Why we shouldn't turn out backs on depression

[Guest guest]

Living Well: Why we shouldn't turn out backs on depression

By BOB CONDOR

SPECIAL TO THE P-I

For 16 years as a practicing psychotherapist, Dr. Simon has

observed a common pattern among people who are sliding into the

highly individual downward spiral toward depression.

" Depression is self-reinforcement to the negative, " said Simon, a

psychiatrist and research for Group Health in Seattle. " Someone who

is depressed fears that others don't care for them very much

anymore. The person fears that others don't think positively of

them. The person tends to view relationships in a negative way. "

This emotional free-fall can be hard to stop. A study published in

the Journal of the American Medical Association last week provides

one more good reason for trying. Researchers linked treating a

mother's depression with helping to prevent the same result and

other disorders in her children. The findings showed children of

mothers in remission are significantly less likely to develop

depressive symptoms than children of moms who are untreated.

" Depressed parents should be treated vigorously, " said Myrna

Weissman, lead author of the study and researcher at Columbia

University and New York Psychiatric Institute. " It's a two-fer: The

impact is not only on them but it's also on their children. "

Vigorous treatment in this case was prescribing an anti-depressant,

Celexa, for clinically depressed mothers who volunteered for the

government-funded study. Forest Labs provided its brand-name drug

and several of the researchers have financial ties to other drug

makers.

Prescribing an anti-depressant creates " an obstacle, " said Simon,

and it is not hard to imagine a mother with kids feeling especially

reluctant to take pills as the way to cope.

" It becomes a moral thing for some patients, " said Simon. " Some

people think taking anti-depressant medication means you are weak,

that you can't handle your problems. "

When Simon determines an anti-depressant may be the best option, he

pulls out a trusty example.

" I explain it this way, " he said. " There are people with high blood

pressure who see that too much salt in their diets sends their blood

pressure sky high while others can eat the same amount of salt and

their blood pressure doesn't change a bit. In the same way, there

are people who are more susceptible to depression while others

simply have systems that are more able to resist stress. It doesn't

mean that person is stronger or more moral, just lucky. "

Simon said the new study is notable because it focuses on the parent-

child effect of depression. He explained that a formidable body of

couples research has showed a similar pass-through or trigger of

symptoms from one spouse to the other.

" It is important to realize this (parent-child) relationship could

go both ways, " said Simon. " If you treat a depressed child, it might

well prevent a mother from developing symptoms. A mother's

relationship with her child is one of the most important and intense

relationships in her life. "

The study strongly suggests value in couples or family therapy

because it can help treat more than one person -- and perhaps become

a way to avoid medications by going to it first. The therapy also

can work as a modality that helps a person wean off anti-depressants.

" Couples or family therapy presents an opportunity to take a step

back in the heat of interaction, " said Simon. " We can point out, 'He

said this, what did you hear?' It allows people to think, 'What am I

hearing? How is my reaction and mood affecting things?' "

According to the non-profit patient organization, Depression and

Biplolar Support Alliance (www.dbsalliance.org), symptoms of

depression include the following:

Prolonged sadness or unexplained crying spells

Significant changes in appetite and sleep patterns

Irritability, anger, worry, agitation, anxiety

Pessimism, indifference

Loss of energy, persistent lethargy

Feeling of guilt, worthlessness

Inability to concentrate, indecisiveness

Inability to take pleasure in former interests, social withdrawal

Unexplained aches and pains

Recurring thoughts of death or suicide

The alliance suggests if you experience five or more of these

symptoms for more than two weeks or if any of these symptoms

interfere with work or family activities, it is time to consult a

practitioner for a thorough evaluation. This consultation needs to

include " a complete physical exam (some other illnesses can cause

these symptoms), being open and honest about how you are feeling and

providing a review of your family's history. "

Simon recommended an additional self-assessment technique: paying

attention to how you react to compliments.

" People who are depressed automatically discount compliments, " said

Simon. " They think the person doesn't mean it or is just saying it

to be nice. Or maybe that the person is 'feeling sorry for me.'

There is a deflecting of compliments. "

In his years as a psychiatrist, Simon said there is less stigma

attached to depression and " more and more people are seeking help. "

He estimated the number of people who participate in therapy remains

at roughly the same percentage, while patients receiving anti-

depressant prescriptions has doubled in proportion.

" A large number of patients take the medications for a few days and

see that it hasn't helped, " said Simon. " They often get discouraged

and drop out. But the medications don't work that fast. "

What's more, there are a number of anti-depressants now on the

market. Some people respond to one medication and not another. Simon

said television commercials about the various brands can create the

wrong impression.

" People get the idea that anti-depressants are happy pills and that

they will lose touch with reality by being so happy, " he said. " I

joke with them that they should be so lucky. "

Feeling comfortable with a practitioner is essential. It is worth

asking friends and health professionals you trust for a

recommendation.

In the case of a mother with children, finding time to see a

therapist can be a challenge in itself. Simon and colleagues have

performed research proving the effectiveness and accessibility of

phone consultations.

That is, if one indeed makes the significant breakthrough to seek

help. That's no small thing.

" By definition, when people are depressed, they have no hope, " said

Simon. " It is a big step to put some faith in a doctor or therapist

message that this is not your fault and there might be something to

do about it. "

Bob Condor writes every Monday about health and quality of life. He

is editor of Seattle Conscious Choice, which covers health,

environment, food, social good, spirituality and personal growth

(visit www.seattleconsciouschoice.com). Send e-mails to

bobcondor@... with any questions or ideas for the Living Well

column.