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and Treating Depression
To understand depression, think of
standing in a pool with the water level up to your lower lip. Moving through the
pool is difficult because of the resistance from the water. Itís tiring, like
the fatigue often associated with depression. Further, any little wave threatens
to overwhelm you so you seek to avoid small ripples and get terrified about even
the thought of a big splash coming your way. That is why depression and anxiety
often go hand in hand.
Antidepressant medication is akin
to pulling the plug and lowering the water in the pool.
With the water level lower, say at
your waist or knees, there is less resistance and you can move through the pool
more easily. This equates to less fatigue. With the water level at your waist or
knees, those same ripples or even waves just donít carry the same threat of
engulfment. This lowers the sense of dread and anxiety. With the water level
lower, depression and related anxiety diminishes. You get on with life.
Antidepressant medication saves you from drowning.
When prescribed antidepressant
medication, it is important to know that unlike almost any other medication, it
doesnít work immediately. In fact, you may not feel the effect of
antidepressant medication for a good six weeks, (plus or minus two).
Our brains have something called a
blood-brain barrier. The role of the blood-brain barrier is to restrict the
admittance of substances that are usually not of service to proper brain
function. Given that antidepressant medication is not something that normally
accesses the brain, the blood-brain barrier does its best to restrict the
medicationsí access. That is why it takes this medication so long to work. The
medication has to reach a certain level in order be effective and it does this
little by little as it builds up in the brain over the course of treatment.
If you are one of the few who
experiences a side effect from antidepressant medication, it will likely be
along the lines of headache, nausea, upset stomach, dizziness or dry mouth. For
most persons these side effects will go away within two to four weeks as your
body adjusts and before you are likely to enjoy the benefits of the medications
Because of how long it takes to
really work and how side effects, if experienced, precede the therapeutic effect
of antidepressant medication, many people quit using their prescription thinking
it was of no benefit and only caused some distress. Those who tolerate the side
effects typically begin to see them diminish just ahead of enjoying the
therapeutic effect of the medication. It is important to be patient when using
antidepressant medication and resist evaluating its effectiveness until at least
about six weeks of usage.
Your doctor will likely start you
on the lowest dose of this medication. That is to get you used to the medication
and to avoid troubling side effects. This starter dose may not be sufficient
though in terms of your therapeutic need. The dose any one person really needs
can be guess work, determined only by each individualís response to the
medication. Size and/or weight and/or level of depression can have nothing to do
with which dose is just right for any one person. The right dosage will be
determined after several months of usage and by discussing how you feel with
your doctor on a month to month basis for about two to four months.
Counselling for you; and if you
are in a relationship, your partner; and if in a family, your family, is an
important part of treatment for depression. You and those around you need to
understand the implications of living with depression. Counselling is
educational in nature and if needed, can also address any other personal or
relationship issue that contributes to your distress. Your counsellor can also
help monitor your mood and provide that information to your doctor to help your
doctor determine dosage.
You want to be well; your loved
ones want you to be well; your doctor wants you to be well; and your counselor
wants you to be well. Together, it is this team, working in unison, which
provides the best approach to treating depression.
Direnfeld, MSW, RSW
Call Gary for your next conference and for expert opinion on family matters. Services include counselling, mediation, assessment, assessment critiques and workshops.
For information on Direnfeld's book, Raising Kids Without Raising Cane, click here.
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