Almost everyone, at one time or another, has experienced what is termed a “Situational Depression” brought on by a major life crisis such as loss of a job, loss of a loved one, a major medical illness, etc. This type of depression is characterized by a period of grieving that usually lasts days or weeks, then slowly resolves on its own as the patient accepts the loss and moves on with life.
The more serious type of depression is called an “Endogenous (or Clinical) Depression” and is caused by a chronic imbalance of the neurotransmitter hormones in the brain that control our emotions.
The major symptoms of Clinical Depression are
- A depressed (or anxious) mood most of the time
- Fatigue, loss of energy
- Slow thinking, forgetfulness, and difficulty concentrating
- Feelings of guilt, worthlessness, and self-doubt
- Preoccupation with physical well-being (multiple symptoms)
- Obsessive worry over trivialities
- Loss of interest in normally pleasurable activities
- Difficulty sleeping
- Emotional lability (tearfulness, anger, “a short fuse” )
- Pessimistic outlook
- Increase or decrease in appetite
- Loss of interest in sex
- Recurrent thoughts of death or suicide
If you have some or most of these symptoms, please come talk to us about what you’re feeling. There is probably a lot we can do to help. The most important things for you to realize are:
- The depression is not your fault.
- There is nothing “wrong” with you as a person.
- Taking medication for anxiety or depression does not mean you are "weak" or "crazy". Depression is surprisingly common.
Gaining balance of brain neurotransmitters (with medication) enables secondary measures (such as counseling, biofeedback, yoga and exercise) to become effective. There is powerful data showing the effectiveness of yoga, in particular, in reducing depressive symptoms and reducing stress. Studies have shown that yoga interventions can reduce anxiety and stress scores by as much as 40% and sometimes by as much as 60%.
If an antidepressant is called for, there are several important things you need to understand about these medicines:
- Antidepressants are not tranquilizers
- They are not "uppers" or "downers"
- They are not habit-forming
If your antidepressant is working well for you, we will probably recommend that you continue taking it for at least 12 months before we consider tapering you off.
There are several things you should know about antidepressants. For the first few days after starting any of these medicines, you may feel slightly drowsy or “spacey”. This is your system adjusting to the medication. It will pass, but be careful about alcohol, driving or any other dangerous activity until you are sure any drowsiness or dizziness has passed. You might also experience dry mouth, constipation, or other mild side-effects, but these are usually transient.
We expect that you will have a very good effect from any medicine we prescribe. Should we, for any reason, not be completely satisfied with the results, we may consider trying a different type of antidepressant. Do not hesitate to call us if you have a questions or problems, and be sure to return for your recommended follow-up appointments.
VERY IMPORTANT POINT: Never discontinue your antidepressant abruptly. This increases your risk of side effects greatly. When we decide to discontinue your antidepressant, we will slowly taper the dose over a few weeks.