By J. Lynne Weilert, LMSW, Leawood Counseling Center
Mood disorders, including major depression, affect 20 million Americans each year. About 17% of people in the United States will suffer from Major Depression during their lifetime. Depression is the leading cause of disability in the United States, and the annual cost of treatment and lost productivity is over 87 billion dollars.
Major Depressive Disorder is the most common form of Depression that responds to antidepressants and/or psychotherapy. A diagnosis is met when a person has five of the following symptoms nearly every day for at least two weeks and one of the first two symptoms is present:
1. Depressed mood
2. Loss of interest or decreased ability to experience pleasure
3. Low energy or excessive fatigue
4. Insomnia or sleeping too much
5. Decreased appetite and/or weight loss or increased appetite and/or weight gain
6. Low self esteem or guilt feelings
7. Decreased ability to concentrate
8. Getting agitated or slowed down
9. Thoughts of suicide or wishing you were dead
Treatments for depression abound. Those with mild to moderate forms of depression may benefit from talking over their problems with a trusted friend, clergy, or therapist and utilizing natural methods of treating depressive symptoms which include: exercise (which increases the production of endorphins), sunshine, and vitamin D, fish oil supplements, increased socialization, eating healthy foods, and getting plenty of sleep.
Many adults find the pressure of taking care of family and a stressful job exhausting. It is important for good emotional health to find “me time” which means finding time to relax and unwind, read a good book, or enjoy a favorite hobby or activity. It is much easier to fight depression and be resilient if one has a healthy balance in one’s life.
Natural therapies are not always effective on their own to treat or prevent depression. Prescriptive antidepressants can sometimes be helpful by increasing the effect of certain neurotransmitters in the brain. Different types of antidepressants work on different transmitters, such as serotonin, norepinephrine, and dopamine. Recently, two new drugs have been approved for Depression. They are: Vibryd, a newer SSRI, and Trintellix, another new SSRI that covers five Seratonin receptor sites in the brain. The most common classes prescribed today are SSRIs (Selective Serotonin Reuptake Inhibitors). This class includes such brand names as Prozac, Paxil, Celexa, and Lexapro. This class is most commonly prescribed for those with anxious depression, but may be used for agitated or sluggish forms of depression. The term “reuptake inhibitor” means that after serotonin has been released into the gap between nerve cells, these drugs prevent its reuptake back into the neuron where it could be stored and used later. This keeps the serotonin molecule in the synapse longer, where it continues its job of communicating with other neurons.
Another category of antidepressants is known as serotonin and norepinephrine reuptake inhibitors (SNRIs). These drugs work on both types of chemicals in the brain, and can be calming and energizing. Common names in this category are: Effexor, Cymbalta, and Pristiq. This class of antidepressant is typically prescribed for a sluggish form of depression, or for one that has been severe and long lasting.
An Atypical class drug that mostly works on the chemical dopamine is Welbutrin, which is often used for sluggish forms of depression and is known for its ability to prevent weight gain and help with smoking cessation.
Tricyclic antidepressants such as Elavil and Pamelor work by inhibiting reuptake of serotonin, norepinephrine, and, to a lesser degree, dopamine. Another older class of antidepressants is the MAOIs, which are rarely prescribed because of the high number of contraindications, but which may be helpful for those who do not respond to other antidepressants.
Antianxiety drugs such as Ativan, Xanax, and Klonopin are effective at calming the anxiety that may be experienced with depression.
Antipsychotic medications such as Seroquel, Zyprexa and Ambilify block the effects of dopamine and can reduce agitation and mood swings. Mood stabilizers, such as Lamictal or Neurontin, can calm brain activity and can be used in low doses for anxiety or in moderate doses for agitation.
If your physician prescribes an antidepressant, it is important to take it every day as prescribed, or the blood levels may not be high enough to provide the maximum effect. Problems may develop if a patient decides to discontinue the drug without specific instructions from their physician or health care provider. Patients may experience uncomfortable or serious side effects if the drug is not titrated (tapered down) slowly.
Because depression has the tendency to reappear in people’s lives, it is important to work out a plan with the patient that will reduce the risk of recurrence. The strongest scientific evidence for methods that can sustain recovery is for CBT (Cognitive Behavioral Therapy), antidepressant medication, and mindfulness meditation. Mindfulness involves “staying in the moment” and not allowing negative thoughts or rumination to take over your thoughts. This involves the development of acceptance, kindness and compassion and learning to accept experiences for what they are.
Working with a qualified therapist or counselor is an important step in learning how to cope with the stresses that many face during their lifetime, and to develop new ways of thinking about those experiences that may lessen the incidence of depression. A therapist can work with your physician to coordinate care and ensure the best possible outcome.
Don’t Be Ashamed
The stigma of depression is disappearing, as people realize that it is a common disorder that millions of people experience, in varying degrees, at some point in their lifetime. If you are suffering with depression, don’t put it off, get help today.
To learn more or to schedule an appointment for an initial consultation, please call Lynne at Leawood Counseling Center
at 913-696-1400 or direct at 913-221-1038. You can also visit her website at www.lynneweilertcounseling.com.
J. Lynne Weilert, LMSW
Lynne is a licensed and insured
Mental Health Professional. She
received her Masters Degree after decades of working in the business world in healthcare marketing and business management. She is a member of the NASW and the Grief Support Network. Lynne has experienced many of the life challenges faced by her clients, and combines her personal experience and professional knowledge to provide a friendly, thoughtful and interactive therapeutic approach to treating clients with Depression/Anxiety, Bi-Polar Disorder, OCD, Addictive Behaviors, Panic Disorder, Compulsive Behaviors, Grief and Loss and various personal and family issues that may cause stress and concern.
Lynne has experience in working at Rose Brooks Women’s Center for victims of domestic violence, and has worked with seniors in a local multi-level care facility, providing mental health assessments, counseling, and facilitating adult care giver support groups as well as assisting with Grief Support.