Severe Depression Treatment

The generally accepted treatment for depression within the medical profession is to prescribe anti-depressants.

Antidepressant medication is a broad term for several categories of drugs that are known to reduce some of the most basic symptoms of depression, like sleep disturbance or loss of energy. These categories include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin re-uptake inhibitors and a group of drugs so different in their chemical makeup that they are simply called “structurally unrelated compounds”. All these antidepressants work by altering the concentration of certain brain message chemicals (neurotransmitters).

Psychologist Michael D. Yapko PhD (“Breaking the Patterns of Depression” 1997) weighs up the benefits and risks of pharmacotherapy succinctly.

In it’s favour anti-depressants:

1.Are not considered addictive

2.Are considered relatively safe to take over long periods

3.Rarely show any serious complications

4.May show a higher response rate in more severe depressions (there is still considerable debate about this point)

5.Show a faster (but not better) rate of symptom remission than psychology alone

6.Do not depend for their effect on the skill of the prescription writer (another debatable point)

He states the disadvantages of pharmacotherapy as:

1.The higher rate of relapse when drugs alone are used in treatment

2.The potential for overdoses with tricyclic antidepressants

3.The presence of unpleasant side effects, ranging from mild to severe, which may lead to reduced treatment compliance or serious complications in patients with certain medical conditions

4.The significant (50 to 60%) chance that the first drug tried will not work

5.The lack of any clear advantage of medication’s success over psychotherapy for most individuals

6.The unfortunate and undeserved stigma often associated with mood altering drugs

7.The tendency to reinforce the ‘disease’ viewpoint, which suggests depression happens to you (perhaps reinforcing passivity and a ‘victim’ mentality)

8.The significant risk to pregnant women, or women about to become pregnant, for foetal damage.

Whilst I believe there is a case for prescribing anti-depressants to a severely depressed person, in order for them to then be able to engage with some psychotherapy, I see over and over cases where drugs have been prescribed almost like Smarties.

The truth is that drugs will never change things. Often they reinforce the message of “I can’t cope”, encouraging the recipient to feel more helpless and more dependent on them.

Depression is not something that ‘happens to us’. Depression is the result of us responding to what we perceive from our negative ‘survival’ brain rather than from our evolved intellectual mind.

The limbic system in the ‘survival brain’ constantly scans the environment for potential threats. It is ready to react to the danger. It is not wired to find ways forward.

It is our evolved intellectual mind that seeks to progress and improve and work to our betterment.

We have the choice from our prefrontal cortex which part to engage with. It might not seem that way when we are overwhelmed with all the negatives flooding through our mind. Yet, the truth is we all have our phenomenal evolved mind which is far superior and can easily handle our challenges and find the ways forward that best serve us.

The length of time someone has engaged with and lived from their primitive ‘survival’ mind will largely dictate the level of their depression.

Rather than give away even more of our power to drugs that don’t actually change anything, I am in favour of teaching people how to live well; how to take back their own power and feel in charge again; how to engage with their intellectual mind and realise their own immense resources; and also, most importantly, how to feel good about themselves.

Even caveman knew that he felt ‘unthreatened’ when he perceived his job, his relationship and his self-feelings to be pleasing.

With our evolved mind we have learned that we can have meaningful purpose without necessarily having a job, we can feel content and happy without a relationship. Yet no one can feel good for long if they don’t feel good about themselves!

Can taking an anti-depressant drug ever help you truly feel good about yourself?

I would recommend finding a good psychotherapist (preferably solution focused) who you feel comfortable with and start on the path to building your self-worth and self-esteem so you feel good about you, to allow you to engage with your phenomenal intellectual mind! From there life takes on a whole new perspective and you need no longer experience depression.