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  • Depression blog

  • April 30, 2008

    Know the keys to successful treatment

    By Gabrielle J. Melin, M.D.

37 comments posted

Need more help?
  • National Suicide Prevention Lifeline
    1-800-273-TALK (8255)
  • Go to the nearest hospital or emergency room
  • Call your physician, health provider or clergy
  • National Alliance on Mental Illness
    www.nami.org
    1-800-950-NAMI (6264)

Thank you so much for sharing all of your stories. I know this takes courage, especially when you are not feeling well. You all need to know that help is available. If you're actively thinking about suicide, get help now!

I was struck by the number of you that have lost someone to suicide. I was also moved by the number of you that have had significant losses in life for any reason. I am sincerely sorry for the losses that you have experienced and know your emotional pain will get better with time.

Depression severity can vary between individuals and episodes. For instance, some people will have anxiety that accompanies their depression, while others do not. We call medications "anti-depressants," but almost all of these effectively treat anxiety as well. While it is true that there is no quick fix or cure, there are keys to successfully treating depression to decrease suffering.

Obtaining the correct diagnosis is so important and sometimes this will change over time. Considering the patient as a whole is crucial to determine how to develop an effective treatment plan. Medications alone are rarely enough. You may need to try more than one medication or a combination. Medications are not always needed for depression, depending on the severity.

Therapy alone can be extremely effective, yet therapy is not for everyone. You need to be comfortable with your provider; therapy is meant to be a safe place where you can talk and not feel judged. Therapists can help by listening and facilitating change, if the patient has insight and is ready for change. Therapists don't make people better or fix them. Therapy is a partnership and takes working together. Keep an open mind during therapy as well. Being your own expert on your illness is important too. Obtain as much information as you can, have your questions answered, know your options, and then you can choose which form of therapy (medications, talk, etc.) you'd like to begin.

On this site, we will continue to read your comments and address topics as best we can. More later on ECT, but know that it is available all over the country. Thank you again for your interest in depression.

37 comments posted

blog index
  • August 1, 2009 10:54 a.m.

    To the "anon" poster: one acupuncturist has told me that treatment for years-long, severe clinical depression is not really an option. For an episode of depression resulting from a more tangible source, like perhaps loss of job, going through a divorce, or loss of loved one, it "may be" of some help.

    - Lanny

  • June 1, 2008 1:05 a.m.

    Suffering from an addiction. This website has a lot of great resources and treatment centers. http://www.treatmentcenters.org

    - jmathew

  • May 17, 2008 7:49 p.m.

    For years I have also pretended that I'm just fine. I keep everything bundled up inside, people would be appauled if they knew this real person inside me.

    - Ann MN

  • May 13, 2008 5:12 p.m.

    Ellie, I understand very well what it is like to have a family that does not understand depression. (I didn't understand depression either until it hit me.) Now, I pretend I'm fine, when the opposite is true. Someone once said that every severely depressed person should get an Academy Award for acting! The stigma of depression is nasty. By all means, get help. You will find depression soulmates in group therapy or in the hospital, if you need to go there. I don't know what I would do without my therapist. She is the only person I can talk with about my depression. I resisted taking antidepressants for years. That was a mistake. There is help out there.

    - No name given

  • May 11, 2008 11:11 a.m.

    Amit, I fail to see how getting up early in the morning can cure depression. Maybe it worked for you, but would not be effective for most people.

    - carol

  • May 10, 2008 Midnight

    AM NOW 62 YRS & DEPRESSION HAS BEEN TRACED BACK AS FAR AS 4 YEARS OLD. prozac saved my life in 1990, & improved things great deal, but not to where I was perky. After ten years, the procac no longer was helpful. after many years, I am now taking Cymbalta as my main antidepressant, as well as Wellbutrin, ritalin, & seroquel.My doc monitors me frequently & we will be fine tuning this the rest of my life.plz don't scoff at any of the other medications. what didn't work for me may work for you.

    - dahlia

  • May 9, 2008 7:36 a.m.

    Ellie, you poor darling, so much going on in your life. Get help with your depression, you don't have to tell your daughter or anyone what you are doing. Its confidental and if you don't tell then no one will know. Then you will be able to take on the other responsibilities you have, you may only need councelling as i think anyone would feel down going through what you are. The son that is giving you some trouble, love it out of him, make him know how important he is to you, how much you need him. Good luck

    - DB

  • May 9, 2008 3:57 a.m.

    getting up early in the morning helps to cure depression one can be cured from ot in 9 months

    - amit

  • May 8, 2008 9:24 a.m.

    I don't know what to do. I have to hide my depression from everyone. My husband is suffering from early dementia and needs my care a great deal. My children all have their own problems and I can't add to them. We moved a few months ago to be nearer our eldest daughter, because of my husband'S deteriorating condition. She doesn't believe in treating depression and so I don't tell her anything. Our former church, friends, counselor are all far away. I wake up every morning wondering how to get through the day. To top it off my younger son is looking like he is getting into a mess and my older son confided in me that he is contemplating a divorce and needs to borrow money from us for legal expenses. I want to lend him the money so that he can get some sort of custody for his children. His wife is very abusive. I know because we have been the object of her abuse ourselves. However, I don't know if we will need the money ourselves eventually for long term care if we can't manage my husband's deteriorating condition. This is not a pity party I just need someone to whom I can express my feelings. I even feel guilty about writing this.

    - Ellie

  • May 8, 2008 7:22 a.m.

    You can't count on dying!!! Keep on breathing. Keep on keeping on! (I survived 2 suicide attempts a week apart 10 years ago, both of which resulted in painful physical disability and scars.) A homeopathic practioner told me, "She, your body, wants to live!" Find one friend or relative who believes in you, who will advocate for you. Find a psychiatrist who believes in you. My adult daughter's love; Paxil, then Celexa (which I continue to take); an excellent psychiatrist/therapy, and situational improvement over years (trust, love for myself & others; home & job) brought me back to rewarding reality. A book published in 2007, "The Brain That Changes Itself" which makes sense out of what goes on in my head. There is no easy fix; however, there is help. Sandy, Denver, Colorado

    - Sandy

  • May 8, 2008 6:47 a.m.

    Amitriptyline is a medication that falls under the class called tricyclic antidepressants. (anti-anxiety too) It can be used to treat pain, anxiety depression and insomnia. This class of medications has been around for some time and is available in generic. It is not for those with significant cardiac problems though and does have other side effects too. check with your Physician.

    - MC.com staff

  • May 7, 2008 10:05 p.m.

    May 6, 2008 Nancy Just wondering if this is Nancy who once lived in Peoria? If so, Nance, I have thought about you so often and wondered how and where you were. If so, post a comment and maybe we can connect again.

    - Susie

  • May 7, 2008 2:43 p.m.

    I have been dealing with bipolar illness for 50 years. It is a miserable way to go through life. I do what i can and have had regular threapy for the last 35 years plus medication. There are times when I feel well for six months or better. I just try to tough out the bad times by keeping busy and treating myself well. Like buying new clothes, getting my hair done and eating! It has been worse since my husband died. I will be glad when my life is over.

    - Barbara

  • May 7, 2008 12:16 p.m.

    I think after last nights group session about support networks i'd have to say the best combination for me in addition to meds is seeing my therapist, seeing my psychiatrist going to weekly group meetings and having family and friends in my support group that are soley concerned with helping me deal with each days concerns. I wish everyone the best, the road is not always easy but this is another thing I've added to my treatment plan to help me get through the days.

    - marie

  • May 7, 2008 9:50 a.m.

    My husband is 90, was always very active but due to shoulder surgery last year, is quite inactive (the other shoulder in now very painful)! He has been having off and on headaches, sometimes, throbbing? Last week, the Dr. prescribed Amitriptyline 10 mg taken at bedtime. In reading the info, it mentioned "depression"........Help?

    - Lois Schmidt

  • May 6, 2008 11:12 p.m.

    Jane, There is an experimental treatment called Deep Brain Stimulation that works something like a heart pacemaker. Look it up on Mayo Clinic or Google. Best wishes, I know your pain.

    - B, Vancouver, Canada

  • May 6, 2008 9:38 p.m.

    i found your blog last week and have added it to my necessary resources to get thru the rough spots. i would like to mention www.dbsalliance.org.this suooort group is a big help. other folks might check if there is a group near them. love to all john

    - john abbott

  • May 6, 2008 7:59 p.m.

    I have suffered with depression on and off for many years. Mine started in my teen years. I had no idea that the bad feelings I had then was depression. I felt horrible with no relief in sight. As life changed and moved on these feelings got better. A busy busy life helped to keep the lows from getting too low but I started to feel down after 13 years on the same job. As another year came and went I started to have memory problems and really awefull feelings crept back in. I lost my job at one point since I could no longer function with constant obsessing about leaving that place and with new management taking over I felt helpless and became useless I suspect and got the sack. This triggered 4 years of major depressive symptoms and a barage of antidepressants and therapy. All of these things did not seem to help for very long and the longer I was without work the worse I felt. Money was of course a facter and depleteing my resouces and relying on friends help made things very bad. I remember many sleepless nights and I gained 60 lbs. Sleep apnea only made things worse before I was diagnosed. Alot of talk therapy and some hypnotic suggestion and Zoloft in small amounts actually pulled me up enough to get a job again and start my new life. Unfortunately I am at wits end again with this job so my situation detector is triggering worry for my future again. This perhaps is normal and a good point to find something new rather than let things happen to me.

    - LLoyd

  • May 6, 2008 6:09 p.m.

    I have suffered with depression and post-trautamic stress disorder for the past 15 years. I have a great Psychiatrist, and take medications also, but nothing seems to help. I just seem to be getting more and more depressed with each day. I have had an extremely rough/difficult life. I also lost my Mom two and a half years ago, and my Dad eight years ago. They were my best friends. I feel all alone here in Chicago with no family. I do have a great church and alot of friends, though. They are supportive. But I feel like maybe I should move to Colorado or Arizona, where I have some family, and try to start a new life. I just keep sinking deeper and deeper.

    - Nancy

  • May 6, 2008 12:43 p.m.

    To Egg-I know and empathize how you feel...My hears of depression have been on going for several years with only incresed severety over the past 10-11 years...I am also a "retired (diabled) Rn with Fibromyalgia caused from multiple surgeries the las being for Uterine Cancer...It always seems that I am beaten down with every step I take forward. I have chronic pain from degenerative cercial, lumbar and sacral discs. I just underwent liver biopsies for a "mass" on my liver, they were negative but the waiting to know is just great. And lets just add on the family of origin issues...it goes on and on. I too like you often think of suicide but could not do that to my family. Although I do reassure them that is I ever make a plan they will never know becasue one day I will just disappear. I work so hard that it fatigues me to no end. But know that the anxiety and depression may never go away per my psychiatrist doesn't help. He told me it is genetic and familial and here to stay...Not what I wanted to hear. I look for words of encouragement but they are faint...but everyday that I can get out of bed is one more day that I survive Immobile

    - Immobile

  • May 6, 2008 7:32 a.m.

    My experience over the years is with underlying depression and then episodes of major depression laid on top, the severity varying. The earliest I remember having an experience of depression was in high school. I have fibromyalgia and chronic pain from arthritis. I have had to stop working Medications take time to work, need to be changed when they don't. Therapy has helped; one has to interview and be discerning. I've wondered whether my being a "retired" (actually disabled) therapist actually makes all this more difficult. I like to think I have a bag of tricks: friends, spiritual community, volunteer work, pets, exercise, movies, nutrition, humor, changing my environment, meditation, journaling, artwork... Nothing helps all the time. Sometimes nothing helps at all. I have felt utterly hopeless and wondered how much longer I could endure this. My own feeling is that I haven't sufficient courage to commit suicide and I do not want to do that to my daughter and my family. I do wonder whether there's any way to improve the quality of joy in my life. I work really hard at all this. After all, my life depends on it. My life work is now managing my health given my finances.

    - egg

  • May 6, 2008 7:09 a.m.

    dear suffering in silence. I'm not a doctor, but what drew me to your comment was that you seemed to know the source of your depression, it is due to the circumstances around you not depression with no known cause, so I wondered if you could see that you are probably one of the luckier ones with depression, that perhaps if you could day by day little by litte learn to love who you were, don't give up if trying something doesnt make you immediately happy, keep trying. I read recently that hypnosis is helpful in changing thought process. Being thin ard pretty doesn't make for happiness, people like that may look happy but they often carry their burdens too. You say why try because you might not be successful. It's better to try and fail than not to try again. Read, draw, write, change what you can find that one thing that you do the best and enjoy the most, it doesnt matter if anyone else likes it only that you do, because your the important one the only one that matters. I hope that you have the courage to keep trying to find the beautiful person within you and find some peace.

    - di

  • May 5, 2008 10:39 p.m.

    I too tried numerous medications that would work for a while, then stop, over and over again. It's very difficult for a depressed person to persist. I have a close friend who also suffers from mental illness. He was very helpful in recognizing symptoms that my family couldn't, among them that I was showing signs of mood swings. I did some reading. The book "Why am I still Depressed?" by Jim Phelps was a big help to me. His theory is that depression is in some cases actually bipolar disorder, in which case anti-depressants may exacerbate the symptoms. I found information online from reputable sources that concurred. My psychiatrist didn't buy it, but by then I had learned to advocate for myself and I persisted. He continues to be amazed that he could have overlooked my mood swings--especially since bipolar disorder is his specialty. I've been taking Lamictal for more than a year, with good results--and it hasn't stopped working!! I recommend the book and I hope that it might help you.

    - joyce

  • May 5, 2008 10:32 p.m.

    di: what's the point of trying if it will never work out? i have nothing to offer other people. i have tried volunteering. nothing makes me happy at all.

    - suffering in silence

  • May 5, 2008 1:14 p.m.

    I have been depressed for forty or more years. Over the years I have been on various medications. The combination of Effexor and Doxepin helped me for several years. I have major depression. Some of it is chemical and some of it is what I term "situational," I worry about my grown child and how I am mentally abused. I informed my psychiatrist that the two medications that I am currently taking no longer are effective. She informed me that 25 million people take effexor and it is an excellent medication. It no longer works for me. She increased the effexor and doxepin. All I did was sleep. The next time I saw her, I stated that sleeping all the time isn't a life or a quality of life. I now just take effexor and am still depressed. I need to try another medication. Years ago, prozac worked for my friend, but the six weeks that I was on it I threw up daily. Medications respond in different ways with diffent individuals. Any assistance would be appreciated. Take care and may God bless all of us.

    - no name please

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