"First, we have antidepressant medication. Secondly, we have psychological interventions. Thirdly, we have lifestyle. Under each of these general categories there are very many options or variations."
Let's face it the first 2 treatments are costly to our finances. I think most of us masnage to get our medicine, however their are still many who don't. Insurance often doesn't cover psychological interventions, or if it does, the copayments are still ridiculously high.
Which basically means that many of us are stuck with working on our lifestyle choices. Which, for the most part our main investment is our time.
"There certainly appears to be scope for investigating the effects of more complex treatments, but what are the limits in terms of cost and acceptability. ...how many people prone to depression take regular exercise and eat a well balanced diet? These are simple activities known to influence mood, yet are often passed over. Are they too much effort, or too demanding?" Often, when we don't "feel" we are getting the results that we expect we let these idea go by the wayside.
I completely agree with making lifestyle choices. When we do not, eat, sleep, exercise,and get vitamin D from the sun ( not all of us us can absorbe it from food or suplements, it causes us to feel depressed and causes imsomnia and many other dangerouse aliments. Also, drinking can make you depressed as well, especially if we can not control it, same with smoking that can make us feel dpressed but not cause clinical depression, however, it still feels the same.
I completely agree with making lifestyle choices. When we do not, eat, sleep, exercise,and get vitamin D from the sun ( not all of us us can absorbe it from food or suplements, it causes us to feel depressed and causes imsomnia and many other dangerouse aliments. Also, drinking can make you depressed as well, especially if we can not control it, same with smoking that can make us feel dpressed but not cause clinical depression, however, it still feels the same.
I completely agree with making lifestyle choices. When we do not, eat, sleep, exercise,and get vitamin D from the sun ( not all of us us can absorbe it from food or suplements, it causes us to feel depressed and causes imsomnia and many other dangerouse aliments. Also, drinking can make you depressed as well, especially if we can not control it, same with smoking that can make us feel dpressed but not cause clinical depression, however, it still feels the same.
I completely agree with making lifestyle choices. When we do not, eat, sleep, exercise,and get vitamin D from the sun ( not all of us us can absorbe it from food or suplements, it causes us to feel depressed and causes imsomnia and many other dangerouse aliments. Also, drinking can make you depressed as well, especially if we can not control it, same with smoking that can make us feel dpressed but not cause clinical depression, however, it still feels the same.
I completely agree with making lifestyle choices. When we do not, eat, sleep, exercise,and get vitamin D from the sun ( not all of us us can absorbe it from food or suplements, it causes us to feel depressed and causes imsomnia and many other dangerouse aliments. Also, drinking can make you depressed as well, especially if we can not control it, same with smoking that can make us feel dpressed but not cause clinical depression, however, it still feels the same.
I completely agree with making lifestyle choices. When we do not, eat, sleep, exercise,and get vitamin D from the sun ( not all of us us can absorbe it from food or suplements, it causes us to feel depressed and causes imsomnia and many other dangerouse aliments. Also, drinking can make you depressed as well, especially if we can not control it, same with smoking that can make us feel dpressed but not cause clinical depression, however, it still feels the same.
I completely agree with making lifestyle choices. When we do not, eat, sleep, exercise,and get vitamin D from the sun ( not all of us us can absorbe it from food or suplements, it causes us to feel depressed and causes imsomnia and many other dangerouse aliments. Also, drinking can make you depressed as well, especially if we can not control it, same with smoking that can make us feel dpressed but not cause clinical depression, however, it still feels the same.
This really is complex, I think. Like Merely Me said, depression is not the same for everyone in how it's experienced or in terms of what causes it. Making lifestyle changes may not be the "cure." I do think that if psychotherapy were more affordable so that it could be accessible for more people, it could be a big help. Sometimes you just need an objective person to bounce ideas off of or to tell you that your line of reasoning is not reality. Sometimes you just need to be listened to. Another path might be to work on the ability to manage the symptoms, with the understanding that they may never be entirely gone. I ask myself how I'm going to deal with feeling unable to accomplish what I need to during the day and usually, my answer is that I can just only take each day as it comes and do my best. That might be the same thing someone with a chronic physical illness has to do. If you start projecting down the road, thinking about having to manage it for years and years, it can be enough to make you want to give up.
I guess what I'm trying to say is, maybe a better way of teaching people coping skills - in terms of coping with depression - would be more helpful than taking more medications. Coping means learning what works when symptoms flare up, when you start feeling overwhelmed or hopeless. For some people, it might mean that they need to talk to somebody, get grounded; for others, it might mean they need to set better boundaries (not that easy of a task) so that they don't get taken advantage of and have more control over their lives. Learn what it is that helps the most.
Well, it IS complicated, for sure!
I'm not sure what you mean by "complexity." Is taking medication while going to therapy while making lifestyle changes complex? When I was severely depressed everything seemed way to complex. Even taking a bath and brushing my teeth. But I did try every tool available, numerous times with numerous practitioners and dieticians and inpatient and outpatient programs, etc. And I swear -- nothing made a bit of difference. I honestly would have done anything to get rid of the depression. I think I just had to wait it out...patience and courage. And I think it finally got better on its own over time. Maybe I just got better at adjusting to reality and slowing down my manic work pace.
Jerry
In the U.S. educational system, each child that is eligible for special services is given an "IEP team" which consists of many different types of professionals who all work together to create an individual educational plan based on specific needs. Granted, some school districts do this better than others, but overall the concept is great.
Wouldn't it be wonderful if each person with depression, or any illness for that matter, had a team of professionals come together in a room to work on creating an individualized treatment plan? The team could have an exercise coach, a nutritionist, a medical doctor, a psychologist, etc. Together they could take this person's individualized and specific needs and create a plan of attack, so to speak. Then, together they could monitor progress and make adjustments as needed.
Eileen
Thanks, Jerry, for raising the visibility of successfully treating depression, and for showing the need to determine the effectiveness of various combinations of treatment. I can only make a few comments from my own experience with depression. Generous sleep, good diet, and exercise play a huge role in staying on top of strong symptoms for me. Having a psychiatrist who closely monitors medication is very important. Setting small immediate goals for personal achievement that can be reached and shared with a counselor who is supportive is stabilizing. Staying in touch with your higher power is the most satisfying, as ultimately all else is for naught, if in the end we have merely been deceived.
Ric
I realize some of my comment above is simplistic and can even seem preachy. My intent was to suggest that there may be priorities in a treatment program, and not to suggest that I have priviledged information. Sharing with a support group or a significant other can have great effectiveness in alleviating suffering from depression. Treatment should never be one size fits all- black or white.
Ric, I found that your comment/suggestions where very sound and consist of good common sense. I did not see them as preachy at all; nor did I see them as priviledged. In cases of "enviromental" depresson. Such as those in a rut or stricken with greif over tough or even traumatic events. Your suggestions where better than reaching for medication instead you suggested natural home remedies but embracing mind, body and spirit as well. I beleive that what you recomended should be tried 1st as well as CBT (Cognitive Behavior Control) and talk theraphy.
Anti-depressants do alter your brain chemistry. If you have a bad reaction it can take months ( depending on how long ypu've taken the medicine) to return to "normal". With just SSRi's. IF you have a Dr quick to prescribe medicine aprescribes what I call "umbrella medicines" ( one medicine to treat an array of illnesses.) such as anti-psychotics you may end up with side effects thst effect you for life, such as nuero tics, ddiabetes or thrown into bi-polar wiich can cause you to become worse off than where you where. That happened to my husband. It also greatly affected our marriage of 25 years as he became adussiv e and acted unbecoming for his best interests. Also, because he was predisposed for diabetes; he became borderline as well as developing nocturnal tics which caused me insomnia for three years as well as behavior that was careless and riisky <all symtoms of bi-polar and of the medication (cymbalta a SSNR) that he was given.
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Hi Jerry
You raise some really interesting points. I guess I am wondering what you mean by "complex treatment" for depression. Do you mean using an individualized approach or multiple treatments?
One thing is for certain...there is no simple treatment for depression. If there were we wouldn't have so many people battling depression on a long-term basis. I think one of the issues which makes things all the more confusing is that there can be multiple causes for depression. And the fact that nobody experiences depression in quite the same way.
This is a great beginning to an in depth discussion on the complexities of depression treatments. I am hoping our members will also chime in with their thoughts.
"This is a great beginning to an in depth discussion on the complexities of depression treatments. I am hoping our members will also chime in with their thoughts."
I'm hoping to see some in-depth discussion on these matters also.