I'm surprised this article doesn't address so-called "atypical depression." It's probably the most common type of depression; it's just called "atypical" because it doesn't tend to respond to the same medications people were coming up with for major depression.
Some of things that distinguish atypical depression are constantly overeating, sleeping too much, and feeling like the limbs are far too heavy for exercise. Seems like it'd be worth mentioning on a site for people who've been having trouble eating well and getting fit.
To begin with, saying that "alternative therapies ... are most effective when combined with medication and psychotherapy" is like saying stone soup is better with cabbage, carrots and a ham bone. The working ingredients are the medication and psychotherapy. Which treatment you get may depend more on who you go to than on what would work best for you.
Non-M.D. psychotherapists are not allowed to prescribe drugs, so they give you talk therapy. That takes a long time to work. Because medical reimbursements are limited, you could be forced to quit before the psychotherapy has done its work, if it would even work at all. But if talk therapy works for you, and you can finish it, you could stop treatment and walk away from the problem.
M.D. psychiatrists have to earn back the cost of their training. If your medical plan is paying them, psychotherapy will take many hours with limited payment and you might have to quit before you're better. Medication, if it works, shows immediate results, and it pays better because they can prescribe medications after a relatively brief consultation and see more patients. Drug companies profit from medication, not from talk therapy. Their profits come from your drug plan, and when the drug plan stops paying and you stop taking the medications your depression will return.
Since the profits and costs of medication vs. psychotherapy accrue to different persons and groups, nobody has an incentive to invest in studies that compare their cost and effectiveness. You're on your own, and if you're already depressed you're not likely to have the resources to make an informed choice.
7/27/2009 4:14:36 AM
Thank you for this article. I have never been a part of a community like this before, but, I am learning that it is important to open up and share, or the entire life experience as a whole can swallow me up. Now that the 40's are upon me, I have found that I am not only overweight - which makes me constantly self conscious of my appearance, but, I have been chronically depressed for some time. I have been struggling with reaching out for help and this article has helped me know that I am not alone. I have had a lot of regret in my life, have always worked hard to live to a standard that would make others proud of me and have not taken time to appreciate all that I am blessed to have and embrace it -I am even learning, now that it is important to embrace the mistakes and tragedies my life has had, because they have made me stronger, and wiser. I am going to seek help for my problem with depression. My husband, and my children deserve a wife and mom who can enjoy them. I find myself so terribly irritable for reasons I don't even understand, and my reactions to life seem to be overly reactive - more so lately than ever. I have been so ashamed to admit that I have this problem, and have become exhausted with "covering" it up...I am truly inspired to get some help from somewhere so that I can begin living life, and not just existing in it. Thank you for this website and this article....it is reaching out and helping people like me take stock in my life, and own up to not appreciating it like I should.
That's great! You've found the right "formula" , one that works for you and has made your quality of life not merely tolerable, but - from the looks of the happy mom in the picture, on the beach with her two children - I'd say wonderful too.
I suffer from bipolar type 1, so you can probably imagine that yes, I would have major depressions. But I also have dysthymia, even when I'm "level" which I've managed to control with a very basic method necessity taught me after the birth of my first child, my son, Ian, at 41. It's your standard "fake it 'til you make it" attitude and lot of self taught behavior modification. I wake and as soon as I've shaken off enough of the fairy dust to realize what day it is and how soon my responsibilities to others are going to start I roll my eyes, take deep breath, head for the coffee machine and count my blessing every day. I'm a concoction person by nature (who ever heard of peanut butter mayonaise and tomatoes on 7 grain bread before?) so I guess it makes sense that each day I need to take a kind of medication soup mix. I have fibromyalgia and need meds for that too, and one of them is (guess what?) an antidepressant that works on pain - one of the tricyclics. The I take Wellbutrin which alone doesn't work for the likes of me so they got about the big guns and added Effexor, and finally Topamax to help with my bipolar disorder, and of course, to "elevate my mood". And as if that list isn't long enough, I'm on Methadone FOR PAIN - not for any addiction problem, Abilify s the primary med for the bipolar, and occaisionally Ambien for sleep.
But at 47, with a five year old child recently diagnosed with high functioning Autism, I am mindful of my diet, I practice yoga and exercise, have a house and a part-time job as I try to hone my skills as a writer of short stories and plays, and a car and all of those basic things we all want - and then some - and I have to say, I'm having the time of my life!
Depression - be it dysthymia or major depression or both, has taken the lives of too may good people with promising futures they couldn't bear to wait for. I still struggle with the blues periodically but try to let it run a time limited course like that of the common cold before I simply refuse to participate in it anymore. I tell myself I have no choice but to attend to my life - and to tend the life of my child ! At that point I make a decison to think about all the good things, all the luck I've had in my life, and about the future which, like a good book, I just have to know how it's going to turn out.! I can't just put it down or throw it a away because I'm at a difficult part to get though or which I don't understand. I figure, sooner or later it will all become revealed somehow and I want to be around til the end. EGM, Bishops corner in West Hartford spring ,2008
I have to say that exercise, the right meds and supplements all help in the fight against depression. Until recently I was not aware that I was fighting depression. My doc says it is a very mild case. I have battled anxiety issues for over 20 years. This article did help me and helped me to feel comfortable with what my doc is telling me.
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