By Dr. Timothy W. Woodard
The cold, dark, winter months are often a difficult time for people who suffer from depression.
The characteristic symptoms of depression are unusually sad or depressed mood, loss of energy or enthusiasm for enjoyable activities, disturbance of sleep or appetite, hopelessness, uncontrollable crying, and in serious cases, thoughts of suicide.
For most moderate to severe forms of depression, the mainstay of medical treatment remains the use of prescription medications. Often, despite good outcomes and general safety of the latest antidepressant medications, some patients show a high degree of resistance to using them. This is, in large part, due to a misunderstanding about the nature of medical treatments for psychiatric illnesses.
One concern that I hear voiced often is, “I don’t want to become dependent on anything.” It is an incorrect perception held by many people that any chemical that has any effect on the brain is automatically and by its very nature, addictive. This is absolutely not the case.
Some medicines, such as amphetamines, can be addictive because they have a direct effect on the circuits of the brain that govern the perception of pleasure and reward. Others, such as Valium, have the potential to cause physical dependence which, like alcohol, can produce life-threatening complications if the drugs are abruptly stopped without medical supervision. Properly prescribed, even these medications are usually safe for those who need them.
Antidepressant medications, however, do not work in this way. Once the best medication is identified and adjusted to the most effective dose for an individual patient, antidepressants are often extremely beneficial. It can be a time-consuming process that requires patience and perseverance but the final result is usually well worth the effort.
Antidepressants change the way certain chemical signals in the brain work. Stopping an antidepressant medication too quickly can cause your initial symptoms to resurge.
This is why many people need to stay on antidepressants for a prolonged period in order to reap the benefits. Six months is the usual minimum recommended duration of treatment, and it often needs to be longer. The average length of time that people remain on antidepressants, according to some studies, is about 80 days.
To rely on a medication to help you stay healthy and functioning at your best is not the same thing as being “dependent,” in the sense of being addicted. It is imperative that we be clear about that. Depression associated with other illnesses, like bipolar disorder, often requires different kinds of medications to treat it but the principle remains relevant. It is not fundamentally different than people with hypertension who rely upon their blood pressure medicine to keep their blood pressure under control.
Untreated or ineffectively treated depression can lead to absence from work, loss of productivity and income, sedentary activity that can adversely affect physical health, strained social relationships and, in the worst cases, suicide.
I believe it is essential for patients to have a realistic understanding of the reasons why medications are used to help prevent these negative outcomes. Few things are more tragic to a psychiatrist than to see a patient forego life-saving treatment because the perceived risks of treatment are far greater than the actual risks and the perceived benefits are far lower than the actual benefits.
At Mountain Crest Behavioral Healthcare Center in Fort Collins, we have an acute inpatient unit for both adults and adolescents who require hospitalization for severe or life-threatening cases of depression, as well as other serious mental illnesses. We also have a fully staffed outpatient clinic that offers medication management under experienced prescribers coupled with psychotherapy for both patients and their families.
If you or someone you know is struggling with depression this winter, please do not let misunderstandings about the nature of medical treatment prevent you from seeking, or encouraging others to seek, help when it is needed.
Dr. Timothy W. Woodard is a staff psychiatrist at Mountain Crest Behavioral Healthcare Center, which is part of the University of Colorado Health, in Fort Collins.
Mountain Crest Behavioral Health Care Center helps adults and adolescents with mental health issues and substance abuse issues achieve a balanced life and a high level of health and well-being. Programs offered at Mountain Crest include:
Substance Dependency Intensive Outpatient
A group experience that helps individuals develop new coping skills to deal with addiction.
More info: 970.207.4843
Mountain Crest Psychotherapy Outpatient Clinic
Individual appointments with a psychiatrist and licensed therapist.
More info: 970.207.4857
An in-home therapy and case management service for adolescents and families.
More info: 970.207.4891
For more information or to learn more about Mountain Crest and programs offered, visit pvhs.org/mountain-crest-behavioral-healthcare-center.