Last month I discussed the symptoms of depression. So, what if you’ve accepted you may be “depressed” in the clinical sense, which means you need to pursue treatment for it? For most people, this is a scary step. When you have depression it’s hard to get motivated to do things. To do something new which involves making yourself very vulnerable, feels impossible. But, going forward without doing something different, feels even more impossible. You are ready to “suck it up” and talk to a professional about your symptoms. Good for you!
People have varying opinions about what type of provider to see first. Research has repeatedly concluded that the most effective treatment for depression usually involves a combination of both psychotherapy and medication. Some people are more afraid to talk about their feelings and prefer to start by taking medication. Others want no part of this, and would prefer just talking to someone.
In my opinion, where you start is less important than making sure you take a positive step forward to get help…from anyone. If you want to try medication first, most primary care physicians are willing to prescribe meds for depression and do so frequently. If you want to go straight to an expert, psychiatrists are the physicians who specialize in treating mental health issues with medications.
There is relatively little risk involved in trying one of the newer antidepressants. If there are any side effects that become intolerable, gradually decreasing and stopping the medicine will almost always resolve them. Most importantly, these meds tend to be quite effective in alleviating both depression and anxiety symptoms, although it takes several weeks for them to work.
If you prefer to try overcoming your depression symptoms without medication, the best option is to find a good psychotherapist. There are psychologists, social workers, counselors, and marriage and family therapists among others who practice psychotherapy. Lots of people will say one or the other of these professions is superior to the other. In my experience, whether someone is an effective psychotherapist has less to do with their degree and more to do with their experience and about who they are as a person. It helps to find someone who has a license in their given profession, as this means they have had at least a minimum amount of supervised experience. It helps to get referrals from other people about who the good therapists are. If you don’t want to tell friends or family you are looking, ask your primary care physician for a referral. They usually have therapists in their community who they collaborate with (and if they don’t, they should).
The advantage to starting with psychotherapy is that your therapist can help to figure out whether medication is likely to be a necessary step for you, or not, depending on your individual symptoms and issues. Depression is usually caused by a combination of biological factors and psychological or situational factors, which is why treatment often (but not always) needs to involve a combination of approaches. A good psychotherapist should be able to help sort this out. Next month, I will give my opinion about the best way to sort out these issues.
Next Month: Effective Treatment For Depression–Is Medication Necessary?