There are many reasons why people become depressed. Genetics can be a component, and certain people seem to be more genetically predisposed to depression. Environmental causes, like intensely stressful events or prolonged periods of heightened tension, are also common precipitating factors for depression. The recent Coronavirus pandemic is an example of just such an intensely stressful event, one that has dragged on much longer and has been more devastating than most people ever imagined. Once the initial shock of this unprecedented event passes, there will be rippling consequences due to the long-term emotional impact. Many who have been pushed the very brink for weeks will start to experience persistent negative emotions, such as depression. During these times, many will begin to ask themselves, “Should I consider taking an antidepressant?”
A: Not all sadness constitutes depression. Sadness, fear, frustration – these are all natural human reactions to negative events. The normal psychological cycle is for someone to react to the adverse event, process the impact while seeking possible solutions, and then recover within a reasonable amount of time. Acute events are mostly reaction-dependent, whereas chronic stressors like a prolonged quarantine involve both reactive and adaptive processing. Individuals that cannot recover from newfound adversity, or successfully adapt to the demands placed by the new chronic stressor, will start to decline mentally and emotionally. This is when the sadness persists and worsens. This is also when basic functioning in life becomes more difficult. People starts to experience physical symptoms, such as fatigue, weakness, loss of appetite, difficulty sleeping, and even increased pain perception. They may notice a general mental slowing, loss of concentration, and worsening memory. They may also experience increased feelings of guilt, negative self-image, and difficulty enjoying things that they would normally enjoy. When someone is experiencing most or even some of these traits, clinical depression is most likely the culprit.
A: The first thing to do is to seek help. The most common mistake people make when dealing with depression is letting it linger or waiting for it to go away on its own. Your body has already been fighting the depression and trying to make it go away for you, like it would with a viral infection. An infection that lingers too long will start to exhaust your body’s resources and immunity. Even if you do eventually pull out of it, it will be at a significant cost of physical depletion. This is because an active infectious state is stressful and damaging to the body. Depression has a similar effect on the brain. An active state of Major Depressive Disorder (MDD) involves neurochemical disruption that is directly neurotoxic to brain cells, causing significant brain cell death. The first time or two that someone goes through a depressive episode, they may pull out of it without help, but at a great cost. At a minimum they will have endured some damage to the brain that will increase their susceptibility to future depressive episodes, which will be worse in severity. By the second or third episode, they may no longer pull out of it and can get stuck in a chronically depressed state, which has a much worse prognosis. Seeking help much sooner allows for a quicker and easier resolution to the depression with minimal damage to the brain cells. The less time someone has spent in the depressed state, the easier it will be to pull them out of it in most cases.
The fundamental combination of antidepressant medication, combined with psychotherapy, achieves the best results in the shortest amount of time. Proper compliance, as in taking your antidepressant medications consistently and as prescribed, is essential. Lifestyle modifications, especially with regards to increasing exercise while improving sleep and diet, make a big difference and speed up recovery. More severe and refractory cases will require more advanced measures, but this less common. When addressed properly and quickly, a depressive episode can be resolved within just a few months. Antidepressant medications are usually continued for at least a year following a full clinical response, to reduce the risk of a recurrence. It can then be weaned off carefully, so as to avoid any disruption. When handled proactively, a person can recover from depression and be back to normal within a short period of time.
The mental health professionals at Raul J. Rodriguez, MD & Associates in Boca Raton specialize in the treatment of depression and can help determine if antidepressant medication is right for you. If you feel you are struggling with depression, contact us today at 561-250-7208 to schedule an assessment with one of our psychiatrists.