THE BLOG

I Shouldn't Need Meds For Depression

03/16/2015 11:28 am ET | Updated May 16, 2015
Eric Michaud via Getty Images

Reader Mind Over Matter writes:

I'm tired, unhappy, and snap at my family.  Depression runs in my family.  My mom was always down.  I am considering seeing a therapist, but, honestly, I have in the past and nothing much changed.  I don't want to see a psychiatrist and start meds though.  They aren't natural and honestly, it's not that bad.  I should be able to deal with this myself if I try hard enough.

sad-505857_640

Dear MOM (apt right?),

I feel you.  Many people feel that they "should" be able to overcome all manner of mental and emotional issues without "resorting" to meds like some "crazy," "weak," or otherwise crappy person.  However, let me tell you that there is another side to this issue.  Picture yourself sitting with your children in 20 years.  One of them says, "Mom, you were always so sad and stressed out.  Did you just not like being a mom?"  And you say, "No, of course not.  I just suffered from untreated depression because I didn't want to take a pill."  And then your children say, "Oh, that makes sense.  Not wanting to take a pill is way more logical than not wanting your kids to grow up with the best mom they could have."  And you hug it out.

Or not.  Because here's how that really goes (and trust me, I'm a therapist): You are 45.  Your kid is 20 and in college.  You know your kid is depressed, and she also has some eating issues and pretty low self esteem.  You say, "Hey, maybe you should talk to someone about how you're feeling."  Your kid says, "Hey, I'm not crazy. Leave me alone."  You say, "Oh shoot, I have absolutely no leg to stand on here because I realize this kid inherited both my depression and my desire to deny it and save face."  Oops.

Here is my point: if you didn't have a family, then you could do what you want.  You want to sit around with untreated depression, cool.  But your kids and your husband don't deserve you not trying to be the best person you can be.  Depression is chemical, it's not just something you can wish out of existence.  I'm a therapist and even I'm saying, you likely can't cure depression without meds. It's just not generally possible.  Especially if it's long standing and inherited.  Talk therapy is great, too, but it works best in conjunction with meds, because depression is a brain imbalance.  You just didn't inherit enough serotonin and dopamine, most likely.

Again, I am a therapist. I cannot prescribe, but if I had to tell you only one way to deal with your depression, either therapy or meds, I would say meds all the way.  Because I may be smart and awesome, but I can't reach into your brain as quickly or fully as meds.  Therapy is best when your neurotransmitters are functioning at maximum capacity, and then you can learn new skills and get insight into the origin of your problems.  Therapy can help you understand yourself and it can help you change who you are.  It can even rewire your brain. But medication, when correct, can make you into the best version of yourself so that you can get the most you can out of therapy.

And this doesn't just go for depression.  It's any disorder.  My husband's ADHD is about 100-percent improved on meds, and I tried about every behavioral intervention for inattention known to man prior to that.  There are people who undergo extensive exposure therapy for anxiety and would have had the same response on two weeks of an SSRI, and an even better response if they used both.

My viewpoint is this: it makes you stronger, not weaker, to open your mind fully to the idea of meds (and therapy, for that matter).  It makes you a better parent if you have the insight and self-awareness to say, "I am not the parent I want to be.  Maybe nothing will change this, but I am going to try.  In fact, I am going to be able to tell my kids that I tried basically everything in the world to help make myself a better parent for them, including meds, therapy, exercise, nutrition, meditation, and whatever else." Note that meds and therapy aren't the only answers.  Sometimes, to deal with psychological issues of whatever stripe, you can also try modifying your schedule, reducing extra stress, vitamins and supplements, limiting visiting/entertaining/activities, changing your diet, getting massage therapy, whatever.  But if you've tried all these and no dice, move on to meds.

So, short answer: go see a psychiatrist like you wish your own parents would have done.  No kid has ever said, "Boy, my mom was irritable and sad throughout my childhood, but hey, at least she didn't relent and try Zoloft."  Till we meet again, I remain, the Blogapist Who Sees Clients All the Time That Wish Their Parents Had the Insight To Try Therapy and Meds.

Visit Dr. Rodman at Dr. Psych Mom, on Facebook, and on Twitter@DrPsychMom.