14 But behold, Zion hath said: The Lord hath forsaken me, and my Lord hath forgotten me--but he will show that he hath not.
15 For can a woman forget her sucking child, that she should not have compassion on the son of her womb? Yea, they may forget, yet will I not forget thee, O house of Israel.
16 Behold, I have graven thee upon the palms of my hands; thy walls are continually before me.

1 Nephi 21: 14-16

Sunday, August 25, 2013

Medication and Therapy

Recently I've had a couple of people ask me about my thoughts on using medication and therapy/counseling as a way to treat depression. There was a similar vein of concern in the people I talked with--the stigma associated with these methods is not often a good one. Many people know of instances where an individual reacted negatively to the medication in some way, such as making their depression feel worse (even to the point of acting suicidal), or they had to deal with frustrating side effects, such as feeling extra tired, or they may feel that they shouldn't need to rely on medication to cope.

Many are also hesitant to see a counselor. Some of these reasons may include bad experiences with a past counselor, feeling like your issues aren't big enough to warrant seeing a counselor (after all--"There are so many people with worse problems!"), or they are simply embarrassed to go, etc.

My opinion on these issues in a nutshell is that I am a total believer in utilizing antidepressant medication as well as seeing a counselor. But let me expound a little and share my experiences with these two subjects.

On medication:

My experience: It is true that sometimes, but certainly not every time, nor in most cases (that I know of), a medication will initially lead to a person feeling worse than before they even took it. This actually happened to me on my mission. The medication I was prescribed immediately made me feel like my depression took a nosedive. I completely lost my appetite, I couldn't sleep, and suicide honestly felt tempting--not because I wanted to die, but because I was so desperate to do anything to stop feeling the way I did. We called up the mission psychiatrist and he told me to stop taking my medication. When I came home from my mission, my family doctor put me on a different medication that was a lot gentler. I was told that I would start to feel a difference in about 2-3 weeks. So about a month later, I did a self-inventory and realized that, yes, I felt a LOT better. The change had been so gradual that I hadn't really noticed it until I did my self-evaluation. It felt wonderful. A couple of months later I went back to BYU to continue my college education and after a couple months I felt like I needed a change of medication again. What I was on had helped tremendously, but I still felt like there was room for improvement. I talked to a doctor at the Student Health Center and I was put on a new medication. This last antidepressant helped even more than the previous one had. It felt incredible. However, this medication gave me the unlucky side effect of feeling exhausted all the time. I was so tired that I thought there must be something else physically wrong with me, so I went and got tested for sleep apnea (that was interesting, let me tell you) as well as mono. I had neither, and concluded that it must have been from my medication. But I felt, and still feel, that I would MUCH rather be tired than depressed, and so I stayed on that medication until I finally felt like I didn't need it anymore and quit using meds entirely.

My advice: So my advice on this matter is that it is worth trying. If it makes you feel worse, TALK TO YOUR DOCTOR immediately and get off of it and ask for something different. Not everyone reacts the same to a medication. The antidepressant that made me feel worse has worked for a lot of other people, and a friend told me that the one that I felt worked the best for me made her feel worse and she needed something different. Also, don't be discouraged if you don't notice a difference right away. 2-3 weeks can feel like forever, but it is worth the wait. If after a month and a half or so you still feel exactly the same, I would talk to your doctor and see if you can try something else. Some people don't get their "match" right away. That's okay. It's frustrating, but it doesn't mean anything is wrong with you. Just ask for something different if you feel like you need to. It is totally worth it when you find one that works. There are TONS of different antidepressants out there. Some are more catered to those with anxiety, some more for depression. Talk to your doctor and he/she can give you advice on what may be a good match for you. Also, if you have been on a medication for awhile, don't EVER quit it cold turkey. If you are going to quit taking it, do it gradually, otherwise you could have some bad physical side effects (shaking, feeling faint, that kind of thing.) Talk to your doctor about it, as each medication could be different.

On therapy/counselors/shrinks/whatever you want to call it:

My experience: I have seen counselors in two different periods of my life--the first was during my Sophomore year of college when I had dysthymia (the less intense form of depression), and the second was after my mission when I came back to school. I saw each of them for about six months. I started seeing a counselor at the recommendation of the doctor that diagnosed me with dysthymia. My initial feelings were of embarrassment and apprehension. I had grown up believing that only people with major problems (that I would never have, right??) went to counseling. When I started my sessions, I was embarrassed and felt like the other people in the waiting room were judging me and I was always grateful that I never ran into anyone I knew. I was also terrified to tell my parents, because I had no idea how they would react. I learned the following really quickly: counselors are there to help, whether your problems be big or small. They provide insights that you don't have and they are trained to help people. All kinds of people. Including you. I also realized that the other people in the waiting room were probably feeling just as painfully self-aware as I was, and that they were probably worrying too much about their own issues to wonder what mine were. I also found that my parents were very supportive. My mom told me that she was glad I was going because our emotional health is just as important as our physical health. I took a lot of comfort in that and never forgot it.

My first visits with each counselor was more of an initial "get-to-know-you" session rather than me venting about all my problems. I was not on any medication while I saw my first counselor, nor did I really need any at that time. Having the counselor was enough at that point in my life. During my second "episode," we'll call it, I was also on medication, because my depression was a lot stronger then. I felt like having both resources was extremely helpful for me then. Both of my counselors were male, and my second counselor had served a mission in Bolivia (I had served in Paraguay, located just below Bolivia). Since a lot of what I needed to talk about and resolve centered on my mission, I felt like he could relate to my concerns. I quit seeing each of them when they and I both felt like I was at a good place in my life and no longer needed therapy. I continued with my medication for some time after I had quit seeing the second counselor, but when I felt like there was nothing chaotic going on in my life and that I was in a good place emotionally, I stopped the medication as well.  I have not had a need for it since. That could always change, but my goal was never to be on medication for forever, but just long enough to get back "on track."

My advice: Counselors rock. But not everyone is going to have the same experience with the same psychologist. If you don't feel like you click with your counselor after some sessions, then there is no reason to not switch. When I started seeing a counselor, he told me right off the bat that if I wanted to switch to see someone else (like a woman counselor, or just someone new) then that was totally fine. This is your money and your life, so there is absolutely nothing wrong with switching to someone that you like better. But remember that the first session is usually an in-take kind of session and not a typical one. So don't quit after the first one--give it a chance. Also remember that going to therapy will not immediately fix things. It takes time. They often are trying to help you make some paradigm shifts in your life and that takes time. But it is worth it. It is so nice to see someone that is professionally trained to help you deal with life, who won't judge you, and who isn't going to call your mutual friend to blab about things you want to keep personal. Also, your counselor can only help you as much as you are willing to open up to them. They are not mind-readers, so don't expect them to be. The more you open up to them, the more information you are giving them, and thus more tools for them to help you.

Also, don't confuse counselors and friends. Friends are not equipped in the same way counselors are. And counselors are not your best bud that you call all the time. Counselors are usually temporary relationships. And don't treat a friend like you would a certified therapist. It is wonderful to have friends to talk to. But if you are consistently telling a lot more to your friend(s) than your counselors about serious issues, then I think that's a little backwards. Venting is one thing. We all need friends to vent to, talk to, and relate to, especially when we find someone that has had similar experiences. Having a friend to talk to who also had dealt with depression was one of the biggest blessings of my life. We got to share experiences and help each other and it was something that really helped me. But she was not my counselor. There was a difference. Be wise. That's all I will say about that, because I'm not exactly sure how else to phrase what I mean.



In conclusion, using medication or therapy does not make you a bad person. It doesn't categorize you into some terrible group of people, and it doesn't mean you are being overly dramatic. These are tools that I honestly believe come from our Heavenly Father, and I believe He is proud of us when we take steps that will help us move forward. Best of luck on your journey.

~hugs~