Note: Always consult with your medical provider before starting a treatment program for any medical condition you may have.
Understanding Depression – A Definition
There are two major schools of thought on the cause of depression. The first holds that depression is the result of chemical imbalances in the brain and advises treatment with anti-depressant drugs. The tricyclic antidepressants, (Elavil®), have fallen from favor, but are still used. Selective serotonin reuptake inhibitors (SSRI), ( Zoloft®, Prozac®, Paxil®, Lexapro®), are thought to work better with fewer side effects. For many patients, drugs combining the inhibition of serotonin and norepinephrine (SSNRI) seem to be a better choice. If you simply prescribe drugs, more than half of patients will improve dramatically.
A second school holds that depression is the result of ideas people have about themselves. The psychiatrist who advanced this theory noticed most of these ideas held by his patients were wrong, or only partly true. He developed a system, called cognitive therapy, to teach patients to recognize the ideas leading to depression, then to test them to (workersxzcompxzkit) see to what extent they were true or partly true. Treatment using cognitive therapy is usually short-term, less than three months, and demand a bit more work than traditional therapy. The therapist may ask the patient to note certain things during the week and be prepared to discuss them at the next session. If you simply use this therapy on patients, about the same percent get well as got well with drugs alone.
Combining drugs and cognitive therapy, results in about half again as many people getting well.
If symptoms are mild and intermittent, try reading Feeling Good: The New Mood Therapy, by David Burns, M.D. It is a self-help book based on cognitive therapy which psychologists say "got it right" --unusual praise for a self-help book. If there is evidence of bipolar disorder defined as swings in mood from higher-than-normal energy and optimism to spells of depression, then mood stabilizers may work better than anti-depressants alone.
Cognitive Distortions and Testing for Truth
It easy to find evidence to support a false assumption. Want to believe the earth is flat? Go to Florida and look around; it looks flat. More evidence? Go to west Texas and look around; it looks flat. More evidence yet? Gee, you're a hard sell. Go to Manitoba and look around; it sure looks flat there. It is only when you look for evidence that the world is not flat that the truth emerges -- it's not flat!
Sometimes someone says, “Nothing I do is right. Everything I do goes wrong.” And this person easily cites lots of things they messed up to support their view. If you look at them and say, “Wait a minute. Your clothes are on right-side-out. Your shoes are on the right feet. You drove here without killing anyone. What do you mean everything you do is wrong?” this may lead to a second cognitive distortion, “Oh, those are little things. It’s the important things I mess up.” One may respond to this statement by saying, “So it’s only important if (workersxzcompxzkit) you mess up? Does that really make sense? Have you ever tried wearing your shoes on the wrong feet; perhaps it’s more important than you think. And wouldn’t you suppose the person you didn’t kill while you were driving here thinks that’s important?”
It’s been found people’s strengths and weaknesses are often the opposite sides of the same coin. They do what they are good at, when it might be better to try something else. This idea seems to work in depression. People are encouraged to “be responsible” or “take responsibility.” But if people take responsibility for things beyond their capacity to control, it sets them up for failure and depression. Depressed people often seem laudable in their willingness to try to solve problems around them, but when it begins to hurt, it's time to quit. It may be worthwhile reminding oneself that one does not have to be perfect to be good, and good enough is often just that -- good enough. Many problems in life can be approached usefully by first asking “Who owns this problem?” If it really isn’t yours, don’t volunteer!
Do not use this information without independent verification. All state laws are different so do not implement any cost containment procedures until you have discussed them with your corporate counsel. Your individual doctor must treat medical issues. We are not giving medical advice; this is an overview of wellness topics, not medical advice.
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Five Top Wellness Tips: How Wellness Programs in the Workplace May Reduce Workers’ Compensation Costs: Tip 5: Depression Treatment
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