RAN INTO
DEPRESSION page 65
AN OLD FRIEND TODAY.
SHE WILL SOON BE MY NEW
NEIGHBOR AT THE
HEATHERWOOD. WE
REMINISCED ABOUT THE GOOD
OLE DAYS AND SHARED OUR
DELIGHT ABOUT OUR FUTURE.
AT THE HEATHERWOOD
YOU WILL ENJOY COMPANIONSHIP,
DAILY MEALS, HOUSEKEEPING,
24-HOUR STAFFING AND
SO MUCH MORE.
Lori Blume puts in long hours in her home based graphics business.
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ATHERWOOD
RETIREMENT COMMUNITY
ull and
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For information call
Kathy Ostrowski
(810) 350-1777
22800 CIVIC CENTER DRIVE
SOUTHFIELD, MICHIGAN
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WEST BLOOMFIELD NURSING CENTER IS T
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How To Help
Encourage individuals to seek pm-
fessional help.
Encourage them to continue
with treatment until it is con-
cluded. It may take several weeks
or months before the beneficial ef-
fects of antidepressant medica-
tions are noticeable.
Offer emotional support. Talk
with the person and listen. Allow
the person to express his feelings
but point out realities and offer
hope.
Don't accuse the individual of
laziness or faking illness or expect
him to snap out of it. Depression
is an illness that requires time for
healing and appropriate treat-
ment.
Don't ignore remarks about sui-
cide. Report them to the patient's
doctor.
Get help. Dealing with a de-
pressed person can be exhausting.
stigmas still prevent too many
people from seeking help that is
available."
Dr. Rubin believes there are
multiple causes for depression. It
is caused by a combination of med-
ical, genetic, and psychological fac-
tors, including family history,
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underlying illnesses, medications,
and sometimes excessive use of
drugs or alcohol.
It does tend to run in families,
the research showing that it's
close to three times more common
among patients who had a parent
with the illness. It's also biologi-
cal in origin for many; there may
be bio-chemical imbalances caus-
ing disruptions in the brain that
are linked to depression. In par-
ticular, neurotransmitters —
chemical messengers that relay
impulses from one nerve cell to
another — may be off balance. Or
there may be environmental caus-
es such as the shorter daylight
hours of winter or a stressful job.
Usually a person is born with
a propensity to develop depres-
sion. Another interesting finding
is that depression affects more
women (1 in 4) than men (1 in 10).
The important point is that de-
pression is treatable. Psy-
chotherapy and antidepressant
medications can be used singly,
but more often are used in com-
bination to successfully treat the
disease.
'The last 40 years have seen a
steady increase in the number of
medications effective in treating
depression, the newer ones often
developed with fewer side effects,"
says Dr. Elliot Luby, clinical pro-
fessor of psychiatry and law at
Wayne State University and di-
rector of residency training in psy-
chiatry. "Which medication is
prescribed depends largely upon
a patient's symptoms, age, gen-
eral health and the side effects
of the drugs."
All antidepressants seem to
work by restoring the proper bal-
ance of neurotransmitters in the
brain. Older classes of antide-
pressants — the tricyclics and
monoamine oxidase inhibitors —
affect neurotransmitters thought
to be related to depression but also
related with some that are not.
This leads to undesirable side ef-
fects including low blood pressure
and incontinence.
Today's antidepressants are not
habit-forming and often take any-
where from three to 12 weeks to
have an effect. Moreover, patients
generally need to continue drug
therapy for six months or more af-
ter symptoms disappear to help
prevent recurrence.
Prozac was the first in a cate-
gory of drugs called selective sero-
tonin reuptake inhibitors (SRRIs).
Since its approval by the FDA,
two other SSRIs are available:
Zoloft (sertraline) and Praxil
(paroxetine).
These drugs act specifically on
serotonin in the body, making it
more available for nerve cells so
that the transmission of messages
doesn't disrupt the chemistry of
the rest of the brain. More re-
cently, Effexor (venlafaxine), a
drug that selectively inhibits the
uptake of norepinephrine and
serotonin, became available of-
fering another option for limited
depression.
"For some, short-term use of
antidepressant drugs is effective,"
says Dr. Luby. "For others, main-
tenance on medication is essen-
tial. It is the skilled physician who
has the knowledge to determine
when medication is necessary and
to select the right drug from the
many now available, and to mon-
itor a patient's reactions. Serious
DEPRESSION page 68