Berkeley Parents Network: Antidepressants

Berkeley Parents Network

Antidepressants

Berkeley Parents Network > Reviews > Health & Medical > Antidepressants

Questions

Do the drugs for depression really help? First steps?
Considering antidepressants, but how long doyou take them?

More advice about Antidepressants:

Do the drugs for depression really help? First steps?

Sept 2006

I have been functional but depressed for many years; I am not in counsling but was in college and was told I would always have anxiety problems. There is a history of depression on both sides of the family, so it should be no surprise. My mother's sister takes medication for depression; my cousin is bipolar and my mother suffered from depression thoughout her life, though never got treatment. Worst of all, I have a 10 year old son, IQ in the hg range, who is clinically depressed. Have already been told by two psychologists that he will likely have anxiety thoughout his life. I feel I need to get treated so I can create a more positive, happier environment for my family, esp. my son, and break this sad cycle. For those who take meds for depression, how does one go about this? Is there a test to confirm depression for get treatment? Who to see? How to choose the right doctor? Do the drugs really help? Which ones to take and which to avoid? Is it safe? Will I be a better parent?
Signed, Anon.

In my experience, depression screws everything up.

I'd say Thing One is to contact your doctor and get a referral to a psychiatrist. A therapist can also help, though cannot prescribe drugs. I think there are many levels and types of depression, and it takes some doing with your qualifed professional to figure out what's right for you. I've had a few bouts of depression over the years, and most recently taking time off work, learning to relax better, and working with a therapist bi-weekly (talk), and psychiatrist (drugs) saw me through a tough two-year stretch. I personally was on Lexapro as an antidepressant and Trazadone (a non-sedative antidepressant) as a sleep aid and it worked for me. What's right for you might be different. I would recommend acting sooner rather than later.
Doing OK in Berkeley

You are to be commended for trying to tackle this issue. I grew up in a family affected by mental illness, which includes clinical depression. You also mention bi-polar disorder which can affect not only the person, but their families, extensively. I recommend you get the book: ''When Someone You Love Has a Mental Illness, A Handbook For Families, Friends and Caregivers'' by Berkeley family therapist Rebecca Woolis (available local bookstores or Amazon.) This will give you some important guidelines for managing both the identified person and those affected of the family and/or friends. It includes info on drugs and what to expect. In my experience, pharmaceuticals can play a critical role in recovery, and my family members' life was improved immensely with the use of drugs, which basically made her life productive again, rather than the quagmire that had become her existence. You'll need to find a good psychiatrist (MD) to manage these for you, as there are many indicators and contraindications to their use, depending on other medical conditions, age, other street or recreational drug use, alcohol, and other meds, etc. (Many people who are ill, self-medicate with street drugs and alcohol, so the entire situation must be dealt with.) Also, some drugs need several weeks to take effect, so patience and perseverance are also important. An experienced and trained professional (MD) is really essential, and a family therapist (MFCC, MFT, LCSW) would also benefit your family. Some problems are too big for the talking cure alone. Best of luck to you and your family in lessening your suffering.
Psychotropics saved our family member

I wish my daughter could answer your posting, but she's in school right now. She has been on anti-depressants for a little over a year now (she's 15). I am not a big fan of chemical meds, but I have to say this has saved her life! She is a happy person (though not ridiculously so), she can function in the world, she can get herself out of hard situations, she doesn't stay silent as long as she used to. Not EVERY piece of clothing is black! She has come out of her shell, in a way. She had the cards stacked against her genetically also. At the same time her father, who had been suffering from massive depression for years (we're not together anymore-probably because of that) decided to try them also (he has Kaiser). I saw a difference in him also, but I think he is a tougher nut to crack (no pun intended) and don't think he's had as a miraculous a change. And I hear his mother is on some kind of anti-depressants too! I think the genetics are real. When things got so bad, my daughter's therapist recommended going to a psychiatrist for meds. I looked around and found someone who treated adolescents. Call your insurnace company see what they can do to help you. They can usually give you a long list of Dr.s in your area. You also might look at the BPN for recommendations for you and your son. You cannot and should not perscribe these heavy-duty drugs yourself. You might have to try for a while to get the dosages or types right. The people on the outside will notice a change before the person themself does. A good Dr. is the way to go.

I don't take them so I can't comment from the inside, but from the outside, I saw such a change in my daughter. It's like she's back from a very dark and lonely place where I coudn't reach her very often, and is so much the stronger, smarter, and with so much more self-awareness. I don't know how long she will be on them, but for the moment she's not wanting to stop.

All the best and please get help for you and your son's sake, whether it's drugs or meditation! anon

I have suffered from depression for years, as has my sister, mother and maternal grandfather. In our case it behaves like a predisposition, making my sister and I more vulnerable to normal stresses. We have both tried medications (Prozac and Zoloft) and found them useless with unpleasant side effects. I have been able to manage my depression to the point of eliminating it using nutritional strategies, esp. the program outlined by Julia Ross. She has two books, ''The Diet Cure'' and ''The Mood Cure'', and runs a clinic near Mt. Tamalpais. Given that you are considering medicating your ten-year-old son, I most strongly recommend at least a consultation with her clinic -- I think if you read her books you will hesitate to manage your child's regimen yourself, though you might find it helpful for your own health. After an initial period when the clinic might recommend supplementing with amino acids, the ''treatment'' consists of a diet that meets US-gov't recommended levels of protein consumption, avoids sugars and refined flours, and includes sufficient fats and _lots_ of veggies and fruits. The basic theory is that much depression can be traced to insufficient levels of neurotransmitters, which can be addressed by ensuring sufficient neurotransmitter building-blocks (amino acids/protein) stabilizing blood sugar.

I found a few of the ideas in the books odd, but the framework quite solid -- the science behind it is robust. Amino-acid supplementation is controversial but a search on PubMed reveals that at the levels her clinic recommends, only beneficial effects have been found. This is how I've managed depression during my pregnancy and through breastfeeding. A.

here are some resources and interiews (audio recordings/podcast) with people who transformed their personal pain into their life purpose - I posted from my book, Listening to Depression: How Understanding Your Pain Can Heal Your Life http://psychjourney_blogs.typepad.com/listening_to_depression/ www.visionarysoul.com

Some progressive psychologists have been working with a new technology that allows for neurotransmitters to be measured via a urine sample. Because the ranges have been established for a ''normal population'', comparison of test results to those can yield some useful information. From there, rather than using pharmaceuticals, target amino acid therapy (TAAT) provides the raw materials for the deficient neurotransmitters (which are made from amino acids, protein building blocks) to help normalize mood. This approach has been used for eating disorders, autism, insomnia, depression, AD/HD, and more. The company that has done the most in this area is Neuroscience, Inc. and their web site offers supportive and accessible information. Nori Hudson

Please see a psychiatrist. They will diagnose you and decide if you would benefit from medication. I highly recommend Richard Levine at the Berkeley Therapy Institute. He doesn't do talk therapy, but he's a master at prescribing the right drug. There are so many antidepressants out there and some may not be right for you. He truly saved my life. Without him, my anxiety would completely control my life. I'm a much better mom now that I don't see life through anxiety-colored glasses. Good luck to you! I hope you get the help you need anon

Boy, did your message hit home with me. I've been in and out of therapy for depression (minor, low-level with anxiety) for the last 10 years. I resisted medication for most of those years, until last year, when I started Celexa, or citalopram, which is a selective serotonin reuptake inhibitor (SSRI).

The change was immediate! I felt almost euphoric at first, then my brain gradually calmed down and settled into a calm state. The constant, grueling self-criticism and gnarling knots of anxiety in my stomach were gone. In its place was the ability to see my life clearly and realistically. The best analogy I can think of is that it's your still in your own skin, but the ''infections'' of anxiety and depression are gone. It's made me a less anxious, more confident mom, too.

I'm a Kaiser member so that's how I got help. I went to counseling and got meds that way. I don't tell people about the medication - there's a stigma, and I'm kind of embarrassed about it, to be frank. But oh, get help if you can. There are millions of moms (and dads) on medication and you'll wonder why you waited so long.

All the best to you
Depressed No More

What medication does is alter the amount of various chemical messengers, called neurotransmitters, that are available in the brain. Typically, people with depression suffer from a lack of serotonin, dopamine, and norepinephrine in the synapses (spaces) between the nerve cells in your brain. What this lack does is cause the ''vegetative'' symptoms of depression, like difficulty sleeping, lack of pleasure in food and sex, low energy, and low motivation. Medication alone does not work as well as medication along with psychotherapy, as studies have shown. A psychiatrist, general medical doctor, or nurse practitioner can prescribe antidepressants. Psychological testing can help determine whether you have depression or not. I recommend that you be evaluated by a professional psychotherapist and psychiatrist. Many health plans cover such treatment, although on a limited basis. For ongoing treatment many people have to go outside their health plans' coverage. I am a licensed psychologist and would be happy to speak with you about this, or you can find a psychotherapist through your health insurance panel (they usually have a number on the back of the card for mental health/substance abuse). I have substantial experience treating depression and am happy to be part of a treatment team with the person prescribing the medication. As with any treatment (including medication), there are risks and benefits to psychotherapy which any responsible clinician will talk to you about before you commence treatment. I hope that you take steps to treat this, since as you noted it can make a positive difference for you and your family. Please don't hesitate to contact me at 510-258-4431 --Lisa Larsen, PsyD

I had post partum depression, and had no idea how to get it treated. I started with my internal medicine doctor who was great. I told her about all my anxiety, my unhappiness, my lack of enthusiasm for anything fun, and she recommended that we try something just for 6 months. I had done some research, and talked to other friends on anti-depressants, and I chose Wellbutrin. It's the only one I tried, but it does lessen BOTH anxiety and depression, has no sexual side effects, and doesn't cause weight gain. There were othe side effects possible (headaches, stomach upset, etc, etc) but none of them happened to me. I also found a counselor through a friend so the meds did accompany counseling, but I really think the meds were the most helpful thing I did. The key advice I received was not to feel bad about taking meds for depression - your body has a chemical imbalance, and the meds are correcting the neurotransmitters/chemicals that aren't being produced enough. It's not like being on a trendy ''Prozac'' gig, like some people joke about. It is really necessary. I noticed I make better decisions now, I don't over-react when times get tough, and I feel more confident about how I feel. I strongly recommend you talk to your family doctor about it soon.... Anon

You ask important questions, but ones with no easy answer.

Each person's experience with depression, and with treatments, is different.

For me, medication is an essential part of managing my depression--along with a healthy diet, reasonable amounts of exercise, regular sleep, social support, and therapy (particularly cognitive behavioral therapy with mindfulness components).

I would be a much worse parent--and may well not even be alive--without the meds. For me, the benefits of the medications far outweigh the down sides & side effects--but you may come to a different conclusion.

For me, treating my depression has meant being willing to try a variety of medications and medication combinations to find the best results. This I have done mostly with psychiatrists at first, and then with my primary care doctor once I have been stabilized. I have always seen a psychologist, as well, to work on the aspects of my mood that are more in my control.

When I am depressed I am robbed of my ability to take joy in my work, my friends, my family, and my dear child. To me, life is too short and too sweet to allow a disease --and I believe it is a disease--to take that time away from me.

Good luck to you
Fellow Traveller

Hi - Some people suffer from depression / mood swings due to hormonal imbalance (which affects men, women and children). Have you looked into this? You might want to check out this web page - http://www.johnleemd.com/store/hormone_bal_rewards.html Please note that I'm not at all affiliated with Dr. John Lee, but there are some really good info in his website that might prove to be 'eyeopeners.' If you wish, I'd be happy to share with you some more info on natural solutions that have helped many.

And one more very important thing...getting spiritual counsel is another great and sure way to cure depression. It's free and it's highly effective. I highly suggest that you explore this option, too. Of course, drugs could also work, but only temporarily (and in most cases, there are side effects to contend with). So anytime you can find natural and even spiritual solutions, explore them. You've got nothing to lose and everything to gain. These have worked so well for me and many people I know, and they could work for you too. Feel free to contact me - and will gladly point you to some helpful resources. Again, here's wishing you the best! Ann

I was on Zoloft for 2 years, off now for the last 2 years or so, am 54 years old and have been depressed for 40 years, though less so since my periods have stopped. Perhaps this isn't the case for you, but I know it's true for me and I suspect a ''couple'' of others folks - that we treat our bodies just as we treat the earth, like garbage dumps, creating severe (hormonal) imbalances and expect to feel good physically and emotionally. And we want to take a pill rather than doing the hard work needed to care for ourselves. Our entire ecosystem, of which our bodies/minds are part, is out of whack. For starters, please go to http://www.womentowomen.com/articles.asp for fantastic articles regarding reclaiming your physical, emotional, and mental help.
anon

i didn't see the original posting, but for depression/anxiety, have you tried acupressure therapy? i just saw anasuya batliner in berkeley (on 6th street, www.mybodywisdom.net is her web site) and i wish i'd found out about this decades ago, the frantic sadness and anxiety went away and now that i know it can go away, i have a lot more hope about things in general. it might not work for everyone but i strongly suggest giving her healing abilities a try. drugs are just so different on different people. but it depends what your depression is like too, as i said i missed the original posting.
anon

I have a lot of genetic loading for depression & bipolar disorder, & suffered through 20 years of depression from low-grade to clinical with briefer spells of high energy which ended in depression.

I had a life, friends, work, but was always hiding what was going on inside of me & grasping to emotionally hold on. I did years of therapy which kept me alive & gave me lots of insight. I did spiritual work, nutritional work, bodywork, & various alternative healing work, many of which gave me some slight relief.

But nothing altered my basic underlying depressive instability & I always had an intuitive sense that something was organically askew.

Finally I went to Langley-Porter Affective Disorders Clinic at UCSF for an evaluation. By then they had identified bi-polar II disorder (a BP with heavy depression & hypomania rather than full-blown mania), & that's what I've got.

It took years of working with top-knotch psychiatrists to work out a medication regime that really works for me, partly because the mood stabilizer that is my primary med wasn't on the market when I began, & partly because my own particular version of the disorder proved to be treatment resistent.

I now take a combo of meds which affect different neurotransmitter functions, I stay within a quite reasonable range of mood stability & I enjoy life. Taking care of myself in terms of diet, exercise, & sleep greatly affect my resiliancy, & those things are an ongoing challenge for me.

Most people find the correct med(s) much, much faster than I did, but I'm telling my story to encourage you to hang in there for as long as it takes, to work with the best doctor you can find, to get a thorough work-up & diagnosis to begin with, & to make yourself believe that there is a person inside you who can enjoy life.

I've never had a lot of money & my depression affected my ability to make a lot, but I went outside my insurance & paid out of pocket (instead of going to the movies, or dry-cleaners, or buying new instead of used clothes, or eating out, etc) when I needed to to get good help, both therapy & psychiatry.

I recommend going to Langley-Porter as a starting place. It's sliding scale & overseen by some of the best teaching psychiatrists in the country
anon

Considering antidepressants, but how long doyou take them?

Sept 2003

I am in a very blue period in my life, and have been talking to my doctor about taking antidepressants. But I'm concerned about how long to take them, and more important, about what happens when I stop. Will there be a rebound? Will the gains melt away? What commonly happens when people start and stop taking such medications? anon.

Everyone is different, but I found antidepressants to be very helpful as a way to cope during a very blue time, and I used talk therapy during that time to build up some resiliency and skills so that when I went off the pills, I had something else to fall back on. I weaned off the pills slowly and did not have an ugly transition. I can only encourage you to get help, through the pills or otherwise, because depression is a serious and debilitating condition. not depressed now

In my experience, when I stop taking anti-depressants the depression comes back. anon

I know a number of people (family and friends) who have been depressed and have taken anti-depressants. The most important thing is to understand that anti-depressants alone will not ''cure'' you - you need to continue to talk with someone while you are taking it. Too many people take pills to feel better; and while they feel better when taking them, they do nothing or little to improve their situation. Pills aren't the answer to everything. You need to learn to understand why you feel the way you feel while you are taking anti-depressants. Good luck. anon

I have severe clinical depression and have been on meds since 1995. I needed to try 6 different types before finding the best one for me. (So don't get discouraged if you try one type and it doesn't work--that's actually pretty common). I tried going off them, but fell into another deep depression--now I realize I will be on them for the rest of my life. That being said, research has shown (and I have found) that the best treatment for depression is a combination of things, including therapy, meds, exercise, good diet, meditation, etc. Some people don't need to be on meds forever--they get through a rough spot, then go off them. Others find that just exercise alone helps them more than meds. Finally, others (like myself) learn that they can't live without meds (and other treatments as listed above). It's not an easy situation. Realize that it'll take some time to figure out what works for you. If you need a good doctor and can go there, I had great luck at Kaiser in Oakland. Best of luck. Feel free to contact me with more questions. Kerrie

I spent the better part of my mid twenties and early thirties on and off anti-depressants and was helped greatly by medications each time I took them. I had success with many and switched around to avoid certain side effects. When I first took them I was anxious to get off as soon as I felt stable and basically went against my psychiatrists recommendation and tapered off after 6 months. I wanted to be 'cured' and felt stigmatized about being on them. To make a long story short, I think I should have stayed on them for a longer time even though I was no longer feeling depressed. I relapsed relatively quickly and had to go back on medication. That's not a big deal in the scheme of things, but I did have to endure the initial side effects all over again and wait for the medication to kick in etc, not to metion the period of pain and suffering I could have avoided... As time went by and I experienced more depressions, I got more comfortable with the idea that I took medication, and I was able to be more rational about choosing the right time to stop and and when NOT to go off the meds.

So, I guess my advice is don't be in a rush to go off medication, if they are of benefit to you. anon

Before you go ''on and off'' of antidepressants, it is important to get an expert and thorough evaluation of what kind of depression you are experiencing. It is not a good idea for anyone to go on and off them many times, but for someone who has a genetically based depression it can actually make things worse by setting off what's called ''kindling''. My lay understanding of this is that the neurotransmitters (there are many, not just serotonin, and even the SSRI's affect them) get overstimulated and can become more and more reactive. Also, if your depression is genetically based and goes untreated (or improperly treated), it can get harder to treat over time.

I don't mean to scare you, but this is important info! Antidepressants, particularly the SSRI's (selective serotonin reuotake inhibitors, like Prozac, Zoloft, and Paxil) are handed out like candy these days by general practitioners and psychiatrists without thorough evaluation and diagnosis. There are many other types of antidepressants, lesser known to the general public, and several types of depression- one size does not fit all.

I have suffered from depression (which finally got diagnosed as a subtype of manic depression) for many many years. It wasn't until I got an evaluation at the Langley Porter Mood Disorders Clinic that I got a proper diagnosis and began appropriate medication therapy. I recommend that resource, and it is sliding scale.

My mood disorder is genetically based- there is a substantial history of it on both sides of my family- and I am someone who will take medication for the rest of my life. At first this scared me and I resented it. Now, I am grateful that treatment exists, and taking medication is a routine part of my day. I have educated myself about the effects on my body of the medication, am able to tell when it needs adjusting, and am reassured that the drugs are not a health risk.

If you are someone whose depression is not genetic but an effect of present life circumstances, you still need to take medication for long enough to give yourself the mental, emotional, and physical strength to change those circumstances- otherwise the depression will likely return. Many people are scared of taking meds and go off too soon. Never go off antidepressants without a knowledgeable doctor's supervision! Going off without a slow tapering can cause a rebound, but appropriate decrease will not. If your depression returns after discontinuing, it means that the cause of the depression still exists, and that requires further evaluation.

I have done much therapy over the years- it gave me insight, allowed me to grow, and kept me alive through very rough spells. But I wasn't able to fully make use of those gains until my genetic disorder was treated.

Best of luck! anon

Your post caught my attention. I was one of those people who resisted taking antidepressants for years, despite having had one therapist who strongly recommended I try them (I actually left her office upset and never went back, I am sorry to say!). After majoring in Psychology though, and learning about the real help that antidepressants can offer us when we are depressed, I decided to try them--and I am not disappointed. It took me a year to find the right ones--I was allergic to Zoloft, and Paxil was just plain BAD for me (new, unpublished research on Paxil documents unhealthful weight gain in the first year of use, along with a documented complex of lethargy and mental fogginess-- beware!!). I now take Lexapro and Wellbutrin every day, with no apparent side effects at all. Lexapro is the only SSRI out there that has no documented effects on body weight or metabolism, and the Wellbutrin is good to counteract any sexual side effects (such as delayed orgasm). This is a good combo for me--yours might be different. Keep trying--get a good Psychiatrist who knows the medications, and who is willing to work with you to find a treatment suitable for you.

All my coursework in Psych. taught me how bloody stigmatized the use of antidepressants is in our world. My take now is that if you need them, you need them, and there is no reason to be ashamed, or feel like a weak or unworthy individual. People with all sorts of other diseases use medications for treatment without shame, and so should you if you feel the need. Depression is a serious disorder that KILLS people, either by suicide, alcohol/drug use, or immunosuppression resulting in the acquisition of other opportunistic diseases. Don't let others' antiquated views of depression as being a disorder of ''character'' coerce you out of getting the help you need. As with all diseases, treatments work best when you combine them-- talk therapy and antidepressant medications together are shown to be THE MOST effective treatment for depression. However, some people still need to be on the meds for life. If you are one of them, don't beat yourself up about it. In that case, it is a chemical imbalance that you can't control.

One more word about complementary treatments...Diet is a key factor in how we feel, but there is no money for this sort of research because corporations can't profit from it. In addition to medications, I have been on a modified version of the Zone diet to control blood sugar swings, and these have DRASTICALLY improved the way I feel--no joke. I eat more calories than the recommended daily amount (1700 is just too low!), but I try to eat the carbs-protein-fat ratio that's recommended. I don't get cranky or exhausted on a daily basis like I used to. Friends (and even my ex!) have commented on how much happier I seem. As a bonus, I have lost 12 pounds since the beginning of May with this minimal effort. I am not trying to promote dieting for dieting's sake, but thought you might want to try a blood-sugar balancing diet to see if it helps you. It sure has helped me. If you want to talk more about this, please write and ask the moderator for my email address. I would be happy to be an email pal/resource for you. Good luck, and be well.
anonymous, please, for privacy

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