Treatment improving for depression
Editor's note: This is the second of two columns looking at depression.
"I don't know, I just feel ... down."
We all do now and then. We may call it by different names - being a bit down in the dumps, having the blues. But we all know what it's like. Being a bit depressed every now and then is a pretty normal part of living.
Yet, for many of us at one time or the other, it starts to feel a bit less than normal. Our depression becomes so severe that we start to wonder if we can take it, or it lasts so long we question whether it will ever go away. That's when it is time to get help.
Most recently, the treatment of choice for acute (intense, severe) or chronic (lasting a long time) depression has involved a combination of psychotherapy (talking to a counselor or therapist) and psychopharmacology (taking an antidepressant medication prescribed by a M.D., often a psychiatrist). There is a reason for this.
Depression often has both psychological and biochemical components. Our depressed feelings and thoughts also involve certain chemical processes in our brain. It is a complicated interaction and one which, to be honest, we don't understand completely.
Psychologically, some theorists suggest that acute or chronic depression occurs when we feel angry at someone (or something) else, but for a variety of reasons turn it inward upon ourselves.
Others think that we feel depressed when we avoid doing something we know we need to do. In my experience, both ideas have some merit.
Biochemically, acute or chronic depression sometimes seems to involve a malfunction in our body chemistry. Researchers have suggested it is as if our brain chemistry gets stuck. We produce too little of one chemical, or, perhaps, flush away too little of another. And with the right environmental situation, we can get pretty down for a pretty long time.
Though we aren't totally clear about what causes depression, we are more and more confident about how to treat it.
Psychotherapy seems to be the necessary component in treating acute or chronic depression. Setting down and working through our feelings with a trained therapist enables us to understand our feelings, their origins, and what we can do about them.
Sometimes this therapy will involve members of our own family - a spouse, parents, or other family members.
Psychopharmacology also can play an important role in our treatment of depression. In some situations it seems necessary to return our biochemical functioning to normal through use of medication in order for psychotherapy to be effective.
Such medication must always be used cautiously and always under the supervision of a trained physician. In my experience, though, medication alone is seldom enough, as it does not deal with the environmental or cognitive factors that likely contribute to, and are complicated by, our depressed feelings. I believe it usually needs to be used in tandem with psychotherapy.
Feeling depressed is something we all must deal with. And sometimes we need a bit of help. Fortunately, the help is there. With time and effort, things can change.
• Dr. Ken Potts is on the staff of Samaritan Counseling Center in Naperville and Downers Grove. He is the author of "Mix Don't Blend, A Guide to Dating, Engagement and Remarriage With Children."