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Depression

Depression is a problem that is so misunderstood. In part, the problem lies with the fact that we use the same word to describe a huge variety of things. Someone might say, “That TV show is so depressing”. Or they might say they are depressed because they aren’t finding the kind of person they want to have a relationship with, or because their dog died, or because they feel stuck in an unsatisfying job. Is the depression referred to in the previous examples the same as the depression people experience when they lose motivation to get out of bed, or feel like crying all the time? Is it the same as the depression that makes you feel that things are never going to get better? Is it the same as the kind of depression that makes you want to end your life?

Distinguishing Between Various Types of Depression Is an Essential Step, Not to Be Skipped or Rushed Through

When we use one word to describe a variety of situations, it can lead others to think they “get it”, that what you are going through is just like what they once went through. The next thing you know they are offering advice (or judgement) based on their own experiences. And that’s not helpful.

This is why people so often come into my office feeling defeated because they were unable to “pull themselves up by the bootstraps”, or because they feel too weak to get through this on their own. They stand in judgement of themselves because they are fighting the best fight but the depression seems to be winning.

It’s unfortunate that people often wait so long to come in for help. They often think of seeing a Psychiatrist for Depression as a last resort, only to be tried when all else has failed. Or they see no reason to make an appointment with a Psychiatrist unless they are planning to start medication for Depression. And that’s a shame. Because many types of Depression do not require medications. And ALL types of depression can benefit to some degree from non-medical interventions.

Is There a Role for Seeing a Psychiatrist for Depression Even if You Don’t Want to Start Medications?

Absolutely. There is great benefit to be gained from making an appointment to consult with a Psychiatrist about feeling depressed. Coming to see a Psychiatrist isn’t a commitment to take medications, or to do a certain type of therapy, or even to have a second session! No one is going to pressure you to take a certain course of action. I encourage my clients to think of me as a consultant who has a lot of expertise in a topic, whom they are meeting with to learn, so that they feel better equipped to decide what’s best.

Most people with depression already feel they are a burden to their loved ones and worry that they will worry or overwhelm them. So it’s often a relief to share with someone who will not pass judgement or think you are weak, or feel burdened by your low mood.

It’s also a relief to learn that feelings of hopelessness are common and don’t mean that your situation is hopeless. I find that most of my patients are relieved to hear that the things they are experiencing are quite familiar to someone experienced in treating depression. It’s comforting to hear that others experience depression in a very similar way, and that if treatment helped them, it might just help you.

What About Treatment Options for Depression that Do Not Involve Medications?

When you make an appointment with a Psychiatrist for Depression you will also learn if Therapy would help the symptoms of depression you are having and if so, what kinds of therapy might be beneficial. Some patients like a more interactive approach with actionable steps or even homework assignments. Some patients feel they have unfinished business from their past and now is finally the time to confront it. While others express that they are not interested in delving into their past and don’t want to unearth upsetting emotions. By sharing your concerns or perhaps past therapy experiences that you have NOT liked, we can craft an approach that works for you.

You will also have a chance to learn about the role of other aspects of your lifestyle which can be modified to offer relief from Depression. You will learn how changes in diet or exercise, sleep or use of alcohol or marijuana might impact your depression. Sometimes clients come in with feelings of depression only to discover that what lies at the root is an eating disorder or gambling addiction or other behavior that they can’t control which is eroding at their self-esteem. Others may realize that there is dissatisfaction in their career or their relationship that is at the root of feelings of sadness or hopelessness.

What if I Think I May Need Medications for Depression but I’m Not Sure?

Many of my clients have serious questions, concerns or anxiety about medication. Perhaps a friend had a bad experience or a family member was overmedicated. Perhaps you read something on the internet about antidepressant medications that sounded awful.

I encourage my clients to think of our sessions as if you have a family member in the psychiatric profession, and you get to ask them all the questions you want without pressure. After over 20 years of patient care I have seen a LOT of clients come in with depression and try antidepressants. So rather than educate yourself with someone’s online testimonial I encourage you to benefit from my observations of the experiences of those who went before you.

If everyone got every side effect they mention in those TV ads, no one would ever want to take these medications! If there’s a side effect you have heard about, I can advise you of how frequently it actually occurs, and what your next steps would be if you developed it. Sharing client experiences allows you to be a “fly on the wall” of other people’s treatments so that you know what to expect, you know you are not alone, you can dispel myths and exaggerations, and you can get helpful solutions or workarounds for the things that concern you most.

Being assessed by a trained professional can help determine if the depression you are feeling has a chemical/physiologic basis. Based on this assessment, you will learn if you have the kind of depression that medications can help with or not. This is an ongoing discussion in which you will have the opportunity to educate yourself, ask questions, think about it, and decide your next steps.

Common Questions about Medications for Depression

For clients considering medication management for depression, we will address topics such as: How do depression medications work? How long do depression medications take to work? How soon will I feel better? Are depression medications habit forming? How long do I have to stay on an antidepressant? Can I drink alcohol on an antidepressant? Will I gain weight on an antidepressant? Will I have sexual side effects from an antidepressant? Can anything be done about side effects from antidepressants if I get them or am I just expected to tolerate them?

Our sessions are an opportunity to ask about treatment options you have heard about in the media or from friends including Transcranial Magnetic Stimulation, Ketamine treatment, CBD/THC, ECT, Ayahuasca, Mushroom micro dosing, Anti-Inflammatories, etc. Consulting with someone familiar with the latest advances can help you determine what might and what might not help.

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