Emotional Wellness
Depression. You wake up in the morning and wonder
how to put one foot in front of the other. You try to do
the things you once enjoyed, but now they seem
empty. You find your self pulling away from family and
friends. Is it the blues, or depression?
Women are affected with depression at double the
rate of men, however, it is an equal opportunist within
the female population; impacting all races and
ethnicities equally. But why do women experience
depression in such higher rates than men? Many
factors attribute to this, including biological, genetic,
psychological and social considerations. What's more,
it is thought that woman are more likely to report
depression, than men.
With such a prevalent disorder, one would think it
would be a popular topic of discussion. But sadly, a
negative stigma remains about depression and the
types of people who suffer from it. In fact, 80% of
those reporting depression, do not seek treatment.
Are You Ready For Help? Where to Begin.
The most effective method of controlling depression is
with a combination of antidepressants and counseling.
But where to begin? Your Primary Care Physician (PCP)
is the best first step. He or she will normally run blood
work first to determine if there are any medical
conditions that may be causing your depression, such
as a hormone imbalance, or an endocrine disorder. If a
medical condition is the cause of your depression,
antidepressants may not be needed.
If no medical condition is found, you may choose to try
antidepressants alone. Many times your PCP will be
happy to manage this treatment. If counseling is
declined, there are activities you can do at home to
increase control of the depressive symptoms (see
below). Keep in mind that antidepressants must be
titrated both up and down. They cannot be
discontinued without a MD or Pharmacist instructing
you how to slowly reduce the dose before quitting
completely. For this same reason, it normally takes up
to 3 weeks to feel the full effect of the medication.
counseling can greatly improve your immediate
symptoms, during this time. Also, while on any
antidepressant, during the first couple weeks of
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treatment, you could actually have an increase in
suicidal thoughts, while your neurotransmitters are in
the process of balancing. It can also compound the
feelings of hopelessness if the person is unaware of the
time needed to feel improvement on the medication.
Bottom line, give it time to work.
Which Medication Is Right For You?
While there are several types of antidepressants, the
most popular are SSRIs, selective serotonin reuptake
inhibitors, such as Prozac, Paxil, Zoloft, and Welbutrin,
to name just a few. These antidepressants work by
controlling serotonin levels, thought to be responsible
for mood, among other things. With the advent of
SSRIs, some less therapeutic classes of antidepressants
either fell out of use, or found off label uses.
In the 1990s, the SSNRIs, or selective serotoninnorepinephrine reuptake inhibitors, hit the market with
Effexor. Since then, Cymbalta, Prestiq, and Savella have
become quite popular, not only for their effective
treatment of depression, but also for the ability of some
SSNRIs to control pain. Cymbalta has been prescribed
for neuropathic and chronic pain. While Savella is a first
line treatment for fibromyalgia. SSNRIs are thought to
be more effective in controlling depression by
increasing the activity of both serotonin and
norepinephrine at the synapses. Norepinephrine is both
a hormone and a neurotransmitter, while serotonin
works as a neurotransmitter, alone.
Next Steps - What To Expect
If you feel you would benefit from counseling, alone