# When medications don't work



## cyberniche (Mar 1, 2007)

Is it possible to have a case of moderate depression that medications will not help? I ask this because I know I am moderately depressed. I also realize it's not due to a chemical imbalance but rather to my life-situations. It basically stems from loosing my religion. I clung to my beliefs as one would a personal floatation device. Now, as my beliefs fade, so does my hope that my situtations can change. It's because, even when I did have hope that they'd change, they never really did. I'm loosing most of the things I treasure, and my life no longer seems important. What's the use? What is there to hope for now? The funny thing is, tommorrow I'll probably feel better, because over all these years I have learned how to cope... you see, I just don't think about my problems. But, we all know thats foolish 'cuz they're still there picking at the back of my brain. sheesh.


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## David Baxter PhD (Mar 1, 2007)

Whether medications will help does NOT depend on what triggered the depression, or whether it is the result of life events or "chemical imbalance". Indeed, the distinction between the two (formerly a distinction between endogenous and exogenous/reactive depression) has become less clearcut than previously. It really doesn't matter why you're derpressed - once you are depressed, in most cases medications will help.

On the other hand, medication is rarely going to be more than part of the solution. All of the research that has examined this isue has shown that medication PLUS psychotherapy (especially including cognitive behavior therapy, or CBT) is better than either one alone, both in terms of relieving the symptoms of depression and in avoiding a subsequent depressive episode (i.e., relapse).

If you have tried medication and it didn't work, it may be that you didn't continue the medication long enough. For full effect, most modern antidepressants should be continued for approximately 1 to 1.5 years or longer before being discontinued.

Alternatively, it may be that the one you tried was not the right medication for you. Again, recent large scale studies have shown that most people who do not respond to the first medication do show a positive response by switching to a different antidepressant (in some cases this may require a bit of trial and error but most are helped by the third one they try if it takes that long).

There are a few people who seem to be resistant to these medications. A recent study has found positive results for such patients by using two medications in tandem.


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## Into The Light (Mar 1, 2007)

> For full effect, most modern antidepressants should be continued for approximately 1 to 1.5 years or longer before being discontinued.


this sounds odd to me. i thought medications could start working as early as 2 weeks (not optimal, i know, but a difference can be possible) and up to the full effect by 8-12 weeks? when you say full effect by 1 year, what do you mean? in my case, it currently looks like i will be on medication until summer, which will be about the 1 year mark.


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## Halo (Mar 1, 2007)

Ladybug,

From what I understood David as saying was that in order to gain the full benefit of the medication that a person needs to stay on it long enough and I think in order to prevent a relapse, should not discontinue it prior to 1 to 1.5 years. 

Now I think that is what he was saying however I am not positive however I am sure that he will correct me if I am wrong.


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## Into The Light (Mar 1, 2007)

that makes sense, i guess i didn't quite read that right, thanks halo


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## Halo (Mar 1, 2007)

no problem


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## David Baxter PhD (Mar 1, 2007)

Halo has it right. Many people will start to feel better in anywhere from a week to 4-12 weeks but that is a bad time to stop taking the medication - you need to continue to the point where the your body reacquires the ability to maintain those benefits and that takes quite a bit longer.


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## cyberniche (Mar 6, 2007)

Thank you for your replies. Sad to say, I don't have any medical coverage so I don't plan to be getting on any meds or talking with any professionals anytime soon.      Still, I appreciate your support.


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## Daniel (Mar 6, 2007)

I have often paid out-of-pocket for therapy, telling my family "it pays for itself."   For example, my therapist was able to help with the all-or-nothing and overgeneralized thinking that is typical of my depression and nihilistic thinking.  

BTW, some quotes from some existentially-themed posts in this forum:



> > It has been suggested by existentialists that one can only learn to live when life has first become meaningless. In this sense the existential approach is particularly pertinent with clients who have lost the will to meaning and who feel trapped in an absurd life.
> >
> > ...As always, people tend to operate with static views of themselves and the world; they think in terms of either/or. Either they will for example believe in God, or they will be stuck with a meaningless universe. Instead they may discover the need for a dynamic integration of their striving for absolute truth on the one hand and their basic sceptical starting point of doubt on the other.
> >
> ...





> It is as if depressed people have a leak in the part of the self that contains a positive, nurturing self-image...
> 
> *Creativity is the antithesis of depression. It is a way of saying that what I think and feel matters. *. . . Depression is not just an illness, but a failure of creativity. We all face the problem of creating meaning in our lives. When we're depressed, we've lost hope for meaning. We all need to make a deliberate effort to make the self fertile; for the depressive, that effort is essential to life.(page 323)
> 
> http://www.undoingdepression.com/book/excerpts.html





> The theme of the movie is: "No magic, no manure."
> 
> I Heart Huckabees (Existential Comedy)


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## ThatLady (Mar 7, 2007)

Cyberniche, it's not absolutely necessary to have health insurance if you have a legitamate health concern. Check for clinics in your area that work on a sliding-scale basis, or provide free care to those who cannot afford to pay. Where there's a will, there's usually a way. :hug:


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