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Depression Is Common and Can Afflict Anyone at Any Time PDF Print E-mail
Written by Dr. David Lipschitz | Creative Syndicate   
Thursday, 24 April 2014 00:31

Many years ago, my heart began skipping beats. I felt each one and was very uncomfortable.

Totally inappropriately, I stopped a cardiologist and obtained a curbside consult. He advised quitting caffeine and prescribed a beta blocker called metoprolol. Immediately, the skipped beats went away. About a month later, I started feeling glum and had this sinking feeling in the pit of my stomach. I stopped another colleague in the hallway. He told me I was depressed and prescribed me Prozac. The Prozac made me anxious and did not improve my mood.

Finally, I had a complete checkup. My wise physician recognized that metoprolol was likely a cause of the depression, so he stopped both drugs. Within a few weeks, I was as right as rain.

I learned a great deal from this experience. I can truly sympathize with those who feel depressed. During the winter, depression becomes more common. Many suffer from a condition called seasonal affective disorder, which causes depression because of an inadequate exposure to sunlight. The best way to prevent this disorder is to spend as much time outdoors as possible and to make the house and office as bright as possible. In some cases, a special bright light that mimics sunlight can be beneficial in prevention and treatment.

In all forms of depression, symptoms are caused by chemical alterations in the brain. Stress leads to depletion of two chemical messengers, serotonin and noradrenaline. When the body is unable to replace these chemicals, either because of continued stress or an impaired intrinsic ability of the brain to produce them, depression occurs.

The latter is called endogenous depression and is more common in older people. This impaired ability to produce serotonin or noradrenaline makes them more susceptible to depression if they are stressed or prescribed a medication that can cause it. Many older people become unhappy around Thanksgiving and Christmas because of loved ones lost, living away from their families, or feeling unwanted or like they are a burden. Depressed people's lack of self-worth makes them feel weak, unimportant and ashamed. Family members are often not sympathetic and make things worse by becoming angry or taunting them.

Lack of serotonin can lead to sadness, loss of hope about the future, loss of self-esteem, excessive or reduced appetite and an inability to sleep. A shortage of noradrenaline causes severe fatigue, a wish to spend all day in bed and a lack of interest in daily activities. Fortunately, numerous medications are available that make depression readily treatable.

Depression is not shameful, and it is never your fault. If you or someone you know is depressed, seek medical help. Often the first antidepressant prescribed is one that only increases serotonin concentrations in the brain. These are called selective serotonin reuptake inhibitors and include Prozac, Zoloft, Paxil, Celexa and Lexapro. Each has a slightly different mechanism of action and side-effect profile.

Other antidepressants increase serotonin and noradrenaline, and include Effexor or Cymbalta. Finally, there is Wellbutrin, the only SSRI that does not affect libido or sexual function.

Each antidepressant functions differently, and what works well for one person may make things worse in another. Thus trial and error is required to come up with a medication that is best-suited to the individual depressed patient. The longterm benefits of antidepressant treatment far outweigh any potential side effects. And there is no evidence depression drugs can cause adults to commit suicide.

I strongly recommend that every depressed person, and sometimes their family members, consider psychotherapy to assure that they come to grips with the likely causes leading to the depression and are more able to adapt to and deal with the many problems each of us face every day.

Dr. David Lipschitz is the author of the book “Breaking the Rules of Aging.” To find out more about Dr. David Lipschitz visit