Tuesday, March 26, 2013

Depression and Divorce, the New Couple in Your Life


Depression and divorce go hand in hand. Your marriage ends, and someone moves out, but someone also moves in. Like an unwanted house guest, depression becomes like a shadow, skulking in the background, right there, everywhere you go. The shadow is depression, and to move depression out, you are going to have to be armed. Arm yourself with knowledge, and call in the troops available to help you.

The bad news about depression is that when it's left untreated it can disrupt your job, your relationships, and your life. No amount of "cheering up," "toughing it out," booze, or exercise will make it go away. The good news about depression is that, once recognized, it usually responds well to treatment.

Depression affects about one of every seven Americans of all religions, races, genders, and income levels every year. About two thirds of those who suffer from depression don't get treatment for it. Take a moment to reflect on what that means. In any average group of 30 people, for example, the odds are that four of them will suffer from depression this year. It is believed that women are twice as likely as men to be affected by depression, but perhaps men are half as likely to seek help, and go undiagnosed. The first line of defense is understanding what depression is, and understanding that you cannot just ignore it, or pretend it is not there.

Just like an unwelcome house guest, it is there, coming right behind you, and though you may not see it, it is making messes, and those messed are left for you to clean up. Depression due to divorce is a double edged sword, because it tends to have a snowball effect. It tends to come ready made with a sense of failure being built right in, anger boils beneath the surface, your children suffer, finances change, living conditions change, it can often precipitate a move. It is no wonder divorce and depression is the new couple in any failed marriage.

Don't self-diagnose depression. Depression is too dangerous, and unpredictable, for any of us to attempt to diagnose or treat depression without professional help. You need the experience and savvy of a physician or mental health professional to help you understand your own case and get the right treatment for it.

Treatment for depression is twofold, including psychotherapy and medication. A lot of very smart people disagree about which is more important. Although it sometimes makes sense to use therapy without medication, it almost never makes sense to use medication without therapy.

Medication to treat depression keeps getting better. Medications now available for treatment of depression are more effective and faster-acting than ever. They have fewer, and have less disruptive side effects.

Most fall into one of four groups:

* Heterocyclics,

* Serotonin reuptake blockers,

* MAO inhibitors

* Lithium

Newer medications are coming on line every month. Here are some suggestions that will help your doctor find the best medication for you:

Use a psychiatrist. Generally, psychiatrists know more about the range of medications available than do general practitioners, for the same reason that pediatric cardiac surgeons know more about the options available for treating heart problems in children. They do it all the time.

Be patient. Although some symptoms may respond to medication quickly, the medications for depression usually take three to six weeks to become fully effective. By far the most significant factor in unsatisfactory treatment for depression is the impatient patient.

Expect changes in the medications. Expect depression to be treated in a trial-and-error manner. It is the only way to find the solution the right treatment for you.

Follow instructions. Take your medicine on schedule. Don't stop taking it entirely. Don't. If you follow your doctor's instructions carefully you equip your doctor with a full range of options for improving your treatment regimen over time and tailoring it for you.

Understand side effects. The side effects of medications for depression include dry mouth, blurred vision, constipation, and changes in urinary and sexual function. Whenever your doctor prescribes a new medication, ask about side effects and what you can do to control them.

Avoid alcohol. Even in moderation, alcohol acts as a depressant. It can interact with medications in unpredictable ways. If you are an alcoholic, make sure your doctor knows this when he or she prescribes medications for you.

Keep your doctor informed. Conscientious physicians want their patients to let them know when they're experiencing something unexpected, because they can then evaluate the case and decide whether to change the medication. Don't expect to talk to the doctor whenever you want, but you should be able to describe your unexpected experiences to a knowledgeable person on the doctor's staff and get a reasonable response. If everyone seems too busy to talk to you, and if you're convinced you're not just being a pest, find another doctor.

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