Antidepressants: A Conversation of Necessity
Thursday, December 18, 2014
Depression is an illness with an ambiguous definition. It involves a cluster of symptoms that vary and fluctuate at different times of a person’s life. To complicate things further, depression often begins mildly, subtly: the beginning could just feel like a couple of bad days. You wait for them to end, but they just keep coming. There is no lab test that can diagnose this disease, so correct diagnosis can be difficult. Increasingly, antidepressants are being prescribed by general practitioners in the course of a routine office visit without any kind of psychiatric diagnosis. Clinical psychiatrist Alan Manevitz, MD, suggests that this could partly be happening because GPs are getting better at recognizing early stages of depression in their patients. The fear, however, is that more Americans are viewing these medications as a way to deal with daily stress and other more benign and natural life events, and that doctors are following suit.
We have a cultural intolerance for painful emotions. Life can be hard. You have an awful commute to a job you don’t like, come home to kids that need attention, dinner that needs to be made, and bills that need to be paid. When the going gets tough, the tough get going. You may be increasingly unhappy, but is this clinical depression? Do you need medication because life is a bit overwhelming? Grief, sadness, and disappointment are normal parts of life. When they do not stop, when you cannot be distracted out of these feelings, that is often a clue that it is time for treatment.
But remember that taking antidepressants will not change the things you do not like about your life. What if instead of pushing through and ignoring those negative emotions, if instead of taking a pill to mask them, you tried something else? If you have mild depression and are looking for alternatives to medication (and have the support of your doctor and co-management by a health professional), here are some things that could help:
Talk Therapy
Talk therapy is a fairly standard suggestion for a patient with documented depression, and there is plenty of research to show that people taking antidepressants do better when talk therapy is part of their treatment plan. In fact, with mild to moderate depression, talk therapy alone can provide significant benefits.
Exercise
Some of the most promising research in non-pharmacological treatment of mild depression is in the realm of exercise. One of the leading exercise advocates, Madhukar H. Trivedi, advocates 3-5 sessions per week at moderate intensity for 45-60 minutes per session for the best results.
Meditation
According to researchers at Johns Hopkins University, people can get relief from depression with about 2 1/2 hours of mindfulness meditation per week. In mindfulness meditation the goal is to keep the mind focused on the present moment, which can help you release the negative replaying of the past as well as any fears over the f!uture. !
Acupuncture
Experts do not know how or why antidepressants work, but some theories suggest that they increase the release of endorphins, your feel-good chemical. Even the most skeptical of researchers have accepted that acupuncture also releases endorphins. There have been many studies that have shown acupuncture to be as effective as antidepressants, without the negative side effects.
Dietary Changes
The gut-brain connection is a rapidly growing area of research. You have no doubt heard of a “nervous stomach,” which is the term used for digestive discomfort that arises as a result of emotional stress. Mounting evidence has shown that the reverse of that — the idea that an unhealthy gut has a hand in mental health issues — is also true. This is a topic better suited for a book than a bullet point, but if you want to find out more about it, find a practitioner of f!unctional nutrition who can help determine if your gut could be contributing to your depression.
Antidepressant medications are mood altering substances, none of which are without negative side effects. They can and do offer serious relief, but not everyone needs them. If you are dealing with mild to moderate depression and you and your doctor have determined that you do not need medication, or if you are currently on antidepressants but feel like you still need more support, trying the above options may be helpful. Not only are they shown to help alleviate depression, but most of the alternative options are also helpful in moderating the side effects of antidepressants. Whatever the case may be, if you are in need of help, do not stop until you get the relief and the support that you need.
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