I started on SSRI's before I had PCA... Brought on by a broken marraige and divorce... Got better, re-married, and got PCA... Jeesh... back to depression again...
Anyway, I learned a lot of info over the last 8 years and in dealing with depression...
1. It is REAL... Once the depression is strong enough and the brain chemistry gets out of whack... You do need professional help. It is not something you can just buck up with and get over. Not if you are in a serious clinical depression and your brain nuerotransmitter chemicals are messed up.... serotonin, norepinephrine, dopamine...
2. Family doctors do not cut it. The depression field, medications, and treatment methods are too complicated for a general family doctor to keep up with. Find a competent psychiatrist... One who knows brain chemistry and is uptodate on current treatment philosophies.
3. Family history and heridity are important... There can be borderline brain chemistries that are more susceptable to clinical depression than others.
4. Learn your stressors... learn your boundaries... take some cognative therapy also... Usually recommended with the SSRI's by a psychiatrist who knows his stuff. I found a great ONLINE cognative therapy workshop supported by the Austrailian government. http://www.moodgym.anu.edu.au/welcome
5. A treatment may initially involve one SSRI at a higher dose or two SSRI's at lower doses. A lot will depend on initial reactions to first SSRI(s) tried. The doc will have you come in every one or 2 weeks at the beginning to monitor effectiveness and side effects. SSRI's used and dosages may change/adjust... but this is why you have the psy doc and not a family doc.
6. You may not see significant effects for 4-8 weeks in some cases. Also note that many side effects may gradually disappear after 4- 8 weeks also.
7. Good sleep is important... many depression episodes may be kicked off by stressors and lack of sleep... brain chemistry starts getting out of balance... serotonin or other chemicals get used up... and you spiral dooooown.... You may also be given some supplemental pills at the beginning to get normal sleep patterns back.
8. Depending on the depth of your depression, recovery, and other heridity factors, you may stay on a significant dose for 6 months to a year... then slowly backed off and monitored. You may end up on a lifetime small maintainance dose... or be able to get off them entirely. But also know the signs when to seek treatment or go back on a small maint dose again.
9. A good psy doc can balance medications if sex drive or feeling like a zombie is an issue... You can be on SSRI's and if managed correctly, be very creative... He will get to know you brain chemistry after awhile and be able to tweak things just for you... A family doc does not spend enough time in the science to understand or keep up with it... he also does not know all the side effects or synergistic/antagonistic effects between the drugs except for summaries read in a PDR... and where combination drug treatment options are not considered...
10. You may be on full dosages for a year, and then be able to taper off to either a smaller maint dose on maybe off of all pills altoghether... It will be determined by your particular brain chemistry, response, and how you handle stressors and set boundaries to what you can or cannot handle in your current state of mind... Just like a computer, your brain can and will crash if it gets too far out of whack... Your best tool to dealing with depression is to learn the signs of when you are slipping and catch it in the bud before major brain chemistry episodes take over.
Long winded, but I have spent a lot of time there... and have experience with mutiple episodes with somewhat different treatment scenarios to draw upon...
I will also answer most any question... here or private email if you like...
Take care and God Bless!
3/2007 - Dx 59 y/o - 12 point biopsy - Left 0/6 Right 1/6 Gleason 3+3 T1c
4/2007 - DaVinci RRP performed - Gleason 6 T2c Nx Mx
PSA 7/07 0.01, 6/08 0.02, 12/08 0.03, 10/09 0.13
11/09 Consult BCR and rec for SRT
1/2010 IMRT SRT - 32 sessions 2 gys for 64 gys total.
6/2010 3 mth PSA post SRT 0.02
1/2011 10 mth PSA 0.01My Extended Signature
Post Edited (pasayten) : 3/22/2011 2:16:09 AM (GMT-6)