The Difficulty in Treating Depression
Although the strides in treating depression have been remarkable, public acceptance of depression as an illness -- with specific symptoms and a high rate of successful treatment -- has not been as dramatic.
As we have explored, many people with depression do not get treatment because they do not recognize what they have is an illness. If people don't know they have an illness, they don't tend to seek help for it.
Depression is often diagnosed in people who have not sought help for it, but have consulted a health care professional for one of depression's many symptoms, such as insomnia, fatigue, aches and pains, or overeating.
Failure to seek treatment is the first -- and largest -- hurdle in treating depression.
Another hurdle for many is expense. All antidepressant medications require a prescription. A prescription requires a diagnosis, which requires a physician, which requires (usually) money.
Also, the cost of the latest antidepressant medications can be as high as seven dollars per day. To many, this extra two-hundred and twenty dollars a month is an impossible expense.
Finally, there is the tendency -- normal in most people but exaggerated in those with depression -- not to make changes and not to try new things. The thought of going to a doctor and saying, "I'm not feeling a lot of pleasure. I think I need medication," seems strange to most people, so they don't seek help.
If the depression cures itself (as it can), the person feels vindicated in waiting. But what about the quality of life during the depression? And what will the person do if the depression returns?
Once a patient sees a physician and is diagnosed as having depression, the treatment begins. Treatment of depression is as much an art as it is a science.
If the treatment is based on antidepressant medications, choosing the right medication for the patient is essential. Unfortunately, the choice is not always clear.
There is no way of knowing, for example, which side effects might appear in which patient taking which medication. The physician prescribes an antidepressant with the fewest side effects and relies on the patient to report the results.
Alas, the side effects of antidepressant medications have caused a good number of people to abandon the treatment of depression altogether.
Another difficulty in prescribing antidepressants is that the optimum dose and timing (how many milligrams of medication how many times per day taken how many hours apart) for antidepressants vary greatly from patient to patient.
Finding the right antidepressant for a patient is a matter of trial and error -- although most physicians prefer to call it "art."
This trial-and-error procedure -- perfectly acceptable and sometimes necessary in medical treatment -- is made more difficult because antidepressant medications can take several weeks to take full effect.
Unlike, say, a pain pill, with which the effectiveness can be determined within a couple of hours, it takes as long as six weeks before one can declare a given antidepressant ineffective.
Further, many of the side effects of prescriptive antidepressants may be severe at first, but can become less and even disappear entirely over time.
These two factors can lead to a months-long (but ultimately worthwhile) quest for the proper antidepressant. As we shall see, using hypericum to treat depression bypasses most of these problems.
One should not think in terms of prescription antidepressants versus hypericum. There is no battle between them. Hypericum is simply a new and medically proven tool for treating depression, a tool that joins prescription antidepressants in the health care professional's arsenal for combating illness, pain, and suffering.
That's where the real battle lies.
Copyright © 1996 by Harold H. Bloomfield, M.D. and Peter McWilliams
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