Major Life Changes, Major Depressive Disorder
When Jessica C. moved to New York City, she knew her transition would be stressful. After all, she was starting a new job and settling into a new apartment. Plus, she had to learn her way around one of the world’s busiest cities. “It was a lot all at once,” she says. “Everything did seem like it was falling apart.” The anxiety proved too much: Jessica stopped eating, lost 15 pounds, and felt tired frequently. Thinking the anxiety from her move was at the root of her problems, she sought out a therapist. “I knew I had some personal things I had to be conscious of, but I didn’t realize the extent of my problems.”
After a lengthy search for a therapist, Jessica found a psychiatrist, and after her first visit, she had her diagnosis. It wasn’t an anxiety disorder as she had suspected; it was major depressive disorder (MDD). She was given a low-dose antidepressant and another medicine to help treat the anxiety.
“I was surprised with the diagnosis. I called my mom after the first appointment because I had this feeling of shame. I remember asking her, ‘What if this medication makes me become a new person?’ She reminded me there was no shame in this diagnosis,” she says.
That was six months ago, and Jessica feels as if she has a new lease on life. She continues the low-dose antidepressant, and her anti-anxiety medication is used only on an as-needed basis now. She sees her psychiatrist once a week, but they’re working on a long-term plan that includes meeting less frequently. As for Jessica and what she understands in retrospect: “Some people don’t realize depression can come from a major life change. My problems aren’t rooted in abuse, and I don’t have a family history of problems,” Jessica says. “If you don’t feel right, get help.”
The Loss of a Loved One
“I lost my dad to suicide when I was 19 years old,” says Kathryn G. “It was a tragedy for our whole family, and we all dealt with it in much different ways. But I’ve come to realize a lot of the things that happened to me happened because of the way I lost my dad.”
Kathryn’s loss translated into a decade of acting out—excessive drinking, partying, having lots of boyfriends. She began seeing a therapist when she was in her 20s, but major depressive disorder coupled with attention deficient hyperactive disorder (ADHD) made diagnosis and treatment difficult. “It took me a long time to really understand depression and to feel kind of OK talking about it,” admits Kathryn, now in her 40s.
For Kathryn, the key to getting better is therapy, which she still attends weekly. (She does use medicine and has for a while.) She had to visit several therapists before finding one she really felt connected with her and helped her stay grounded. “It has to be comfortable. I went to some that just really felt off, and I knew it wasn’t a good fit,” she says. “But it really should be a nurturing yet tough relationship that makes me be accountable for things.”
Finding the Right Medicine
A key component of most treatments for MDD is medication. For some patients, one type of medicine will work for an extended period of time without problems. For others, medicines can become less effective, or side effects may become too intrusive. That’s the experience David W. has had in treating his dysthymia and MDD. “My treatment has been by drugs primarily,” he says. “Talk therapy helps stabilize the depressive episodes, but for me, chemicals need to be present.”
David, who says a history of suppressing experiences in his past brought on his depression, sees a counselor, psychologist, and psychiatrist. His psychiatrist prescribes and monitors the medicines he takes to treat his depression, a relationship David calls “very important.” “It’s essential to have a good relationship with your psychiatrist,” he says. David has learned to be very open about how the medicine is making him feel and any side effects he’s experiencing, as well as to recognize when a drug becomes less effective. “I’ve cycled through several medicines, and I’ve educated myself on the drugs and the symptoms and side effects associated with depression. It’s very important to do that so you can recognize when the drug isn’t as effective.”
Unfortunately for David, sometimes the negatives of the medications outweigh the positives. Side effects have been a real concern during his treatment for MDD. “The worst for me are the sexual side effects, which are unfortunately common with a lot of antidepressant medications,” he says. “I also have some anxiety and sleep issues, so I take medication to treat those, too.”
Still, David says the combination of medication and talk therapy has helped him tremendously. “I am a functioning, productive member of society. I have a wife, and we’re raising three kids,” he says. “I also have a job. It’s a high-stress job, unfortunately.” David attributes his successes in managing his condition to the regular dialogue he has with his doctors, and knowing that he can be open and honest about his feelings, experiences, and concerns.
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