Is Clinical Depression Treatable?

Clinical depression is readily treatable with counseling and/or medication.  Medication can correct the chemical imbalance (low levels of serotonin and norepinephrine) which is found in people with symptoms of depression.  Approximately 50% of people with such depressive symptoms never get help and suffer silently as a consequence.  Untreated, the average clinical depression can last 9-12 months.  With treatment, people often report significant relief within 4-6 weeks.

Who is susceptible to Clinical Depression?

Depression often has its first onset in people between the ages of 18 and 22.  Many stressors which can contribute to the onset of depression are present in those years: separating physically and psychologically from one's family; managing the increase in personal freedom; dealing with the successes and disappointments that occur in academic, athletic, and extracurricular activities; developing and losing love relationships; experiencing the death of a loved one; choosing an academic major; finding a job; and leaving the familiarity and security of college for the "real" world.

Is depression a sign of personal "weakness"?

Depression is one of the most common mental health concerns/disorders brought by students to the Suffolk University Counseling Center.  It is NOT a sign of personal weakness. It is not a condition that you can will or wish away. People suffering from depression cannot merely expect to "pull themselves together" and get better. Without treatment, symptoms of depression may persist or get worse. With treatment, you may begin to experience significant relief within four to six weeks.

What are the health effects of depression?

There is increasing evidence that people who suffer depression significantly have a higher risk of heart disease. Some medical authorities believe that depression should be considered a risk factor for heart disease. In a study with elderly people in a nursing home, those people that were depressed were twice as likely to die as those who were not depressed. Depression is the cause of at least 1/2 of all suicides. Depression suppresses our immune system, which leads to frequent colds and other illnesses.

Is there a blood test for depression?

At present, there is no blood test that can confirm or eliminate the diagnosis of depression.

If I am taking medication, will I still need counseling?

In the majority of cases, the combination of medication and psychotherapy is the most effective way to treat depression.  While medication can help improve depressive symptoms, it cannot change the events, thoughts or behaviors that are problematic or distressing.  Even before becoming depressed you may have been struggling with personal or family issues that affected how you felt about yourself and your relationships. Psychotherapy can help you begin to explore and resolve these concerns. Individual and/or group psychotherapy may also be recommended to assist you in improving self-esteem, relationship skills and strategies for managing stressful events.

Shouldn't I be able to feel better without taking medication? Don't other people get through this without medication?

Even without treatment, some people will feel better. Unfortunately, "feeling better" can take a year or more. If untreated, depression can get worse and seriously interfere with your ability to study, work and enjoy relationships. Depression can also be a life-threatening illness when there is a risk of suicide. Medication will not "fix" everything, but it may help lighten your mood and help you to function so that you can begin working through other problems.

How does an antidepressant work?

Depression is an illness in which factors such as genetics, chemical changes in the body and external events may play an important role. Research suggests that depression may be linked to changes in the functioning of brain chemicals called neurotransmitters.  Certain genetic factors and changes in hormones have also been implicated in some depressive conditions.  These complex biological changes can produce profound changes in your mood and behavior.  Antidepressants are thought to correct some of the chemical imbalances present in a depressive illness.

How long will I have to take a prescribed medication?

You and your treatment professional(s) will meet regularly after medication is prescribed to assess any changes and/or concerns and to evaluate how the medication is working for you. Typically, people take antidepressant medications for eight to twelve months or longer.  While it is often tempting to stop taking the medication when you feel better, it is important to continue until you and your Health Care Professional agree your depression is treated.  Stopping the medication early can result in the return of your original symptoms.  You may be asked to gradually decrease or "taper off" the medication.  "Tapering off" is particularly important with some medications to allow your body an adjustment period.

Will the depression come back when I stop taking medication?

In the majority of cases, depression is an illness that can be effectively treated with medication and counseling.  However, there is always a chance that your depression may return once a medication is stopped.  Continuing antidepressants and/or therapy for the recommended time period minimizes this possibility.  Unfortunately, in a small number of cases, depression reoccurs after treatment is complete.  Recognizing the signs of a new depressive episode and seeking treatment early are very important.

Is the medication addictive? Will I get "high"?

The currently prescribed medications that are approved for the treatment of depression are not considered addictive.  Although not addictive, the use of some antidepressants may lead you to wonder whether you are getting "high."  Early on in treatment, antidepressants may cause you to feel unusually energized, especially compared to your previous state.  As with most prescription medications, there are also potential side effects with antidepressants.  Feeling "high" or intoxicated suggests an unusual reaction to your medication, an interaction with another medication, or complications from drug or alcohol use.

What are some of the effects of medications I might take?

Medication will not change who you are as a person, your unique personal characteristics, or your life circumstances.  Antidepressant medication assists people in experiencing the full range of human emotions without feeling overwhelmed.  Antidepressant medication can help you to recover your ability to react to people and interpersonal situations in a more positive way, which is often seen by others as a positive "personality change."

What might my Health Care Professional ask me to do before prescribing medication?

Your Health Care Professional may ask the same questions you have already been asked by another professional.  While you may find this repetition frustrating, keep in mind that questions are repeated so that your doctor can gain a thorough understanding of your symptoms, medical history, medication use, and drug or alcohol use.  For female patients it will also be important to discuss the issues of pregnancy and birth control use since medication may be potentially harmful to a fetus or nursing infant.  Since certain drugs, as well as some medical conditions, can produce depressive symptoms, you may also be referred to another Health Care Professional for a complete physical exam and laboratory tests.

How will my Health Care Professional choose which medication to prescribe?

There are approximately 20 antidepressants currently available and approved for the treatment of depression.  Antidepressants are generally classified by the chemical properties of the drug and the way in which they are thought to work.  Groups of medication your Health Care Professional may refer to include:  Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclic Antidepressants (TCAs) or Monamine Oxidase Inhibitors (MAOIs).  An "ideal" medication that does not pose some potential problem or risk is not yet available.  Side effects are generally mild and decrease with time.  Research is focusing on more selective medications for depression that produce fewer and less problematic side effects.  It is important that you ask your Health Care Professional about any concerns you might have about a medication or its potential side effects.

What are the possible side effects of antidepressant medication?

Antidepressants are a relatively safe treatment option in otherwise healthy individuals being treated for depression. Most of the time, side effects are mild, manageable and disappear over time.  Common side effects include nausea, loose stools or constipation, dizziness, drowsiness, nervousness, sleep changes, dry mouth, headache and blurred vision.  Some people experience a change in sexual interest or functioning.

Your Health Care Professional will have information sheets that outline a range of potential side effects.  Each time you meet with your doctor for follow-up sessions, you should be asked about your responses to the medication and to check for problematic side-effects.  Unusual side effects or those that could interfere with your ability to work or study should be reported to your Health Care Professional immediately so that changes in the medication can be made.  Most side effects are reversible and gradually disappear after a medication is stopped.  All antidepressants take time to work.  Each person is unique in his or her response to medication.  Don't be discouraged if you don't feel better right away.  Therapeutic response typically occurs within two to four weeks after treatment is started.  It is not unusual for your friends and family to notice signs of improvement before you do.  If you do not respond to one medication, your Health Care Professional may recommend a change of dosage or a change to other medication(s).

Can I take other medications along with antidepressants?

When antidepressants are taken in combination with other drugs, the chances of side effects or drug interactions increase.  It is very important to consult with your prescribing Health Care Professional, particularly about allergy medications.  Be sure to tell your doctor about any medications you use, even over-the-counter or "natural" vitamins and herbal products. One known medication interaction effect is that the effects of the birth control pill can be reduced, thus increasing the chances of an unplanned pregnancy.

Are there "natural" substances I can use to treat depression?

There has been a great deal of publicity about herbal preparations such as St. John's Wort for the treatment of depression.  To date, there have been no well-designed studies which have proven that herbal remedies are an effective treatment, especially when compared to standard antidepressants for certain forms of clinical depression.  In addition, herbal preparations may not have any significant impact on severe forms of depression.  At present, it is not recommended that traditional antidepressants be mixed with herbal preparations.  Be sure to talk with your Health Care Professional before attempting any form of "self-medication."

How much will antidepressant medication cost?

Although the cost of medication may be difficult for some students to budget, the cost of not treating a depression are also high.  Your ability to function in school, relationships and outside employment may be significantly affected by an untreated episode of depression. The average cost of medication for depression will be about $10 to $70 per month (taking one medication at the average dose level).  Many insurance companies pay a portion of medication costs. You may be required to pay a "co-pay" (often $5 to $10) for your portion of the cost. Other insurance companies pay a certain percentage of the cost. You will need to check your individual insurance policy to find out what medication expenses are covered.

Why can't I use alcohol when taking medication?

Alcohol itself is an extremely potent depressant. You certainly don't want to feel more depressed!  The use of alcohol and drugs can complicate the diagnosis and treatment of a depressive illness.  Many depressive conditions are associated with the excessive use of alcohol and some drugs.  Using drugs or alcohol can increase the risk of dangerous behaviors including suicide or cause complicated interactions with your prescribed medication.  Alcohol use (more than one drink per day) increases the metabolism of the medication. This means that very little of the drug will get into the bloodstream. In sum, alcohol or drug use can reduce the effectiveness of your treatment, prolong your illness, and increase the risk of negative medication side effects.

What if I forget to take my medication as prescribed?

If that occurs, you should discuss it with your Health Care Professional.  In most cases, if you miss a dose of your medication, do not take a double-dose the next time. Simply continue with the next scheduled dose and try not to miss again.  If you miss several consecutive doses, you may experience problems such as headaches and nausea.  Needless to say, your recovery is likely to take longer and to be more complicated if you do not regularly take your medication.