Continued from "Depression and Women - A Treatable Illness"
THE PATH TO HEALING
Reaping the benefits of treatment begins by recognizing the signs of depression. The next step is to be evaluated by a qualified professional. Although depression can be diagnosed and treated by primary care physicians, often the physician will refer the patient to a psychiatrist, psychologist, clinical social worker, or other mental health professional. Treatment is a partnership between the patient and the health care provider. An informed consumer knows her treatment options and discusses concerns with her provider as they arise.
If there are no positive results after 2 to 3 months of treatment, or if symptoms worsen, discuss another treatment approach with the provider. Getting a second opinion from another health or mental health professional may also be in order.
Here, again, are the steps to healing:
- Check your symptoms against the list above
- Talk to a health or mental health professional.
- Choose a treatment professional and a treatment approach with which you feel comfortable.
- Consider yourself a partner in treatment and be an informed consumer.
- If you are not comfortable or satisfied after 2 to 3 months, discuss this with your provider. Different or additional treatment may be recommended.
- If you experience a recurrence, remember what you know about coping with depression and don't shy away from seeking help again. In fact, the sooner a recurrence is treated, the shorter its duration will be.
- Depressive illnesses make you feel exhausted, worthless, helpless, and hopeless. Such feelings make some people want to give up. It is important to realize that these negative feelings are part of the depression and will fade as treatment begins to take effect.
Along with professional treatment, there are other things you can do to help yourself get better. Some people find participating in support groups very helpful. It may also help to spend some time with other people and to participate in activities that make you feel better, such as mild exercise or yoga. Just don't expect too much from yourself right away. Feeling better takes time.
WHERE TO GET HELP
If unsure where to go for help, ask your family doctor, OB/GYN physician, or health clinic for assistance. You can also check the Yellow Pages under "mental health," "health," "social services," "suicide prevention," "crisis intervention services," "hotlines," "hospitals," or "physicians" for phone numbers and addresses. In times of crisis, the emergency room doctor at a hospital may be able to provide temporary help for an emotional problem and will be able to tell you where and how to get further help.
Listed below are the types of people and places that will make a referral to, or provide, diagnostic and treatment services.
- Family doctors
- Mental health specialists such as psychiatrists, psychologists, social workers, or mental health counselors
- Health maintenance organizations
- Community mental health centers
- Hospital psychiatry departments and outpatient clinics
- University- or medical school-affiliated programs
- State hospital outpatient clinics
- Family service/social agencies
- Private clinics and facilities
- Employee assistance programs
- Local medical and/or psychiatric societies
1 Blehar MC, Oren DA. Gender differences in depression. Medscape Women's Health, 1997;2:3. Revised from: Women's increased vulnerability to mood disorders: Integrating psychobiology and epidemiology. Depression, 1995;3:3-12.
2 Cyranowski JM, Frank E, Young E, Shear MK. Adolescent onset of the gender difference in lifetime rates of major depression. Archives of General Psychiatry, 2000; 57:21-27.
3 Frank E, Karp JF, and Rush AJ. Efficacy of treatments for major depression. Psychopharmacology Bulletin, 1993;29:457-75.
4 Lebowitz BD, Pearson JL, Schneider LS, Reynolds CF, Alexopoulos GS, Bruce ML, Conwell Y, Katz IR, Meyers BS, Morrison MF, Mossey J, Niederehe G, and Parmelee P. Diagnosis and treatment of depression in late life: Consensus statement update. Journal of the American Medical Association, 1997;278:1186-90.
5 Leibenluft E. Issues in the treatment of women with bipolar illness. Journal of Clinical Psychiatry (supplement 15), 1997;58:5-11.
6 Lewisohn PM, Hyman H, Roberts RE, Seeley JR, and Andrews JA. Adolescent psychopathology: 1. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. Journal of Abnormal Psychology, 1993;102:133-44.
7 Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, and Goodwin FK. Comorbidity of mental disorders with alcohol and other drug abuse: Results from the epidemiologic catchment area (ECA) study. Journal of the American Medical Association, 1993;264:2511-8.
8 Reynolds CF, Miller MD, Pasternak RE, Frank E, Perel JM, Cornes C, Houck PR, Mazumdar S, Dew MA, and Kupfer DJ. Treatment of bereavement-related major depressive episodes in later life: A controlled study of acute and continuation treatment with nortriptyline and interpersonal psychotherapy. American Journal of Psychiatry, 1999;156:202-8.
9 Robins LN and Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic Catchment Area Study. New York: The Free Press, 1990.
10 Rubinow DR, Schmidt PJ, and Roca CA. Estrogen-serotonin interactions: Implications for affective regulation. Biological Psychiatry, 1998;44(9):839-50.
11Vainionpaa LK, Rattya J, Knip M, Tapanainen JS, Pakarinen AJ, Lanning P, Tekay A, Myllyla VV, Isojarvi JI. Valproate-induced hyperandrogenism during pubertal maturation in girls with epilepsy. Annals of Neurology, 1999;45(4):444-50.
12 Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, Joyce PR, Karam EG, Lee CK, Lellouch J, Lepine JP, Newman SC, Rubin-Stiper M, Wells JE, Wickramaratne PJ, Wittchen H, and Yeh EK. Cross-national epidemiology of major depression and bipolar disorder. Journal of the American Medical Association, 1996;276:293-9.
HELPFUL BOOKS Many books have been written on major depression and bipolar disorder. The following are a few that may help you understand these illnesses better.
Andreasen, Nancy. The Broken Brain: The Biological Revolution in Psychiatry. New York: Harper & Row, 1984.
Carter, Rosalyn. Helping Someone With Mental Illness: A Compassionate Guide for Family, Friends and Caregivers. New York: Times Books, 1998.
Duke, Patty and Turan, Kenneth. Call Me Anna, The Autobiography of Patty Duke. New York: Bantam Books, 1987.
Dumquah, Meri Nana-Ama. Willow Weep for Me, A Black Woman's Journey Through Depression: A Memoir. New York: W.W. Norton & Co., Inc., 1998.
Fieve, Ronald R. Moodswing. New York: Bantam Books, 1997.
Jamison, Kay Redfield. An Unquiet Mind, A Memoir of Moods and Madness. New York: Random House, 1996.
The following three booklets are available from the Madison Institute of Medicine, 7617 Mineral Point Road, Suite 300, Madison, WI 53717, telephone 1-608-827-2470:
Tunali D, Jefferson JW, and Greist JH, Depression & Antidepressants: A Guide, rev. ed. 1997.
Jefferson JW and Greist JH. Divalproex and Manic Depression: A Guide, 1996 (formerly Valproate guide).
Bohn J and Jefferson JW. Lithium and Manic Depression: A Guide, rev. ed. 1996.
National Institute of Mental Health
Public Information and Communications Branch
NIH Publication No. 00-4779