Depressive Disorders

Depressive Disorders


Whether we call it, “major depression, unipolar depression, clinical depression, etc”, is a very mean and wicked disease.  It attacks nearly every major system within the brain that has to do with regulating how you think, feel, behave and approach your daily life.  Specifically, it becomes impossible to think positively, to ‘get motivated’, to do the things you know you should be doing but can’t.

I describe it as a ‘negative’ disease

Everything sinks to a negative low – one’s thoughts about themselves, their lives, their ability to function, what they have/haven’t done with their lives…these are all seen within a negative, critical and judgmental perspective.  Often the person has no energy, no interest in doing the things they use to enjoy, can’t get a good night’s sleep or, the opposite, finds themselves choosing to sleep all the time – sometimes hoping they won’t wake up.

Not everyone thinks specifically about suicide but many just wish they would not have to keep living like this.

Misery IS Treatable

In the end, it doesn’t matter what the ‘label’ is that is used to describe one’s depression.  What matters is the fact that this misery IS treatable and that this is NOT normal. Everyone has a bad day or even a bad week at times.  Depression is a bad day, every day, often for as long as the person can remember. People try to ‘minimize’ their symptoms, push through their days and hide how they are truly feeling.  However, what is missing from their lives is a quality of life, a feeling of joy on occasion, of satisfaction on a regular basis and of general contentment with their lives.  Depression, as I stated, is a mean disease that robs people of all those components which create a quality of life.  Treatment is designed to restore a quality of life – and one should never be satisfied with their treatment until that has happened.

Do I have ‘Depression’

In determining if the symptoms which you are having are the result of a depressive illness, it is important to have a comprehensive evaluation by a physician, preferably a psychiatrist.   One of the reasons is because the ‘party line’ within the psychiatric profession is that this is a disease that CAN and should be treated to remission.  It is not good medicine to prescribe some medication and tell you to return in a couple of months.   You should be closely followed by your doctor and monitored for a change in symptoms in a reasonable period of time.  There should be some evidence of improvement in the first couple of weeks or the medication should be changed, increased and/or adjusted in some way.

Genetic testing

In order to minimize the time it takes for my patients to begin to respond to medications, we offer genetic testing to determine how that individual’s liver enzymes metabolize the various medications (see separate discussion).  This serves to eliminate a lot of ‘guessing’ as to the best medication choices and allows treatment to offer a greater chance of success as early as the second visit.

There is much more that can, and should be said about depression

The internet is full of resources, suggestions for enhancing your treatment as well as ideas for helping to ensure that, once your depression is under control, you can help to keep it from coming back.  Here are a few of those links and others may be suggested in the course of your treatment.  There is a lot of information out there. However, it is best utilized in conjunction with a trusting and mutually respectful relationship between your doctor and you.  Never hesitate to ask questions, raise concerns and offer an opinion.  In the end, you want to be the one in charge of your health and your doctor is an important resource which you should utilize in achieving that goal.