Countdown
The count to “down” has begun, and we’re all strapped in to take that power surge to lethargy, hopelessness, and feelings of worthless. No one is immune, in these times of economic hardship, when selling a mother-in-law for a tank of gas becomes not such a bad idea. How did it all start? Where did it come from? Why are the air waves and magazine ads so full of the trance-like visages and the artificial smiles of mental zombies hawking the wares of pharmaceutical leviathans bent on addicting us all to powdered sunshine, in the form of pills, capsules, and tablets, to the tune of greenback or euro billions in treasure trove earnings?
Down for the count, or count as we go down. Let’s face it, life is no picnic, and it’s getting no easier, as our worries mount and our life’s savings go the way of the horse and buggy. Sending our troops to war to keep them employed and off our streets has created an enormous financial shortfall and an army of the homeless and destitute middle class back home, who have no jobs, no health insurance, and no viable nest eggs to cover mortgage payments, spiraling gasoline costs, and the high price of sending junior to college. It’s no wonder that depression has become a best friend and bed partner, as we pray in Chinese to puppet masters across the Pacific, who produce everything today but our children. So, let’s do the math, as countdown numbers decrease, and our anticipatory downward trajectory begins.
Ten. Let it be known that depression affects 1 in 6 Americans, with women bearing the brunt of its weight. Diabetics are particularly vulnerable, although no one is sure what actually causes the illness. A sudden life event, a serious illness, or simple everyday chronic stress may trigger depression-causing biochemical changes in the brain, and then that’s all she wrote. In addition, the association of depression with diabetes, heart disease, stroke, HIV/AIDS, cancer, and Parkinson’s disease leaves the door open to a wealth of exotic theories on its origins.
Nine. The definition of depression has been hashed and rehashed ad nauseam. While we know that its signs and symptoms must last at least two weeks to fit the paradigm, we are often caught off guard when the former are atypical and run the gamut from irritability, restlessness, and anger to physical symptoms such as headaches, digestive problems, and a worsening of chronic pain symptoms.
Eight. While depression is often a subtle companion whose talons don’t draw blood, its toll on the ability to work, develop and maintain friendships, establish intimate relationships, raise families, and engage in self-improvement is undeniable. Swallowing a barrel and pulling the trigger is extreme in most cases; eating too much and cutting out physical activity to the point of obesity is not. When blood sugar goes up, depressive symptoms worsen, to the joy of cavity-drilling dentists caught in an economic slump, and the chagrin of those of us who cast daily headlong stares into our bathroom and dressing room mirrors.
Unlucky seven. Teaching a depressed person to think or behave differently, in order to shut down negative thoughts and actions, is not as easy as it sounds. Sad, sleep-deprived, emotionally exhausted patients with chronic aches and pains are fertile terrains for failure of behavioral modification. It’s not that they don’t want to improve and feel better. They just don’t have the bag of tricks at their disposal to be successful.
Six, and we’re halfway there. So, when teaching fails, it becomes necessary to call in the big guns, namely, the antidepressants. They come in all shapes and sizes, and one size does not fit all. Trial and error is the name of the game here, as only 6 out of 10 people feel better after following the treatment regimen with their first antidepressant. The most common and widely used antidepressants are selective serotonin reuptake inhibitors (SSRIs), which all of us have seen advertised between segments of our favorite morning news programs or at Sunday half-inning, quarter, or film intermission. Household names like Prozac (fluoxetine) and Zoloft (sertraline) work by increasing available serotonin in the brain, whose shortage is postulated to cause depression.
Five. Antidepressants do not kick into high gear immediately. In fact, they are downright slow, and can take up to several weeks to elicit their desired effects. Their ultimate success may come at a price, however, as weak and depressed patients may then find the force to carry out their suicidal ideations, or, at the least, fall victim to the potpourri of side effects inherent in the antidepressant beast. The latter encompass a daytime plethora of unfriendly fellas such as constipation, daytime sleepiness, diarrhea, dizziness, dry mouth, headache, nausea, sexual problems, shakiness (with exotic names such as tardive dyskinesia and others), lip smacking, trouble sleeping, and weight gain. While side effects may disappear in a few weeks, there is no guarantee that they will not last until discontinuation of the medication.
Four, and we’re getting there. We’ve heard the horror stories, and we decide to go the herbal route. So, we mount our trusty, gas-guzzling SUVs, and go down to our local neighborhood Walgreens or Wal-Mart pharmacies to pick up the newest installment of St. John’s wort or some such other herbal magic bullet in the good fight against depression. What we fail to recognize is the fact that such over-the-counter herbal supplements, which require no prescription or authorized professional supervision, can be dangerous if used with certain drugs.
As the countdown reaches three, we make one last stand, before lowering our colors and hoisting the white flag. We begin an exercise program to alleviate the symptoms of depression. Many studies have linked physical activity to improved mood. Not only does exercise boost spirits, but it takes no Oprah, Doctor Phil, or Doctor Oz to attest to the innumerable ways in which it can improve general health.
Two. Almost there. Our engines begin to rumble, and we try to reign in stress. Actually, taking on too much stress, whether that be in the workplace, at home, or in our day-to-day relationships, can make us vulnerable to depression. Carefully monitoring our stress levels, whether that be via timeouts, vacations, yoga, or an “unplugging” at the same time everyday, can go a long way to aborting the count.
Finally, one. Sometimes God helps those who cannot help themselves. A simple distress call to the Almighty or to our friends and family will set the wheels in motion on the road to recovery. We can’t solve the problem unless we acknowledge its full ramifications, admit our inability to go it alone, and call in the necessary players to act in our behalf and in concert with us.
If we permit the countdown to reach zero, blast-off will take us to new heights. Unfortunately, they will not be of this world!
Copyright 2011, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
6/13/2011 07:07:00 AM
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