Understanding and Managing Depression Treatment
The Importance of Treatment Consistency
When it comes to managing depression, consistency is key. Both antidepressants and psychotherapy play crucial roles in treating depression, but their effectiveness relies on continuous usage. Unfortunately, many individuals discontinue their treatment prematurely, jeopardizing their progress.
In the words of Jo Anne Sirey, PhD, a professor of clinical psychology in psychiatry at Weill Cornell Medicine, “What often happens is [people] just stop taking your medications. They don’t refill their prescriptions and don’t think about coming back.”
It’s essential to understand that abruptly halting antidepressants can lead to withdrawal symptoms like headaches, dizziness, and anxiety. This can not only hinder your recovery but also increase the risk of relapse.
Common Reasons for Treatment Interruption
There are various reasons why individuals may halt their depression treatment. From concerns about side effects to societal stigma, these factors contribute to discontinuity in care. It’s crucial to address these issues to ensure successful treatment outcomes.
Side Effects
- Drowsiness
- Weight gain
- Dry mouth
- Loss of sexual desire
- Difficulty reaching orgasm
While side effects can be bothersome, consulting with your healthcare provider can help mitigate these challenges. Adjusting dosage or switching medications may alleviate these concerns.
Challenges in Finding the Right Treatment
Finding the most effective antidepressant for your condition is a process that requires patience and experimentation. Unlike treating physical ailments, managing depression involves trial and error to determine the best course of action.
Dr. Jessi Gold, an assistant professor in the Department of Psychiatry at Washington University in St. Louis, emphasizes the importance of giving medications time to take effect. It may take weeks before noticing improvements, and adjustments may be necessary along the way.
Overcoming Stigma and Misconceptions
Stigma surrounding mental health conditions like depression can deter individuals from seeking treatment or adhering to prescribed regimens. Internal and external pressures contribute to the reluctance to engage in therapy or medication.
Education and open discussions are vital in dispelling myths and fostering a supportive environment for individuals battling depression. Creating awareness and fostering understanding can help combat stigma and encourage individuals to prioritize their mental health.
Exploring Alternative Treatment Options
In cases where traditional treatments prove ineffective, alternative options like transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT) may be considered. These interventions offer additional pathways to managing severe depression and should be explored under professional guidance.
Collaborating with your healthcare provider to evaluate the suitability of these treatments can expand your options and enhance your overall treatment plan.
The Importance of Collaboration and Communication
Establishing a trusting relationship with your healthcare provider is essential in navigating your depression treatment journey. Open communication, shared decision-making, and continuous evaluation of your progress are key components in achieving optimal outcomes.
Remember, managing depression is a collaborative effort, and your active involvement in decision-making greatly influences the success of your treatment.
Summary
Depression treatment involves a multifaceted approach that combines antidepressants, psychotherapy, and potential alternative treatments. Consistency in medication usage and therapy sessions is crucial for long-term success.
Addressing common concerns like side effects, treatment efficacy, stigma, and misconceptions is vital in maintaining treatment adherence. Exploring alternative options when necessary and fostering open communication with healthcare providers can greatly enhance treatment outcomes.
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If you have depression, antidepressants and psychotherapy may be part of your treatment plan. Antidepressants change the levels of serotonin and other chemicals in the brain. They can be an effective way to relieve sadness and other symptoms of depression, but only if you take them.
Psychotherapy can help you resolve what is bothering you and prevent you from repeating things in your mind over and over again.
The most effective treatment plan will combine medication and therapy. But it will work that way only if you continue doing both.
Not everyone follows their depression treatment plan. Studies find that about half of people stop taking their medications or skip doses. Concerns about side effects, beliefs that the medication doesn’t help, and stigma are some of the reasons people stop taking their medications before they are ready.
There are many reasons why people may stop going to therapy. Some are beginning to see it as a sign of weakness. Others think it doesn’t help because they don’t see the benefit. Even more are overcome by stigma.
“What often happens is [people] just stop taking your medications. They don’t refill their prescriptions,” says Jo Anne Sirey, PhD, professor of clinical psychology in psychiatry at Weill Cornell Medicine. “And they don’t think about coming back.”
Stopping cold turkey could cause problems. Your brain becomes accustomed to having greater amounts of serotonin when you take antidepressants. Stopping the medication too quickly causes a decrease in this brain chemical, which can lead to withdrawal symptoms such as:
- Headaches
- Dizziness
- Fatigue
- irritability
- Anxiety
- Sleeping problems
- Humor changes
Without the medication, your depression could return. Leaving depression untreated could increase the chance of a hospital stay or other serious complications. If you are thinking about stopping your medication, talk to your doctor first to make sure it is the right time and that you are doing it safely.
There are some common reasons people give for stopping taking antidepressants, including:
I have side effects. Like other medications you take, antidepressants can cause side effects. Research says that about 40% of people have side effects from selective serotonin reuptake inhibitors (SSRIs), a commonly prescribed type of antidepressant.
Side effects vary depending on the medication you take, but the most likely of antidepressants are:
- Drowsiness
- Weight gain
- Dry mouth
- Weight gain
- Loss of sexual desire or difficulty reaching orgasm.
Some side effects are more bothersome than others, especially sexual ones, says Jessi Gold, MD, assistant professor and director of wellness, engagement and outreach in the Department of Psychiatry at Washington University in St. Louis.
“[People] I don’t like what this does to his self-esteem. “They don’t like what this affects their relationships.”
You can wait a few months to see if the side effect goes away, especially if the medication helps with depression. If you can’t wait, your doctor may reduce your dose or switch you to another antidepressant that doesn’t have the same side effect.
If drowsiness is a problem, taking the medication at another time of day may work. Sexual side effects sometimes improve when another medication such as bupropion (Wellbutrin) is added.
Finding the right medication for depression is not an easy task, like treating other conditions.
“We like to think of depression as pneumonia. You take a medicine and you get better,” Sirey says. Rather, it involves some trial and error. “You have to find the right medication, and sometimes that takes more than one try.”
I don’t need medication, I feel fine. If you feel better while taking your antidepressant, you may be under the impression that you didn’t need the medication in the first place. The goal of taking antidepressants is to improve your mood. When your depression symptoms improve, it means the medication is doing its job.
The risk of stopping is that depression will return. At least half of people who have an episode of depression will have one or more episodes in the future. Your depression may not return right away. It could reappear after a fight with your partner or a hard day at work.
“Now they don’t have the protection that helped them,” says Gold.
The medication doesn’t work. Waiting for your symptoms to improve may seem like an eternity, but you need to give the medication time to take effect, Gold says. Antidepressants are not like antibiotics. You won’t feel better in a couple of days. It may take 4 to 8 weeks before you start to see the effects of a new medication.
If you still don’t see any improvement after a few weeks, ask your doctor if it’s time to make a change.
I worry what people will think. Our understanding of mental illness has come a long way, but there is still a lot of stigma around depression. That can prevent some people from getting the treatment they need.
Sometimes the stigma comes from within.
“People see themselves as potentially defective, as potentially unsuccessful, because there is something wrong with them,” Sirey says. In her research, she discovered that stigma was a real factor that caused some people to stop taking their medications.
Others face external pressures from family and friends.
“I work with college students and I’ve had people go home on vacation and their parents threw away their medication,” Gold says.
Sirey says education helps combat stigma. She recommends that you and your loved ones read about depression and its treatments from trusted sources.
If your doctor has tried increasing the dose of your antidepressant, prescribing a different medication, or adding another antidepressant and your depression still has not improved, you have other options to try along with psychotherapy.
Transcranial magnetic stimulation (TMS) is another option your doctor might suggest. TMS applies pulses of magnetic energy to your brain through the scalp to relieve depression. I would do this 5 days a week for 4 to 6 weeks. About 50% of people with major depression who try TMS see their symptoms improve and about a third go into remission.
Electroconvulsive therapy (ECT) is for people with severe depression who have not improved with antidepressants or psychotherapy. While you are under general anesthesia, small electrical currents pass through your brain to trigger a seizure. This treatment is done three times a week for 2 to 4 weeks. ECT is painless and safe. But it can cause temporary side effects such as confusion and memory loss.
If you have thought about stopping your treatment, regardless of the reason, pause before doing so.
“Call your prescriber and talk to them,” Sirey says.
It’s important to find a doctor and therapist you trust, so you feel comfortable talking about how you feel and what you want. If you and your doctor decide it is the right time to stop taking your medication, your doctor will gradually reduce your medication. Every few weeks, you will go down to a lower dose until you stop taking the medication without causing withdrawal symptoms.
Stopping medication can be a good thing if the time is right, says Gold. The important thing is that your depression is under control and that you involve your doctor in the decision.
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