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Major Depression and Treating Depression With Antidepressants
Q & A

These are several questions and answers about the disease called depression. Please read all of these carefully, since it is very important that you understand your disease as thoroughly as possible.

Instructions to Patients to be Read Before the Patient Leaves His Office
Joseph H. Talley, M.D.

l. WHAT IS DEPRESSION?

It is a disease affecting the entire mind and body, causing a person to feel miserable in many ways. Changes in brain chemistry make it happen. It is a brain disease.

2. WHAT CAUSES DEPRESSION?

We do not know. We used to think it was due to something unhappy in a person's life or to some psychological hang-up. We now know, however, that this disease happens to people who have no reason "to be depressed." In other words, depression can strike normal and healthy people too.

3. DOES HAVING A DEPRESSION MEAN THAT A PERSON IS GOING "CRAZY"?

No, but it will very often make him think he is.

4. IS IT A COMMON DISEASE?

Yes, it is the most common disease seen in all of medicine; however, it is often confused with other illnesses. For example, many people who think, or who are told, they have low blood, vitamin deficiency, sinus headaches, low sugar, menopause, burnout, and "all run-down and need a rest" actually have depression that causes their troubles.

5. WHAT TROUBLE DOES A PERSON HAVE WHO HAS DEPRESSION?

A person who has depression will usually feel most of the following things:

1. He will feel very tired all the time, even when he has not worked or exerted himself very much. He will be just as tired on days when he has rested as on days when he has worked hard.
2. His sleep will usually be affected in one of two ways. He will either go to sleep and then wake up during the night and remain awake, or else he will sleep too much - even during the day. He will not get restful sleep.
3. He will feel very irritable. He will get upset very easily over little things that ordinarily would not upset him.
4. He will feel very sad for no reason, and, in fact, may break into tears without knowing why.
5. His normal sex drive will be decreased; in fact, it often will go away altogether.
6. He will often have a headache that is present most of the time. Almost any chronic pain elsewhere such as in the stomach or back can be caused by depression. These pains are not imaginary; they are quite real and often severe.
7. He will find it difficult to enjoy things. He will feel little enthusiasm even for things he used to look forward to.
8. His will often be constipated or have other digestive symptoms such as abdominal pain or diarrhea. He may lose or gain weight.
9. He will find it difficult to concentrate, make decisions, remember things and getting things done.
10. He will feel like he is an ineffective, worthless person, even though there is no reason to feel that way.

6. IS THIS REALLY A SERIOUS DISEASE?

Yes. In a mild depression, the person will often think he just has a case of the blues, or that he is just getting older. His efficiency will be affected. In a more severe depression, it is a very serious disease. This disease can cause a previously healthy and happy person to kill himself.

7. CAN A PERSON DO ANYTHING TO FIGHT BRAIN DISEASE?

Not by his own efforts. This is a disease over which a person has no control, and it will do him no good to "try to fight this myself."

8. IS THERE ANY EFFECTIVE TREATMENT?

Very much so. There are several medicines which are usually very effective in treating depression. They are also very safe medicines.

9. ARE THERE MEDICINES, TRANQUILIZERS, SLEEPING PILLS, PAIN PILLS, HORMONE PILLS?

No, none of these. The medications that help are called antidepressants.

10. ARE ANTIDEPRESSANTS ADDICTING?

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Absolutely not. A person can not become addicted even though he takes these medications for months or years. People who take insulin and high blood pressure pills are not addicted; neither are people who take antidepressants. A person who does not have depression would feel no effect if he took an antidepressant. They work on the brain chemistry that gets out of balance and results in depression.

11. DO ANTIDEPRESSANTS HAVE SIDE EFFECTS?

Unfortunately, they have pesky side effects; they rarely have serious side effects. The chief side effects of antidepressants are dry mouth, constipation and drowsiness. Dry mouth can be effectively overcome by drinking water or sucking non-caloric mints. Constipation is corrected by adding bulk to one's diet. The sleepy effects are taken care by taking the medicine before bedtime. The body usually adjusts to all these side effects.

12. ARE ANTIDEPRESSANTS THE SAME AS "PEP PILLS" OR "UPPERS?"

Absolutely not. Pep pills give anybody a sudden boost of energy whether they have depression or not. Pep pills are all dangerous, and not used for depression. Antidepressant pills, on the other hand will do nothing to a person without a depression, but will help a person who has depression by returning his brain chemical to normal.

13. HOW LONG DOES A PERSON HAVE TO TAKE ANTIDEPRESSANTS?

It varies. Sometimes as little as four months, other times longer than a year. These medications can be taken safely for as long as they are needed, even for a lifetime.

14. DOES THIS DISEASE HAPPEN TO A PERSON WITHOUT ANYTHING IN HIS PERSONAL LIFE CAUSING IT?

Yes. However, many people have things in their personal life that are bothering them a great deal, and if they happen to get depression while these things are bothering them, then everything gets much worse. For example, if a person is having difficulty in their marriage or job and they get a depression also, then the difficulties with the marriage or job will get worse, because their ability to cope with their difficulties is impaired.

15. WHAT SHOULD I TELL MY SPOUSE OR RELATIVES ABOUT DEPRESSION?

Have them read this paper too. A person with depression will almost always find that their spouse or relatives are very much affected by the way he feels. Most often relatives will not realize that a person's symptoms are due to a disease, and will think you simply do not love them any more. They may think the fault is somehow theirs. It is very important that they know that depression is simply a disease - just as pneumonia or diabetes are diseases, and that you or they are not responsible for it. We would welcome them to come back with you on your return visit and discuss this with them in detail. It is a great help to have your loved ones understand what is happening, why you need medication, etc. (Read "How Family and Friends Can Help the Depressed Person.")

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