Depression For Beginners

I recently had someone close to me contact me about what to do when their child was going through a mental health crisis.  I responded with the following email, but also thought it would be worth posting in a blog for anyone who might benefit from this info.

Here it is, in blog form:

Hi [Removed],

I’m so sorry to hear this.
Depression is something that can last indefinitely and isn’t a cut-and-dry type of affliction.  It’s complicated and messy.  It’s an illness of the mind that can affect how one interprets information from others as well as from themselves.

There is no “cure.”

Management is ongoing, and, while you can do things to help and support, it’s the responsibility of the person with the mental illness to maintain, even when they are at a low point.

I have always been on some kind of combination of medication and therapy since about 20 years old, and those are really the only ways to deal with it.  I’m always trying to maintain it, learn more about it, and remind myself about the things I have learned.

It’s a lot of work.  I feel like I should have an honorary psychology degree for as much as I’ve taught myself.

Sometimes I think of depression as being another child in my life that I have to manage.  If I ignore it or don’t take care of it, I suffer.

Best Practices:

Always take your meds.

Do it at the same time every day.

Often when people start on antidepressants, they start to feel better so they stop taking them.  This is when people are most vulnerable.  The withdrawal from antidepressants can be extreme and lead to heavy mood swings and severe behavior.

Antidepressants are fussy.  It can take 2 weeks for them to achieve full therapeutic effect, and can leave your bloodstream very quickly once you stop.  It’s best to take them every day at the same time(s) of day.

Experiment

Since no two people are the same, no identical combination of meds and therapy will work for everyone.

This can be a frustrating process.

You may need to try one kind of medication or therapy for 6 months before you realize that it’s not working for you.  Then it’s time to try something else.  Another frustrating piece of this is that your insurance may change, so something that was working will have to change because your insurance won’t cover it anymore.

It’s a good idea to write down everything that you’ve tried, the dates you tried them, and why you switched.  This comes in handy when switching providers either because they’ve moved into another position or because your insurance changed. I’ve often had to recall which medications I have already tried, but I don’t always remember why I stopped.  Sometimes the switch was due to insurance, other times it was due to side effects, and other times I switched because the therapeutic effect had lessened over time.

Experimenting takes patience.  Try not to get too discouraged when you’re not happy with one type of therapy or medication, then move on to the next one.

Talk Therapy

Admittedly, I’m not always on top of this one.  Talk therapy should always compliment medication.  You can start off every week, then as time goes on you can lessen the frequency.

The difficult thing with talk therapy is that it can get really old when things are going well.  You go in for an hour every week and don’t have much to talk about.  In my experience, it’s okay to lessen the frequency of your appointments when you get to this point.  However, you don’t want to stay away too long.  Checking in every 6 months isn’t a bad idea if you’ve been doing really well for a really long time.

The important thing is to always be in some kind of talk therapy.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy has been one of the best tools for helping me get over some of my mental hurdles.  The difficulty is that, as with talk therapy, it is ongoing and easy to forget about doing when things are going well.

Ask Your Doctor

As you know, I am not a doctor.

Find a doctor you trust (also part of the Experiment phase), and ask them questions.  A good doctor will be up on the latest studies and medications and therapies, and will be able to guide you in the right direction.

I hope this helps.  Feel free to contact me any time if you have questions.

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