Mental Health Q and A
Question 3:
I have had several sessions of psychotherapy, and I have been going to a support
group ever since I had a child born with special healthcare needs. I have come
to accept my daughter's condition and my depression has lessened. I am sleeping
better and starting to enjoy life again. I still have some crying spells, but my
eyes aren't burning all the time. Some of the other mothers in my support group
told me that they couldn't have survived without antidepressant medications.
Should I try medication?
Response:
The emotional landscape for parents who have a child with special needs can be
slippery and treacherous at times, so your question has broad implications for
others. This response will explore this important mental health facing parents.
First, let's be clear about the common symptoms of depression which include:
Constant feelings of sadness
Loss of interest or pleasure in usually enjoyable activities almost every day
Unwanted weight gain or weight loss
Sleeping too much or too little
Loss of energy or fatigue
Feelings of worthlessness, hopelessness, or guilt
Trouble with memory, concentration, or decision making
Thoughts of death or suicide
Second, everyone feels sad or “blue” on occasion. Most people grieve over life
experiences that are upsetting such as death, major illness, divorce, etc.
Depression can be a phase or stage of grief, and it has been often called the
“common cold” of the mind. There are actual changes in the body's chemistry
which affect one's mood and thought processes. When the feelings of extreme
sadness and other symptoms such as those mentioned above last for two weeks or
more, the depression reaches the clinical threshold. This includes interference
with the activities of daily living, such as working, eating, sleeping, and
caring for one's self.
Fortunately depression is treatable and responds well to competent care.
Situations like having a child with special healthcare needs may bring on
depression because it is a situation over which a person has no control. Parents
benefit greatly and often quickly from being able to express their feelings and
concerns and come to grips with what is in their control and what is not. The
vast majority of people treated for depression get better through psychotherapy,
medication, or both.
Third, as a psychologist, I usually recommend that people start with
psychotherapy (“talk therapy') as opposed to psychopharmacology (medication).
The exception is when an individual is seriously thinking about harming oneself
or another person or when is having trouble taking care of him or herself. In
these cases I recommend an immediate evaluation for medication by a
psychiatrist. There are many safe and effective medications which act to balance
one's mood and restore more positive thought processes. The choice is based upon
a person's specific symptoms and past history.
According to the World Health Organization, major depression is the leading
cause of disability worldwide among persons aged 5 years and older. It is also
the most common and widespread of all psychiatric disorders. To learn more about
depression, check out the Medscape resource Center at
http://psychiatry.medscape.com/Medscape/features/ResourceCenter/depression/public/RC-index-depression.html
Now getting back to the original question, you are considering
medication, but you are improving without it. Sometimes when you begin feeling
better you realize just how far down you have been. Medication is an important
tool, but not everyone needs it to recover from depression. It is an individual
choice, but not a necessity, for many people. Some people are looking for a
“magic pill” to make thing all better. So for you and other readers who question
whether medication would be appropriate for them, I suggest that you first talk
to your regular physician. That doctor, or another trusted person, such as a
good friend, a relative, or a member of the clergy may be the person to ask for
a referral to an experienced mental health professional.
Often parents who are struggling to cope with the demands of a child with
special needs stop taking care of themselves. They become totally absorbed in
the day to day challenges and stop enjoying life in the ways they were
accustomed to. Spending some time doing things you really like and enjoy with
people you like being with can be great medicine. Exercise and healthy food can
also make a huge difference. Sometimes taking a walk each day brightens one's
mood and prevents the need for antidepressant medication. There are many natural
antidotes to feeling down.
Everyone deserves to enjoy life. If you have symptoms of depression that are not
improving, seeking help is not a sign of weakness. Rather it can be a strong and
positive vote for enjoying your life. Taking care of yourself is not selfish-far
from it-it's a good example for the entire family.
RN
