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Don't Want To Take Meds

Question:

Hi. Recently, I went to a psychiatrist who diagnosed me as having Depression. I’ve been feeling the symptoms of depression for a couple of years now, and I’ve always suspected there was something wrong with me. However, when I was told I had depression I didn’t believe it and haven’t told anyone about it. And I don’t intent to. My doctor prescribed Lexapro to help but I stopped taking them after two days. There’s this part of me that doesn’t want to get well. Is that a symptom of Depression as well?

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Answer:

You’re describing a kind of ambivalence regarding your recent diagnosis. On the one hand, you know something isn’t right and you’ve invested enough in working to correct that problem to have gotten yourself to the right sort of doctor who might be able to help you. On the other hand, you’re not pleased with the doctor’s confirmation to you that you do have a problem, or with his treatment recommendations. Perhaps you are ashamed of being labeled "depressed". Having an illness or medical syndrome is not most people’s idea of a fun time and neither will anyone envy you your condition. Many people view depression in moral and characterological terms as a weakness and judge themselves very harshly for not being able to "kick" the problem on their own (like a "strong person" would do). This is not an accurate view of depression, by the way, but it is a common one.

Mild and moderate forms of depression are often characterized by pessamistic views, doubts, harsh judgements of self and other and a ready willingness to feeling ashamed. Depressed people may believe that they deserve to be punished, or ill; that they do not deserve to feel better; or even that life is not especially worth living. That you feel ambivalent about getting better is completely consistant with these negative ways of thinking and behaving and not all that remarkable in of themselves. What is nice to see is that you’re not paralyzed by your negativity but instead are open to seeing a doctor and considering his or her suggestions for treatment. Even if you are stuck for the moment with regard to accepting treatment, it is good to know that you’re open to learning about it. That is a positive sign.

Whether you decide to take anti-depressant medication or not is up to you, of course, as is your decision to share your diagnosis with others around you. You should know, however, that if you have been depressed for an extended period of time, that the liklihood of your depression simply going away on its own in the near future isn’t high. So you might want to do something about your depression if only because you will become more comfortable if you do.

It isn’t necessary (for most mild to moderate depressions) to take antidepressant medication, although antidepressant medications can be quite helpful. Specific forms of psychotherapy are also available which are known to be very helpful and effective in helping to disolve depressions. Such therapy is private, has no side effects, and does not involve drugs. If you pay out of pocket for services (basically, for the therapist’s time and attention) there need be no third party record of treatment (as will be the case when insurance is involved). I can strongly recommend two forms of psychotherapy for depression: Cognitive Behavioral Therapy (as originated by Aaron Beck: Cognitive therapy referrals are available at the Academy of Cognitive Therapy website), and Interpersonal Therapy (as originated by Myrna Weissman). Both are what are known as empirically validated psychotherapies, meaning that they have been studied scientifically and have carefully collected bodies of evidence behind them suggesting that they work. Ask for these therapies by name for the best results.

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