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Many patients as me if one can treat depression without medication. They want to get better without medication. Is this possible? Is it realistic?
Yes, in many cases it is. Especially when speaking of lighter forms of depression, there is no clear medical evidence that antidepressants make the healing process faster or better.
In a light depression, psychotherapy or online self-help is the best method to use. These can help in changing negative thoughts and feelings, helping you rebuild your life and activities in small steps.
No, it is not always possible. Some heavier depressions, especially when they are long-term, do have a clear benefit from the use of antidepressant medication.
Studies show that antidepressants really only are useful for the patient in the case of a deep depression. You should then, together with your doctor or psychiatrist, find out which antidepressant works best for you, with as few side-effects as possible. It is also important to speak to your doctor about how long you should take this medication, because if you stop taking it after a too short period of time, there is a risk of relapse.
In this case, a combination with therapy or online self-help is recommended too.
If you have a clear bipolar disorder with deep depressive episodes and manic or euphoric phases (where you unrealistically think you can do anything), you generally do need medication. In this case it is crucial that you seek guidance of a psychiatrist in order to figure out your medication.
Most often you will then need to take Lithium. The problem is that Lithium is hard to adjust. You will definitely need the help of a specialized doctor or psychiatrist for this. Lithium will most often be combined with a normal antidepressant.
If you want to know to what extent stress, anxiety, or even depressive feelings have a role in your daily life, then find out via this simple test with 21 short questions.
Paul Koeck, MD