Thursday, February 28, 2008


I inadvertently went off anti-depressants a couple of years ago. I was in between health insurances – waiting for the new one to kick in– when I started tapering my meds to make them last. Soon I realized that I wasn't having the usual effects I experience when I don’t take the meds as prescribed – the electric zaps one can feel in their head. Even though I had an appointment to see my shrink and get a new prescription, I didn't keep it. I decided that I was going off of the Zoloft and Wellbutrin I was on.

I had been off and on meds since the late 1980’s. First Prozac - which was popular in the late 80’s – then Celexa, Effexor, Zoloft and Wellbutrin - each at different times. Finding the right medication is akin to finding the right therapist. It takes time, patience, and tenacity. It was the beginning of a new year and a new job for me - so it seemed appropriate.
I also decided to clean out the toxins from the meds by drinking Aloe Vera juice; which I believe, also assisted in helping me lose weight. I started eating healthier; stopped drinking soda, ate more veggies and fruits, cut my juices with mineral water, and cut way back on sugar and starches.
I put on my Walkman and walked for an hour every night. The bloat and weight from the years of medication and overeating started to melt away. My cholesterol numbers dropped down to normal and so did my blood pressure. I started looking like the old Carmen again.
But, I also started feeling emotions that had been buried deep underneath the medications that kept me aloft, stable, and emotionless. I experienced joy and sadness. I could cry over any little thing; which was welcome since the meds seemed to dry up my emotions and tears.
But, about six months into my newness, I started feeling anxious. I woke up with my stomach in knots and nausea. Doom and gloom plagued my thoughts of the present and future. What the hell was this? It was anxiety! The depression had dissipated, but now I was dealing with anxiety, I had forgotten that I was also taking medication for. But, I was determined to do it naturally.
I have always been a proponent of using herbal remedies, having read the Bible of herbology “Back to Eden” some forty years ago. Twenty years ago, I wasn't so sure that herbal remedies would have helped me, when I started on Prozac. There are tinctures, teas, tablets, and capsules filled with singular or combinations of herbs to help depression and anxiety. Certain vitamins can lesson stress and anxiety.
Exercise, yoga, meditation also can alleviate the stressors that contribute to depression, and can boost that much needed serotonin –the feel good hormone that contributes to emotional well being. Two years later, I’m still Prozac free. And I’m doing it naturally. I will discuss what I’m doing in the next few blogs.

Saturday, February 16, 2008

The Bare Facts

According to Psychology Information Online:
Depressive disorders come in different forms. There are several different diagnoses for depression, mostly determined by the intensity of the symptoms, the duration of the symptoms, and the specific cause of the symptoms, if that is known.
Major Depression - This is the most serious type of depression, in terms of number of symptoms and severity of symptoms, but there are significant individual differences in the symptoms and severity. You do not need to feel suicidal to have a major depression, and you do not need to have a history of hospitalizations either, although both of these factors are present in some people with major depression. There is no official diagnosis of "moderate depression."
Dysthymic Disorder - This refers to a low to moderate level of depression that persists for at least two years, and often longer. While the symptoms are not as severe as a major depression, they are more enduring and resistant to treatment. Some people with dysthymia develop a major depression at some time during the course of their depression.
Unspecified Depression - This category is used to help researchers who are studying other specific types of depression, and do not want their data confounded with marginal diagnoses. It includes people with a serious depression, but not quite severe enough to have a diagnosis of a major depression. It also includes people with chronic, moderate depression, which has not been present long enough for a diagnosis of a Dysthymic disorder. (You get the idea!)
Adjustment Disorder, with Depression - This category describes depression that occurs in response to a major life stressor or crisis.
Bipolar Depression - This type includes both high and low mood swings, as well as a variety of other significant symptoms not present in other depressions.
Psychological treatment of depression (psychotherapy) assists the depressed individual in several ways.
First, supportive counseling helps ease the pain of depression, and addresses the feelings of hopelessness that accompany depression.
Second, cognitive therapy changes the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create depression and sustain it. Cognitive therapy helps the depressed person recognize which life problems are critical, and which are minor. It also helps him/her to develop positive life goals, and a more positive self-assessment.
Third, problem solving therapy changes the areas of the person's life that are creating significant stress, and contributing to the depression. This may require behavioral therapy to develop better coping skills, or interpersonal therapy, to assist in solving relationship problems.
Unfortunately, many poorly trained counselors never move beyond providing supportive counseling. This alone will not eliminate the depression. As a result, the depression, and the therapy, continues indefinitely, with little improvement. Supportive counseling "feels" helpful, and as part of the overall treatment plan does help.
But, unless the depressed person makes critical life changes, the depression will continue. These changes are both internal and external. Internal changes are usually needed in problem assessment, self-evaluation, the evaluation of others, and the expectations the depressed person has for himself/herself, others and about life. External changes may be needed in problem solving skills, stress management, communication skills, life management skills, and the skills needed to develop and sustain relationships.
The length of treatment will vary, according to the severity of the depression, and the number and kind of life problems that need to be addressed. Most people will begin to experience some relief with 6 to 10 sessions, and approximately 70-80% of those treated notice significant improvement within 20-30 sessions.
Mild depression may be treated in less sessions, and more significant depression may require extended treatment. Treatment sessions are usually scheduled once per week, although they may be scheduled more frequently initially, or if the person is experiencing significant life crises.
Except in the more severe depressions, and bipolar depression, medication is usually an option, rather than a necessity. Antidepressant medication does not cure depression, it only helps you to feel better by controlling certain symptoms. If you are depressed because of life problems, such as relationship conflicts, divorce, loss of a loved one, job pressures, financial crises, serious medical problems in yourself or a family member, legal problems, or problems with your children, taking a pill will not make those problems go away.
However, some symptoms of depression, such as sleep and appetite disturbances, significant concentration problems, and chronic fatigue, interfere with your ability to make the life changes necessary to eliminate the depression. In more serious depression, suicidal thoughts and urges, and preoccupation with death, may require medication in addition to psychotherapy.
Antidepressant medication can help relieve those symptoms, and allow you to make needed life changes. The decision to take medication, in addition to participating in psychological treatment, should be discussed with your treating psychologist and your primary care physician.
Your thoughts and feelings regarding medication, after considering information about both the benefits and risks involved, are an important part of a collaborative treatment approach between psychologist and client. If medication is part of your treatment, either your primary care physician or a psychiatrist will supervise the medical part of your treatment, while you continue psychotherapy with a psychologist.
If you have a chronic medical condition or a serious illness, and you are taking medication for that condition, then the medical specialist treating that problem should be involved in your treatment. The medical specialist may supervise all of your medications, or coordinate the medical treatment with the physician providing the antidepressant medications.

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