Sometimes the blues is more than just the blues.

 

Virtually everyone gets depressed from time to time, especially during high-stress times such as the holidays. But if your mood isn’t lifted by any of your tried and true methods—visiting a friend, your favorite music, a relaxing bubble bath—you may need to pay special attention.

 

The recognition of depression seems deceptively simple (you’re sad—really sad—right?) but in reality, symptoms can be ignored or misunderstood by the sufferer and medical professionals alike. Many of the symptoms seem somewhat paradoxical (eating too much or too little, sleeping all the time or hardly sleeping at all). Other symptoms can seem like physical maladies (headaches, stomach problems, etc.) Therefore it is important to be honest and thorough when explaining any concerns to your physician.

 

Any medical doctor can prescribe anti-anxiety or antidepressant medications. However, most studies show that a combination of medication and “talk” therapy is most effective in treating emotional distress, so don’t be afraid to visit a specialist (i.e., a psychiatrist). Don’t be worried if you can’t find an obvious cause for your depression (“Everything is going so well in my life—why on earth am I depressed?”). Depression is a medical illness caused by brain chemistry, and it needs a doctor’s care much like asthma or heart disease. And antidepressant medication (which is not addictive, by the way) can be seen as relating to depression the way that insulin relates to diabetes.

 

Interestingly, no one knows exactly how antidepressants work, but within several weeks of beginning treatment most clients report their symptoms have improved (and yes, the percentage is higher than with placebo). The problem is that every person’s physical chemistry is different. The medication that works very well for one person may not work at all on her friend. That’s why it’s so important to work as a team with your physician and be willing to try more than one medication if the first one(s) don’t seem to work. There are about 30 different antidepressants on the market today, and most people with clinical depression will be able to find one that alleviates their symptoms with a minimum of side effects.

 

So, what about side effects? Many, such as drowsiness or nervousness, will go away within a few days or weeks of beginning medication therapy. Others, such as diminished sex drive and weight gain, may, unfortunately, be there for the long haul. Antidepressants known as SSRIs (selective serotonin reuptake inhibitors) such as Paxil, Zoloft and Prozac are often blamed for weight gain; however, again, different people will respond in different ways. One SSRI may cause you to gain weight while another won’t. And certain antidepressants, such as Welbutrin (also used to curb the craving for nicotine), are less likely to cause diminished sex drive.

 

In addition to SSRIs, the newest antidepressants, there are tricyclics and monoamine oxidase inhibitors (MAOIs). People taking the MAOIs have to be very cautious about their diet and any other medications they may take, because negative interactions are common. But about 95% of all antidepressants prescribed today are either tricyclics or SSRIs.

 

Because all systems of the body are connected, doctors may prescribe antidepressants for a variety of physical ailments, such as chronic pain and chronic fatigue syndrome. In addition, people with depression may respond to other kinds of medication, including a new class of meds known as atypical antipsychotics. If your doctor prescribes an atypical antipsychotic for you, it doesn’t mean he thinks you are psychotic: it means that the kind of depression you have may be alleviated by this kind of medication.

 

Only the “team” of you and your doctor can decide when or if to stop taking antidepressant medication. Some people dealing with a particular situation, such as the death of a loved one, will be able to stop the meds when their situational depression has lifted. Others may need to remain on meds for many years. It is most important not to stop taking medication abruptly without your doctor’s knowledge. If you are or plan to become pregnant, speak with your doctor. So far, evidence suggests that babies don’t suffer ill effects in utero when their mothers take antidepressant medication, and such medication can prevent potentially tragic cases of postnatal depression.