alt.support.depression FAQ Part 2 of 5

Image: The Sorceress by John William Waterhouse Part 2 of 5
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**Causes** (cont.)
– What initiates the alteration in brain chemistry?
– Is a tendency to depression inherited?

**Treatment**
– What sorts of psychotherapy are effective for depression?

**Medication**
– Do certain drugs work best with certain depressive illnesses? What are the guidelines for choosing a drug?
– How do you tell when a treatment is not working? How do you know when to switch treatments?
– How do antidepressants relieve depression?
– Are Antidepressants just “happy pills?”
– What percentage of depressed people will respond to antidepressants?
– What does it feel like to respond to an antidepressant? Will I feel euphoric if my depression responds to an antidepressant?
– What are the major categories of anti-depressants?
– What are the side-effects of some of the commonly used antidepressants?
– What are some techniques that can be used by people taking antidepressants to make side effects more tolerable?
– Many antidepressants seem to have sexual side effects. Can anything be done about those side-effects?
– What should I do if my antidepressant does not work?

Causes (cont.)
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Q. What initiates the alteration in brain chemistry?

It can be either a psychological or a physical event. On the physical  side, a hormonal change may provide the initial trigger: some women dip into depression briefly each month during their premenstrual phase; some find that the hormone balance created by oral contraceptives disposes them to depression; pregnancy, the end of pregnancy, and menopause have also been cited. Men’s hormone levels fluctuate as deeply but less obviously.

It is well known that certain chronic illnesses have depression as a frequent consequence: some forms of heart disease, for example, and Parkinsonism. This seems to be the result of a chemical effect rather than a purely psychological one, since other, equally traumatic and serious illnesses don’t show the same high risk of depression.
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What to Do (On and Off the Web) While You’re Waiting for Your Antidepressants to Kick In

Image: Starry Night by Vincent Van Gogh

Starry Night by Vincent Van Gogh

I’ve been there; I’ve done that. I’ve suffered from depression nearly my whole life, and wasn’t diagnosed till I was 27. I know all the stages you go through when you’re waiting those six interminable weeks for your antidepressant meds to start working. So, as my gift to you, since I know your mind might be kind of cloudy if you’re depressed right now, I’ve compiled this list of suggestions. I hope they give you some moments of relief. Just so I’m not accused of discriminating against non-depressives, you all who don’t suffer from depression can feel free to check out my suggestions too. Someone pointed out to me that it takes some people more than six weeks to feel much better. That’s definitely true. Everyone’s different, and some people could even take fewer than six weeks to feel normal again. And the newer antidepressants can take considerably less time than six weeks to be effective. This guide is divided the way it is as just a general guideline. Continue reading

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What to Do During the Middle Two Weeks You’re Waiting for Your Antidepressants to Kick In

Image: Harmony in Red (The Dessert) by Henri Matisse

Harmony in Red (The Dessert) by Henri Matisse

Chances are you’re not having quite so many devastatingly low days now. You’re functioning a little better overall, but you’re still not ready to run any marathons yet or run for public office. Don’t worry about it – this recovery takes time, and it happens so subtly you may not notice it till someone else points it out. You’re probably still not eager to spend too much time outside your home, but the cyberworld provides many diversions (you can wander around it in your pajamas, and no one will know). I’ve found that things of beauty are both soothing and refreshing at this point, so that’s where we’ll start first. Continue reading

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10 Things You Can Do This Month to Manage Your Depression

Depression treatment can make a big difference, but it has to be managed. Many people with depression lack the motivation to pull together an effective treatment program, so if you feel like you’ve been thrashing around and getting nowhere, these suggestions might help you get on the right track.

1. Assess your level of satisfaction with your doctor. Your doctor is a crucial element of successful treatment. Are you happy with yours? If you haven’t made progress, is it because your doctor doesn’t seem really engaged in your treatment? If you have a doctor who doesn’t listen to you, respect your right to ask questions and doesn’t seem to really care whether your depression is successfully treated, then it’s time to move on.

2. Prepare a list of questions ahead of time for your next doctor visit. This is a good idea anytime you go to visit a doctor, but especially with depression, given how fuzzy it can make your thought processes. Continue reading

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Jump-start your day with exercise (Yes, even if you’re depressed)

It’s 5:30am and it’s still dark. For some reason I’m actually awake. Granted, my usual waking time is only half an hour later, but to me, voluntarily getting up early is an idea that just doesn’t compute. However, I am deliberately giving up sleep for a good reason. I’m going to jog, using a game on the Wii.

If you’re suffering from depression, you’re probably thinking, “How nice for you.” After all, you can’t even contemplate exercising when you’re depressed. Just getting through the day is an accomplishment. Trust me, I do know how you feel. I went through twenty years of untreated depression. But I also know that some of my best periods during those two decades were the times when I was exercising regularly.

Several studies have suggested that exercise can alleviate depression. A study released recently by a team at Temple University found that it can even help postmenopausal women with stress, anxiety and depression (but not hot flashes, alas). Exercise not only relieves stress, which is believed to contribute to depression, but also gives you some immediate relief due to the endorphins that exercise produces. They’re like nature’s happy pills.

And exercise will help your mood, no matter how severe your depression is or what type of treatment you’re under for it. If your depression is mild, it can be an effective alternative remedy. If your depression is moderate or severe, exercise is a great way to augment an antidepressant or antidepressant/therapy regimen.

But, but…I can hear the excuses coming to your lips now. It’s winter and too dark or cold to walk or jog, you can’t afford gym fees or you don’t know where to find a gym, etc. Or maybe the big one – I don’t have any motivation. Sorry, but I’m going to knock all of those reasons (or excuses) down so you’re going to, at the very least, think of new ones.

If you live where the weather’s inhospitable in the winter, there are plenty of ways to exercise indoors. To do yoga, all you need is a mat and a book or DVD. I use a DVD called A.M. and P.M. Yoga for Beginners. If you’re lucky enough to have a Wii, like us, I can promise you that the jogging, tennis and boxing workouts on the Wii Sports game will burn off plenty of calories, and games like Dance Dance Revolution for the XBox 360 do the same.

Or, if it’s just cold and not raining or sleeting, why not bundle up and go for a walk?

Five ways to motivate yourself

1. Think of the workout as another prescription for your depression. I have no idea why it works, but it does – at least, it did for me on many occasions.

2. Get an exercise buddy. Yes, I can practically hear the groans now. But it’s a tactic that really works. On the day that you really don’t feel like working out, your buddy hopefully will be full of motivation.

3. Keep the payoff in mind. If you find that exercise does lighten the darkness, even for a short time, isn’t that kind of relief worth the effort?

4. Recognize that, when you start thinking of excuses, they are, for the most part, not very impressive. Okay, so it’s raining – are you going to melt? You’re tired? Well, you will feel more energetic after you work out, so get up off the couch. Obviously you should not exercise if you’re injured or truly sick, but don’t let a case of sniffles or a slight headache give you an excuse that you think is plausible – it’s not.

5. Find your favorite way to pass the time if you find the workout boring. If you don’t feel like listening to music, try books on tape. You do tend to walk a little slower, but you may find the workout flying by.

One last thought: Keep your goals realistic. If you haven’t been exercising at all, and decide that you’re now going to work out every day for an hour faithfully, there’s a good chance you’re going to fail. There’s a good chance that someone without depression would fail taking things that way. Start by making small changes in your routine. For instance, I recently started parking my car farther away at work, which adds just a few minutes of walking to my day, but it does help. Maybe you can come up with a similar “baby step” to jump-start your exercise.

Good luck!

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