Depression: Causes, Symptoms & Treatments
Joseph M. Carver, Ph.D., Psychologist
Psychological Treatment: Psychologists and other
therapists work with you to repair the damage done by the "garbage", helping you sort out reality from what your brain has fed you over the past many months. Many people feel going to a psychologist or therapist involves laying on a couch and talking about your toilet training during childhood - Nonsense! Modern psychologists are experts in not only brain chemistry, but how to repair "thinking" damage and rebuild/reconstruct your confidence. The combination of medication and therapy is extremely effective.
Usually, successful treatment for severe depression involves both medication and therapy/counseling. With both, you can expect normal sleep to return first, followed by a slowing of mind speed and the garbage truck leaving.
Some General Thoughts:
1. Depression is the most common mental health problem treated by modern psychologists and psychiatrists. In most cases, hospitalization is not required unless you have waited until you have active suicidal thoughts.
2. If you are depressed, expect your brain to be filled with mental garbage - get ready for it! During this time, do not take action on those garbage thoughts and make no major changes in your life. It's best to wait until the garbage truck leaves before making decisions that will or may change our life.
3. Depression has been researched by physicians, psychologists, psychiatrists, scientists, and others. Listen to the advice of your professionals who study depression - not your neighbors or your aunt Gladys. If placed on medication, you may be told "Don't take that Dope!". Remember, the people giving you advice don't have a 200 mile-per-hour garbage truck following them! Stick with professional opinion. Depression is a chemical problem, not caused by demons, devils, poor eating habits, a new moon, or other old-wives tales.
4. You may have other symptoms with your depression, such as severe anxiety or agitation (pacing, no sleep at all, "hyper", etc.). That only means another neurochemical has kicked in. In these cases, a psychiatrist can best select the medication for the combination of anxiety and depression.
5. When you are depressed, those who love you will become a pain-in-the-butt. They will "bug" you constantly, trying to cheer you up, giving you advice ("snap out of it" is most common), and trying to be by your side. Children will become shadows when their mother is depressed, almost protecting Mom. Be prepared for this.
6. During depression, remember that your brain goes on a bad-memory hunt, looking for old memories to torture you. Be prepared to relive or re-feel old hurts, old doubts, old guilt, and old sorrows. Be curious about what memory files the brain selects rather than focus on those memories. You can expect your brain to constantly replay the video tape (your "worst hits" tape) of your life. You'll feel guilty for things you did as a child, mistakes you made ten years ago, etc. You'll live in the past as long as the depression remains. It may interest you to know that as the serotonin level increases, the "past" returns to the past as a memory - not a torture.
7. As your brain tortures you, it may "lock on" horrible thoughts. You may feel you have a terminal disease. You may become preoccupied with guns, evil thoughts, etc. Often, individuals feel they are somehow contaminated by a killer disease, fearing they will pass it to their family. One husband brought his wife in for treatment when she began fixing breakfast in a surgical mask and rubber gloves! One man sought treatment at the office after nailing his closet door shut with 148 nails - his brain became preoccupied with the shotgun in that closet, telling him to kill his family and then himself.
In other depressed situations, people become obsessed with other issues, almost always "the road not taken". Often viewed as mid-life crisis, a straight-laced businessman now wants a Harley and a tattoo while another individual begins suddenly thinking about a past sweetheart. In almost all of these situations, the individual acts totally out of character.
8. All depressed folks look for escapes. Common methods of trying to escape depression are excessive alcohol use, drugs, sexual relationships, changing jobs, etc. A lot of good marriages are lost during these times as the spouse of the depressed partner hears "I've got to have space" or "I've got to get away and find myself!" You'll find these escapes don't work. These methods only complicate your depression and your recovery. Best bet - don't make changes, just get to a professional.
9. Most people classify all medications that act on emotions as "nerve pills". This is far from the truth. Psychiatrists actually have medications for anxiety/nervousness (Valium, Ativan, Xanax, etc.) and those for depression (Elavil, Prozac, Zoloft, Sinequan, etc.). Different brain chemicals are involved in each condition and many people make the serious mistake of taking an antianxiety medication for their "nerves", thinking they are treating their depression - Wrong! While you will be calmer, you will stay depressed. It's like drinking six beers for a broken arm - you might feel the pain less but your arm is still broken. A psychiatrist is most qualified to select the proper medication for your condition.
10. If you are placed on medication, don't expect an immediate recovery. With antidepressants, it's similar to refilling the oil in the car, only at 1/8th of a quart a day. As you continue to take the medication, your mood will slowly improve as the serotonin level increases in the brain. When depressed, every day is bad and full of mental garbage. As medication continues, you'll have a bad, then good day. As serotonin gets higher, you'll have a bad morning, then three good days. In short, it's bad-and-good at first, then finally good days with routine hassles. No one is happy all the time. People that are happy all the time are institutionalized - it's not normal. "Normal" is a good mood with normal reactions to the stress of everyday life.
11. In selecting a therapist/counselor, each one is different. All have different personalities, styles, and attitudes. Select one that has your style and most important - somebody that makes sense. If you meet one that says "I don't believe in medications" - get out of there! That therapist is about thirty years behind modern treatment. Often, your family physician is in a position to recommend the best therapist in your area. You can also look for signs of acceptance in the professional community, such as hospital privileges. You may have to shop around to find a therapist right for you.
As a word of caution, many inexperienced therapists or those with limited training may miss the fact that you are depressed. You may arrive at the therapist office preoccupied about something in your childhood that actually happened 20 years ago. You may also fool your family physician with multiple physical complaints as when Serotonin is low, all body systems seem to go haywire. A properly trained therapist will not only asked about your life and upbringing, but about the physical aspects of your situation; your sleep, sexual interest, concentration, and other indicators of low-serotonin depression or stress. The inexperienced therapist might focus on the "garbage truck" thoughts and miss the big picture, the presence of depression. If you are clinically depressed, weekly discussions of your past as told by the garbage truck will only prolong your depression and possibly intensify it. If in doubt, consult your family physician to obtain a medical/physical view of the situation as most physicians are usually trained to recognize the indications of low-serotonin depression. If you think depression is part of the problem, ask your family physician to refer you to a psychiatrist or psychologist in your area.
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