When are antidepressants appropriate for treating depression?
In my opinion, antidepressants can and should be tried as an intervention for depression when people are suffering some of the following symptoms for over two weeks, which hinder their functioning and ability to live a normal life:
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 that 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, while a physician only sometimes treats 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, then the person needs to be followed up by his/her doctor to see what the results are and if there are any side effects from the medication. Usually, the doctor or psychiatrist wants to see this patient within two weeks after starting the medication. The patient and doctor need to talk about any other current medications he/she is taking which might be contraindicated for use with an antidepressant. Many other factors must be assessed such as: is the person dealing with an alcohol or drug addiction, or is the woman pregnant, looking to become pregnant, or breast-feeding? 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. 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 which are causing the depression. So, the doctor and the counselor need to 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, ie., serotonin, catecholamines... 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 sexual abuse. Those 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 5, "Why are you downcast, O my soul? 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 in 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. Non-Christians express anger towards 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.
Perspective and beliefs about God and Who He is changes one’s feelings and perspective on life. When people know that there is a God of the universe who loves them and has a plan for their lives, they begin to feel more hopeful and experience the comfort and peace they need to work through any trial or disappointing circumstance. They begin to pray and read the Bible, which changes the false beliefs underlying their depression.
Since human beings are very complex, it is necessary as well to look at all the underlying causes of depression such as: low self-esteem, losses, physical pain, relationship or financial issues, guilt, shame, trauma, dysfunctional family issues, along with the spiritual and physiological reasons.
Most importantly though, people need to discover a relationship with Jesus Christ so they can be forgiven and be assured of spending eternity in heaven. Experiencing that 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 their 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.
Used with permission. Originally published at thelife.com.
©2004 by Lynette J. Hoy, NCC, LCPC
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