William E. Jones, MD

     There are two basic types of depression.
     Almost everyone, at one time or another, has experienced what is termed a "Situational Depression" brought on by some sort of major life crisis such as the loss of a job, the loss of a loved one, a major medical illness, etc.    This type of depression is characterized by a period of grieving that usually lasts days or weeks, then slowly resolves on its own as the patient accepts the loss and moves on with life.
     The more serious type of depression is called an "Endogenous (or Clinical) Depression" and is caused by a chronic imbalance of the neurotransmitter hormones in the brain that control our emotions.

The major symptoms of Clinical Depression are

If you have some or most of these symptoms, please come talk to me about what you're feeling. There is probably a lot we can do to help. The most important things for you to realize are

The depression is not your fault.
There is nothing "wrong" with you as a person.
There is absolutely nothing you can do about the depression on your own.

Trying to "gut up" and "think positive thoughts" isn't going to help. Praying a lot won't help (unless the answer to your prayers is "go see your doctor"). Hours, days, or even months of counseling can't really help a Clinical Depression any more than a lot of counseling can correct a thyroid deficiency or diabetes. These are all hormonal conditions, and they all require the appropriate medicine to rebalance the hormones before the patient can start getting well. Only after the hormones are back in balance can good counseling really become effective in speeding and solidifying the patient's full recovery.

If we decide to start you on an antidepressant there are several important things you need to understand about these medicines:

We could taper you off the antidepressant at any time; and the worst that could happen is that after the effect wore off in a day or two, you might feel as bad as you do today, nothing more. If the medicine works well for you, I will probably recommend that you continue taking it for at least 12 months before we even consider stopping it.

There are several things you should know about all antidepressants. For the first day or two after starting any of these medicines and after any dose increase you may (possibly) feel very slightly drowsy or "spacey." That is simply because your system is adjusting to the medication, and it will pass. Just continue taking your medicine as prescribed; but be careful about alcohol, driving or any other dangerous activity until you are sure any drowsiness or dizziness has passed. You might also experience dry mouth, constipation, and other mild side-effects; but usually these are not troublesome enough to necessitate a change to a different medicine.

I expect that you will have a very good effect from any medicine I prescribe. Should we, for any reason, not be completely satisfied with the results; we may consider trying a different type of antidepressant. Do not hesitate to call me if you have a questions or problems, and be sure to return for your recommended follow-up appointments.

ONE IMPORTANT POINT: Never discontinue your antidepressant abruptly. There have been rare reports of patients having seizures when they suddenly discontinued an antidepressant medication (usually these patients were taking a very high dose). When we decide to discontinue your antidepressant, it's quite safe if we simply taper the dose over a few days or weeks.