Depression Treatment: You Shouldn’t Have to Compromise
Depression can be hard to manage, but in my 20 years as a psychiatrist, I’ve seen people learn new coping skills and find medication that helps them recover. It may take some time, and some people will try one or more medications that aren’t the right fit, but I want people to know they don’t have to settle. By partnering with their psychiatrist, they can find treatment that gives them the support they need without side effects that interfere with their quality of life.
Although it can take a few tries to find the right depression treatment for each person, there’s a wide variety of options available, so we have a lot to work with. It’s critical to have an in-depth conversation with each patient to go through the many treatment options we can explore. Once I understand the nuances of a patient’s depression experience, I’ll lay out all the safe and effective options I think could be a good fit. I’ll explain their benefits and risks, and then empower the patient to choose among the options.
One of the challenges of depression is the patient needs to be engaged in their treatment in this way; they need to be able to report changes in their symptoms and any side effects they experience to their doctors. However, many people with depression lack the energy to take this active role in their condition; in severe cases, they might not have the energy to even get out of bed. It’s frustrating to reckon with the fact that you don’t have energy because you’re depressed, but to get better, you need to mine some energy. A type of talk therapy called cognitive behavioral therapy (CBT) can help patients adjust their mindsets and realize they can do a bit more than they feel capable of. That’s why I always recommend talk therapy to patients in combination with medications to treat depression. Both play a role and complement each other to help people improve.
When patients partner with me in their care, it’s very likely we will find something that manages their depression symptoms in the nuanced ways they need, without side effects they are unable to tolerate. One of the biggest challenges around depression treatment is the potential side effects, which can include changes in sleep patterns, changes in appetite, sweating, dry mouth, and, commonly, sexual side effects like reduced libido. Understandably, patients can feel frustrated when they find a medication that improves their depression symptoms but causes some of these problems. It’s crucial to talk to your psychiatrist about any side effects you’re experiencing so you can find a solution together. Don’t accept the side effects if they don’t work for you. Sometimes, changing a dose or adding on another medication can solve the issue. Or, you may need to try another drug that can work just as well without impacting your quality of life.
When it comes to the trial-and-error process of choosing the right depression treatment, it’s important to recognize that everyone responds differently to medications and deals with a variety of depression symptoms we’re trying to address. Many of my patients wish there were a quick and easy pill that would make them feel better right away. I wish it were that straightforward. It can take a few tries to identify the right medication–and dosage–that you respond well to and that improves your specific symptoms. Side effects can be frustrating and cause you to change medications even if your mood improves. Plus, with each new drug, it takes time to see results. The good news is eventually the majority of people find something that works well for them. And medication isn’t your only tool–talk therapy also plays a key role in treating depression and can support you as you continue trying to identify the medication that works best.
I try to emphasize to my patients that they can find the treatment that works for them over the long-haul without compromising or settling for ‘good enough.’ Part of staying motivated throughout this process relies on finding a psychiatrist whom you really respect and trust, being honest with them, and then listening to what they say. When my patients trust me, they believe me when I tell them, “We haven’t tried everything yet. In fact, there’s a whole bunch of options or a combination of treatments–medications and otherwise–we haven’t tried. There is research providing evidence that people get better with these treatment options. Let’s choose one and see what happens.”