I have been talking about the ten “basics” that are supported at the intensive outpatient program I attended as the foundation of recovery from depression. One of the basics is the discipline of taking medications as prescribed. Not everyone with depression needs to go on meds, and for some people meds are only used as a short term measure to help get them out of a slump. For me, they have been and most likely will continue to be a major component of my treatment.
That being said, meds are not the be all and end all of treatment for depression. They are only one piece. Proper diet, adequate exercise, and adequate sleep all help. Psychotherapy helps. But for many of us, those measures alone just aren’t enough.
I’m not a doctor, and there are so many psychological and physiological factors involved in gaining and maintaining mental health that I’m not even going to pretend to understand the complexities and interconnections of it all. I can only speak for myself and my experience.
I do have one strong opinion about taking medication for depression, and that is to consult with a medical professional whose practice is predominantly with mental health issues. Family practitioners may or may not be up on the latest information, but they most likely do not have the depth and breadth of knowledge that a more specialized practitioner will have.
I first started on depression medications in my early 20s. Results were hit and miss and the side effects of the drugs in use at that time were not pleasant, to say the least. I was able to go off the meds for a number of years after I got married and began raising a family. I was still having bouts of depression, but they were manageable.
When I suffered another major depressive episode in the year 2000, I went to my family doctor who prescribed a medication for me. It worked beautifully. I almost immediately felt like a new person, full of energy and hope and enjoyment of life. I called the doctor to report how well I was doing and asked if I could go ahead and stop taking the meds now that I was better. The doctor said that would be fine.
Once off the meds, I immediately crashed again. I went back on the same medication, but it didn’t help this time. I became suicidal and was eventually referred to a psychiatrist. The psychiatrist got me on a different prescription and began working with me in therapy sessions. I came to realize that the MD I had initially consulted had done me no favors whatsoever.
The family doctor apparently didn’t have enough of an understanding of depression and mental health treatment to realize that drugs were not a quick fix, nor to acknowledge that drugs alone don’t necessarily resolve all the issues surrounding major depression. I will give him credit for referring me on to the psychiatrist once it became obvious that his limited scope of knowledge was not sufficient to help me.
I have been on meds for my depression ever since that time. I have gone through numerous types and combinations of drugs. Sometimes they work for a while and then lose their effectiveness, some have not worked at all, and some have had side effects that I couldn’t tolerate. It is definitely not an exact science as to specifically how the meds work and which ones will work for any given person. It has been a lot of trial and error for me.
I have been to many therapists in the interim for counseling, but for monitoring my meds I have stayed with the same psychiatrist for 12 years now. She knows my history. She knows what has worked for me and what hasn’t. She is able to make an educated assessment of how I am doing on my meds and what may need tweaking. She sees enough patients and prescribes and monitors enough drugs that she has firsthand knowledge of how the drugs work for people, and which ones have proven the most effective in certain situations. While we are all different in how we respond to any given medication, there are trends that can be seen which may not be discernible in the epic literature that the manufacturers send along with the drugs.
I have gone off the meds at various times and can definitely feel the difference. It’s not good. I am consigned to the notion of taking drugs most likely for the rest of my life. My psychiatrist is willing to work with me to limit the meds to as low of dosages as possible, and she also champions the other factors such as exercise and diet and social interaction and therapy. She’s not just a pill pusher.
I will continue to work on improving my physical health to better combat the depression so that I can rely as little as possible on drugs. It’s not ideal to have to depend on drugs for my mental stability, but it’s a godsend that they are there to help me.
So for that I am grateful.