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I’ve struggled with depression for as long as I can remember. Even as a young child I felt a general sense of despair knowing that life would someday end; I was all too aware of its finite nature. I’m not exactly sure where this awareness or feeling came from (something that I continue to work through with my own therapist) but it felt…heavy. At the age of 24 I had a life that many would have envied, I was attending a university studying what I wanted, I was married to a partner who treated me with love and care everyday, yet I was unable to shake the ever-present sense that life was meaningless. I had seen a couple of therapists in my early twenties and I always found an excuse to stop going. Finally I decided to see a psychiatrist. I was immediately diagnosed with MDD (major depressive disorder) and given a prescription for 150mg of Zoloft daily as well as Xanax for anxiety. The pills worked in the sense that they helped me block out my true feelings. I wasn’t feeling depressed anymore but I also wasn’t feeling much of anything. Most days I just felt numb but I was able to carry on with day to day activities. I remember one point running out of my prescription and having to go without for almost 2 days. My body reacted horribly; I was dizzy, sweating, and had blurred vision. I couldn’t eat or sleep. Despite the discomfort, this reaction was a wake-up call; I knew I didn’t want to be reliant on these pills forever and I knew deep down that I hadn’t been doing any work on myself. At this point I was up to 200 mg of Zoloft a day as well as the Xanax. I felt so low but also knew that I was slowly losing myself and becoming a zombie. I wanted to feel again. Slowly I weaned myself off all medication. I changed my diet and began exercising regularly. I started to learn as much as possible about the link between our daily habits and how they affect our mental health. Most importantly I began earnestly working with a therapist to process trauma from my childhood that I had been holding onto for years and years without even admitting to myself that it was there. This work was heavy and grueling and painful. But it saved my life.
Everyone seems to be dealing with depression these days. Current studies say that 1 in 6 Americans are taking some kind of antidepressant. This is a conservative estimate as many studies can be found that claim 1 in 4 adults are prescribed an SSRI. Between constant media bombardment about the seemingly horrific state of the world and the increase of virtual experiences over real-life ones, our psyches seem to be starving for some love. I can hardly talk to a friend or colleague without hearing about someone they know who is struggling with depression. Of course, there is a difference between feeling depressed and being clinically depressed. Feeling depressed is, unfortunately, an entirely normal part of being human. We all go through periods in which we feel down, hopeless, or unsure about the future. Part of practicing good mental health care is taking inventory of how you are feeling. Are you feeling sad because you just lost a loved one, or lost your job? Or have you felt depressed for weeks or even months and can’t explain its source? These are different scenarios with different possible treatments.
The DSM-5 defines Major Depressive Disorder as a disorder in which 5 or more of the following symptoms have been present during the same 2-week period and in which the symptoms are different than what is regularly experienced. One of the symptoms must be a.) depressed mood or b.) loss of interest or pleasure. In addition, at least 5 of the following symptoms must be experienced for at least a 2 week period: daily insomnia or hypersomnia, significant weight loss or weight gain without dieting, fatigue or loss of energy, feelings of worthlessness or excessive guilt, psychomotor agitation or retardation (being slowed down), and recurrent thoughts of death. Dysthymia is a form of depression that typically lasts longer than 2 years.
SSRIs, like the Zoloft that I was prescribed, are commonly used for the treatment of depression in adults. An SSRI (Selective Serotonin reuptake inhibitor) works by helping to control the levels of serotonin in your brain. Serotonin is a neurotransmitter that directly influences how happy we feel. An SSRI works by helping to block the absorption of serotonin, which essentially allows the brain to hold on to more of it.
The problem with prescribing an SSRI is that most psychiatrists are not counseling their patients to seek out the deeper reasons that are causing their depression. Working with a mental health professional to create a treatment plan is imperative. Although I’m sure the psychiatrist I saw in my twenties had no intention of harming me, a great disservice was done by not properly educating me on how the medication would work and what else I should be doing to combat the illness. Yes, the root cause of some people’s depression is a chemical imbalance in the brain, but giving someone a pill as the only form of treatment is denying the patient their right to self-determination. It also discounts the many other forms of treatment there are for depression. Not everyone wants to take a pill every day of their lives. For others we want to take back some control over our own happiness, and for others still, taking a pill may be triggering if there is a history of drug abuse.
The same combination of interventions do not always work for everyone. Depression is a spectrum disorder which means that there are a variety of treatments. Research tells us that the combination of medication and therapy is usually the best treatment but the scope of treatments within ‘medication’ and ‘therapy’ are huge. When you are trying to decide a course of action, finding the right therapist is paramount for success. A good therapist will recognize if you are not an appropriate client for them but will also help steer you in the right direction.
My approach to treating depression is not one that discounts the invaluable use of modern medicine. Not everyone who experiences depression is able to overcome without the aid of medication and being pragmatic is important, especially with our health. If other approaches aren’t working, an individual’s physiology cannot be denied and an antidepressant can sometimes serve as a life preserver, something to temporarily help until we are on solid ground again. Medication can be the boost to get us from the drowning zone to a space where we feel safe and have learned skills that will keep us moving forward. It can also be an immediate and necessary intervention strategy so you can get to a place where you can get out of bed and work on yourself. This is where therapy is so important because it can serve as a parallel intervention which will bridge the gap between medication and a state of high self-functioning.
Learning to manage your depression is vital not only for yourself but for your world around you. Negative moods can directly influence your level of hostility and anger and can have long-lasting ripple effects. It is possible to regain some control over your emotional state. If we spend time learning our own minds and becoming self-aware of our own emotions, you can learn how to strengthen your mental fortitude and lift yourself out of despair. Life is full of emotional highs and lows, sometimes we feel depressed because we are not living our best lives or not being true to ourselves. Doing simple things like taking stock of your life, of who you are and what type of life you want to lead is extremely helpful because it gives you a place to start from. Be honest with yourself. Write this down. Make a list of steps of how to get where you want to be and work on this list, even if it’s in a small way, every single day. Humans are purpose driven animals. If we don’t feel we have a purpose than our overall life satisfaction can be significantly decreased.
If you are experiencing depression, please reach out for help. Call a family member or a friend, go outside, take a walk, blast some music and dance. Force yourself to get out of your head and into your body, do yoga, go help somebody who is also experiencing troubled times. And if you are able, begin working with a therapist as soon as possible. Most importantly, remember that you are not alone, there are so many others experiencing depression. We aren’t meant to isolate and shield our problems from others, we are meant to take care of each other and to rely on those in our community. If you don’t have someone to reach out to or are unable to afford services, click the link on the bottom of the page for free community resources.