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Being sad or unhappy is a normal part of life. But being unusually depressed for more than three or four weeks weeks at a time is not normal. You should consider any longer-lasting depression or recurring episodes of depression as a cause for concern and seek medical attention. This will be more worrying if you have a family history of mental illness — some conditions are genetically inherited. In strictly medical terms, all depressive and anxiety conditions are now considered an illness and no different than any condition for which there is a clearly identifiable physical cause such as a broken bone, cancer or a heart disease. Whether you have been in a car crash or your brain chemistry has changed, the result is just as painful. Equally, no matter what the cause, any illness or disease that goes untreated may become life-threatening (not only from suicide).
If your symptoms are only mild, you probably do not need any treatment at all. Simply talking about your problems with a doctor will give you a better perspective on your condition and begin to realign your mental state. Alternatively, if your sadness is linked with a specific stressful event, some form of counselling or therapy may ease your suffering. If you have no history of emotional problems, it is not wise to rush into taking an antidepressant. Only if you find it increasingly difficult to continue functioning normally should you seriously consider taking an antidepressant.
The major problem to confront is cultural. Because depression has been classified by the medical profession as an illness, the assumption is that it can be treated with the available drugs. The pharmaceutical industry uses aggressive marketing campaigns to convince doctors that their drugs are highly effective, and potential patients that they will benefit if they persuade doctors to prescribe those drugs. As a result, doctors and patients often treat antidepressants as the first choice for treatment. Yet there is ample research evidence to show that up to one third of all who take antidepressants find no improvement in their condition and that even among those who do improve, there is a significant rate of relapse. In fact, up to 80% of patients relapse. The resulting assertion that depression is therefore a chronic condition requiring long-term treatment is self-serving. It simply sells more drugs into the market. Then there are all the people who find the side-effects more unpleasant than the original depression and stop taking the medication.
The evidence is that, if left untreated, most depressions clear up after eight months. The expectation in drug therapy is that treatment will continue for between six and twelve months. There is a claimed reduction in the rate of relapse if drugs are used over longer periods of time. But the use of other forms of treatment, for example combining cognitive, behavioural and interpersonal therapy, have been shown to have a much lower rate of relapse. The clear benefit is that dealing with you as an individual helps to calm the situation more quickly. If you can see that you are the centre of attention, you are more likely to become involved in the interpersonal therapies. The intention to help you make constructive changes to your lifestyle will produce better results. Which do you think is better? Have someone give you a pill and tell you to come back in six weeks, or have someone start giving you emotional support, teaching you problem-solving skills, and suggesting how you might modify the way you think and act so that your basic needs are met?
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