When Antidepressants aren't the best option (3)by Beth McHugh | More from this Blogger 11 Apr 2006 03:32 PM
Collette's children have both left home and her husband, Bryan, sustained mild brain damage in a workplace accident and no longer works. A former nurse, Collette is responsible for the daily care of her husband plus her usual chores. But because of Bryan's head injury, he often becomes aggressive, forgetful, and says hurtful things to Collette which he cannot remember having said five minutes later. Not surprisingly, after five years of caring for him, often in the role of a caretaker/nurse, Collette is tired, stressed, and often at her wits end. However, the most difficult thing for Collette is that she feels she has "lost" her husband, as his personality has changed, made more poignant by the occasional heartrending glimpse of the old Bryan which make her realize how much she has lost. Her two sons are busy with their own lives so Collette has little family support. Sometimes she visits a neighbor just or a break when she feels that she just can't take anymore. Her doctor's advice? "Try to let what he does go over your head and here's a prescription for an antidepressant". Collette dutifully took the antidepressants. They helped a bit and so she kept taking them. But once she felt better, she tired of the side effects and weaned herself off the tablets. What happened next was entirely predictable. After about two months, feelings of anxiety, of being overwhelmed, of being incredibly sad, descended again. Reluctantly Collette went back to the doctor, who promptly announced she was depressed again and put her back on medication. Collette continued this merry-go-round life for several years. She would take the medication, feel like she could cope, go off the medication, go downhill again. But did Collette have a chemical imbalance in her brain that was making her sick? No, she didn't. She was reacting in a perfectly natural way to a very difficult situation. She was inwardly grieving for the loss of her husband, she was her husband's sole carer, and she had no-one to talk to who really understood the situation. She felt isolated and frightened. The antidepressants helped, but did not address the real problem. Fortunately, Collette got a new neighbor who was a Social Worker. She quickly recognized the dilemma Collette was in and organized for Collette to see a counselor. Taking about her grief, her guilt, and her depression helped Collette to feel better. Community care was organized so that Bryan could spend two half days at respite so Collette could spend time alone enjoying herself. Her family was brought in and asked to help out where possible and Collette joined a support group for people in her situation. Bryan has not changed, but Collette has. She worked consistently in therapy to deal with her grief about her husband, and she also had to work through guilt at sending him away for two days so that she could recharge her batteries. Today Collette does not take antidepressants. She has learned to accept the situation and work with it. She copes much better with her husband, and she has a smile back on her face. The antidepressants she took did help her in their way; they allowed her a breathing space in which to exist. But they were no solution to her problem, only a band aid. Collette has now since developed her own coping skills and enjoys life again. Contact Beth McHugh for further information or assistance regarding this issue. Learn more about Beth McHugh  Beth McHugh began her career as a geologist and worked both in industry and as a university researcher. Relevantmental health tags sex | relationships | parenting | Scrapbooking | christmas | children | pregnancy | marriage | family | Kids User Comments  Kai Wilson (146) 12 Apr 2006 11:52 AMI was placed on antidepressants many years ago, and they changed me completely - long story short, it turns out that medications of any kind are bad for me and I'm an unmedicated bipolar one. Great article, I agree, medication isn't always the best idea, and information helps people understand and make informed choices. Jen (314) 12 Apr 2006 12:55 PMSo what does someone do who needs medication but can't take it? What alternatives are there for treating serious depression, if antidepressants are out of the question? Prevacid (5) 13 Oct 2007 11:07 PMPsychological illnesses should not be treated with pills, in my opinion. Well, except the hard cases. I was put on antidepressants two years ago and I'm thinking this is the worst thing my therapist did to me. I'm kind of addicted now. Plus they gave me digestive problems so I have to take prevacid in compensation.  Beth McHugh (12962) 14 Oct 2007 12:55 AMAntidepressants are very useful for certain people, in certain cases, however their original inventors never intended for them to be used as a permanent life support. Sometimes antidepressants have been known to leave permanent side effects, which persist even after the medication is stopped. Ultimately, the reason for the depression needs to be addressed and antidepressants can then be slowly phased out. This is where therapy can help when other resources such as family and friends do not have the emotional distance or expertise to nut out the reason for the depression. My philosophy is that depression is there for a reason and in my practice I attempt to help my clients discover that reason and find better ways of dealing with the pain in their lives. It's not easy, but it's permanently rewarding! Anyone requiring a pathway out of antidepressant and anti-anxiety medication is welcome to visit my website at http://youronlinecounselor.com JustMJ (26) 22 Nov 2007 10:06 AMI took AD meds for several years while going through the menopause my doctors all told me I was too young for. They didn't help, and I gained weight. But 4 years ago my doctor put me on what was then a new drug, Lexapro. It changed my life. It didn't do much about my weight but it pulled me out of the quicksand. I don't like the extra weight, and I haven't had much luck shedding it. But I am no longer a prisoner of my moods, and that for me is a miracle. It's strange, how certain treatments help some people so much, but are completely ineffective, or even harmful, in others. Beth McHugh (12962) 22 Nov 2007 01:49 PMHi JustMJ, have you had your progesterone levels checked? Many women going through perimenopause and menopause have low progesterone which contributes to both depression and anxiety, and this can persist after menopause causing distressing emotional symptoms. Supplementation with natural progesterone cream can assist in evening out mood swings. You can get a prescription from your doctor, or try to find books by Dr John Lee, the pioneer in natural progesterone and mood swings. Beth McHugh (12962) 22 Nov 2007 02:25 PMThe Lexapro isn't addressing the anxiety associated with being without a support person. This is where antidepressants fail in that they mask mood swings but don't address underlying issues. Cognitive-behavioral therapy and exposure therapy combined with relaxation assists with panic disorder and agoraphobia. I also work with looking at the root cause of the fear, part of which is habit and part of which is grounded in one or more false beliefs. cal1 (75) 06 Jan 2008 09:44 PMAntidepressants are one tool in the arsenal used to find depression. But that's it, nothing more, nothing less. They're only one of many options are they're not always even the best option, (and often one of the more expensive options at that). In rough order of effectiveness (% of patients responding * % of improvement), the following modalities come out something like this: 1: ECT - far and away the most effective. The best choice for pregnant women. Obvious risks and side effects make this a last choice, however. 2: Exercise and getting outdoors (may be difficult with severe depression) 3: Combination of SSRI or next-generation meds and talk therapy (usualy CBT, DBT, or interpersonal) Some research suggests MAOI drugs are more effective but are rarely used due to significant dietary restrictions 3: (tie) either meds or talk therapy alone are about equally effective depending on quality of therapist. 4: Other things can be very effective for some, but are more hit-and-miss: Dietary changes, adding Omega-3 supplements, making life changes (ie jobs, moving, starting or ending a relationship) Generally the more catatonic and withdrawn the person is, the more important the meds are to help boost the patients functionality to where they can implement some of the other things. cal1 (75) 06 Jan 2008 09:50 PMI've been on multiple medications for a long time - like 10 years or more. After reading some of the anti-pharma rants and conspiracy theories, and because of the fact that I literally cannot remember what I feel like without meds, I'm considering going med-free. I realize I need to taper down and do one at a time to minimize withdrawal reactions, but I'm a bit nervious about it. I think my Psych is smarter than me, and she as told me that as a patient, it's my call, and she'll try to support me if I decide to go off meds, but she said she strongly feels it would not be in my best interest because I am severely depressed and unstable, and she fears that if I go cold turkey I'll end up in the hospital or worse. So I'm not sure what to do really.  MarriageMax (10) 17 Jan 2008 01:35 PMI think Collete was very lucky to got a neighbor that was a Social Worker. And that’s true; antidepressants are not always the solution to our problems. Sometimes family and friends can heal the grief â€" antidepressants just make you forget the problems, but don’t resolve them. Beth McHugh (12962) 17 Jan 2008 02:26 PMIf only antidepressants made you forget the problems! They do mask some but not all of the emotional pain, but you're right, they don't resolve anything. Overwhelmed (6) 04 Feb 2008 06:01 PMI have tried every anti-depressant you can think of and all of them have made me feel suicidal. It starts with feeling like a zombie for 2 weeks and then it turns into suicidal thoughts. I have the most severe case of PTSD imaginable from being abused at a young age and later in life finding out a family member was raped by the abuser. Here I am in my 40's and for all intents and purposes I am like everyone else, I don't want people to pity me nor do I want to live like this...what are my options? I am a mother of a beautiful daughter, wife to the man of my dreams and still I feel as though I live in my little bubble where all my problems reside with me and my family is not in the bubble with me, I don't want to be in this bubble, why would I invite them in. I have built the most amazing bubble, no one can penetrate it and I can't get out of it. My daughter has a condition that is incurable and only manageable. I feel so bad and yes I keep it all inside of me, I'm selfish and don't want to share the pain I feel daily. If you saw me walking by, you would never know what I feel, I keep a smile on my face all the while I am crying on the inside. So, where do I go from here? How did I get here? I can only use a drug to maintain my PTSD, anti-anxiety and that's it. There is no magic pill for me. Is this a cry for help or is this a final good bye...I don't know. I do know I'm not ready for that final good bye. Overwhelmed to the power of 10 Community Tags antidepressants, coping skills, depression, reactive depression Discuss this article
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Antidepressants can make an enormous difference to the quality of life of sufferers of both depression and anxiety. But as we discussed in When Antidepressants aren't the best option (1) and (2), there are cases when antidepressants should not be prescribed, or should be used in conjunction with other therapies. Let's look at another case study.
