Depression: Are Antidepressants the Answer for Everyone?
By Tracy Morris
Q. I have so many friends who are being treated for depression. Is it really that common? And are antidepressants the best way to manage it? What other depression treatment options are there?
A. Studies have long documented that major depressive disorders occur more frequently in women. The “why” of this is often explored in research that looks at sociodemographic factors. Variables that seem to be most influential on the occurrence of depression are: gender, age, marital status, socioeconomic status, social stress, and social support.
The good news: there are myriad treatment paths available. Still, it’s tough to explore the options while you’re experiencing the sadness, lethargy, distraction and other symptoms of a depressive episode. Preventive health care requires learning a little in advance so that you can be ready if necessary to care for yourself.
Will you experience depression?
It’s estimated that one in eight women will experience clinical depression in her lifetime. Sadly, because so many believe that depression simply goes along with being a woman or because they feel ashamed, fewer than half will seek treatment. Indeed, there are familial ties, so stories about relatives with this or other mental health issues can lend to the appearance that depression “just happens.”
Some studies conclude that single women are less prone to depression. Paradoxically, men who are single suffer more than those who are husbands. Divorced or otherwise single-again women may testify to possible reasons when they compare their before-and-after lives.
The influence of hormonal changes through a woman’s lifespan can be tracked in some women as their personal incidence of depression waxes and wanes depending on biological age. As a group, women who are perimenopausal or post-menopausal are more vulnerable than those in their reproductive prime.
Of course, related issues intervene in the mix, increasing single women’s chances of a depressive episode. Those who struggle with financial difficulties, for example, surely also suffer more often from depression. Women who are isolated, whether for reasons linked to career or family demands, have a harder time avoiding emotional valleys.
Standard “Western” treatments
For the past few decades, treating depression with pharmaceuticals has become standard, especially for severe episodes. The types of drugs have evolved as researchers learn more about causes of the illness. Anyone seeking treatment via medicine should be thoroughly evaluated by a physician. Some types of medications for other health conditions, even when taken as prescribed, can increase the risk of depression. Prescribing physicians need to be told about any medications that a patient is taking.
The classes of drugs used for depression are:
• Selective serotonin reuptake inhibitors (SSRIs)
• Tricyclics & monoamine oxidase inhibitors (MAOIs)
• Mood stabilizing anticonvulsants & lithium for bipolar disorder
One of the treatment challenges is that often little is known about which individuals will respond best to a given medication. So there’s sometimes a trial-and-error period of a few months before finding the medication that works best for a patient. During that time, it’s crucial that a patient use her medication precisely as prescribed and keep in touch with her physician to report any worsening of symptoms or new symptoms arising.
Alternative & complementary treatments
Alternatives to conventional medicine range from emotional workouts to nutritional therapy to different modalities of medicine. Some of the best known are Ayurveda, traditional Chinese medicine, homeopathy, and nutritional therapy.
Ayurvedic practice regarding the treatment of depression starts with the premise that emotions are just as physical as they are mental. Practitioners believe that depression is caused by imbalance in the person’s dosha, or life forces, and a lack of deep self-awareness. Treatments will vary depending on the specific nature of the imbalance and may include dietary changes, changes in daily living routine (even as seemingly unrelated as the time you head for bed,) meditation, oil massages and other purification procedures, and herbal remedies.
The results of ayurveda are said to begin more immediately than Western antidepressant medications, and unless there is a conflict between pharmaceutical and herbal medications, ayurveda may be used to complement Western treatment.
Traditional Chinese medicine (TCM) looks for Patterns of Disharmony in a body’s organs and stored energies. Disturbances in the flow of energy will adversely impact one’s emotional stability. The goal of treatment is normalizing a person’s relationship to self and others, producing calm. Acupuncture, herbal medicines, and Qi gong exercises are typically prescribed.
As with Ayurveda, TCM patients may also use conventional Western medicine, and should take care to keep their practitioners informed about medications in order to avoid adverse drug interactions.
A distinguishing feature of homeopathy is the viewpoint that symptoms of disease are considered to be the body’s naturally occuring defense. It follows that homeopathically trained physicians will use therapies to boost such defenses. Such a principle is referred to as “the Law of Similars” or like will cure like.
Homeopathic treatments will start at the body’s top and work downward, from within outward, and from major to minor organs. Symptoms are said to clear up in reverse order of appearance and patients will see emotional improvement before physical. Specially prepared medicines are prescribed, as well as nutritional changes.
While some Western medications have requirements for administration (such as pills that must be taken with or without food, or at certain times of the day), homeopathic prescriptions have even more stringent rules. All must be taken orally without contamination by food, drink, tobacco, or even toothpaste, and the usually tiny tablets must be dissolved within the mouth rather than swallowed.
Nutritional therapy, using food to not only optimize health but to actually treat health conditions, focuses on the circulatory system, blood sugar levels, and the brain’s neurotransmitting chemicals.
Aside from the common knowledge that eating certain “comfort” foods can elevate our moods (chocolate, anyone?), several nutrients stand out in research as being related to depression.
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