don't settle for anything less than remission.

But treating depression involves more than just taking a pill. Lifestyle changes including regular

exercise,
healthy eating habits,
and social support are also part of the treatment plan,

it is often difficult to reach out and ask for help. Talk to your doctor about lifestyle changes that can help you feel better until your medication kicks in.

Life didn't promise to be wonderful.

Stick with a schedule that includes regular exercise, set sleep and wake times, showering, and socialising. Stick to your schedule, and eventually these things will become enjoyable again.

Every man has a rainy corner of his life whence comes foul weather which follows him.

It may take a while before you start to feel better, which is a normal part of learning how to manage your depression.

Behold, I have refined thee, but not with silver; I have chosen thee in the furnace of affliction.