In my opinion as a certified counselor, antidepressants should be tried as an intervention for depression when people are suffering symptoms that would hinder them from functioning normally for more than two weeks, such as:
Difficulty sleeping and eating.
Loss of weight.
Poor work performance.
Thoughts of suicide or “I wish I were dead.”
I encourage clients to get a complete physical examination to rule out any underlying physiological disorders which may be causing the depression, such as hypothyroidism or hormonal problems.
Then I recommend they go to a psychiatrist to get an evaluation to determine the need for medication, since a psychiatrist specializes in diagnosing and treating mental health disorder. Physicians only sometimes treat mental health problems. Many people today opt to be treated by their family physician because it is more convenient and less expensive.
When an antidepressant is used, the person needs to be followed up by his or her doctor to see what the results are and if there are any side effects from the medication. Usually, the doctor or psychiatrist will want to see the patient within two weeks after starting the medication.
The patient and doctor need to talk about any other medications the patient is taking, which might be contraindicated for use with (that is, they may not be safe to use with) an antidepressant. Many other factors must be assessed, like if the person is dealing with an alcohol or drug addiction, if they are pregnant or looking to become pregnant or breastfeeding. These patients may not qualify to use an antidepressant.
I encourage clients to manage their own health care by getting the drug insert, which gives information on side effects, complications and when it is contraindicated (what other drugs it is safe to use with).
When clients are on medication, they tend to start feeling better and then stop going to counseling. Unfortunately, they avoid dealing with the real issues causing the depression. So I encourage them to continue in counseling to learn better coping skills for the situations or relationship issues they face.
Clients need to learn to increase their neurochemicals through natural ways such as exercise and taking time to grow spiritually. The medication will boost their neurochemicals (i.e., serotonin, catecholamines, etc.), but it doesn’t change the fact that one has to work through the loss of a loved one or still has to deal with past abuse.
Crises and losses need to be dealt with, processed and grieved.
There most certainly is always a spiritual dimension to depression.
David writes in Psalm 42:5-6 (New International Version), “Why, my soul, are you downcast? Why so disturbed within me? Put your hope in God, for I will yet praise Him, my Savior and my God.”
Every person who walks into my office feeling depressed has an issue with God. Most Christians who are depressed have a general sense of disappointment with God. They struggle with periods of doubt about God’s love for them and begin to question whether He will help them through their problems.
People who are not Christians express anger toward God, wondering how a good God can allow suffering. Believing that God does not exist, might not exist or doesn’t care actually is the basis for some of the hopelessness and despair causing their depression.
In my experience as a licensed mental health professional, I have seen that perspective and beliefs about God and who He is change one’s feelings and perspective on life. When people know there is a God of the universe who loves them and has a plan for their lives, they begin to feel more hopeful. They experience the comfort and peace needed to work through any trial or disappointing circumstance. They begin to pray and read the Bible, which changes the false beliefs underlying depression.
Since human beings are very complex, it is necessary to look at all the underlying causes of depression, such as low self-esteem, losses, physical pain, relationship or financial issues, guilt, shame, trauma, and dysfunctional family issues, along with the spiritual and physiological reasons.
I believe people need to discover a relationship with Jesus Christ so they can be forgiven and assured of spending eternity in heaven. Experiencing a relationship with Christ, freedom from sin and hope for eternal life makes one’s life on earth more bearable and even joyful.
Medication can give people more motivation and energy to get through a depressive period in life, but it will not be a cure-all for depression.
One must take steps to fight depression on all fronts — spiritually, mentally, physically, emotionally and relationally.
Lynette Hoy, NCC, LCPC, CAMS-V is a Marriage and Family Counselor and National Certified Counselor, Certified Anger Management Specialist-V, author and speaker. She is the President of the Anger Management Institute and CounselCare Connection, P.C., providing online and office counseling for individuals, couples and families. Lynette regularly presents seminars on anger management, marriage, assertiveness, grief and divorce recovery, and stress management.
©2018 Lynette J. Hoy, NCC, LCPC. All rights reserved. Adapted with permission from TheLife.com.
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