Treatment of depression still has shortcomings

08/22/06 – Ask anyone to explain to you what depression is all about. Ask them what it is, why people suffer with it and if you can “snap out of it.”

I venture to guess that you will hear a variety of explanations, and a number of them will be wrong. Ask anyone who has depression and they will tell you they wish they could just “snap out of it”or the other popular notion, “just get over it.”

Severe depression is caused by a chemical imbalance that puts it in the ranks with bipolar disorder and schizophrenia as a serious mental illness. I call it a “crouching beast” that waits in the shadows to destroy. It is chronic and lifelong but can be controlled with a delicate balance of medication, psychotherapy and a lot of hard work.

Depression has been in the news lately with all the controversy about antidepressants and suicidal thoughts, especially in teenagers. I have dealt with family members who thought about or tried to commit suicide, and I know these thoughts are still there today. Some were teenagers and some were adults when they started down this long road.
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I remember vividly the time I talked my first one out of it and had to watch him be taken away by the police to be hospitalized. A few years later he moved away, and I was called in the middle of the night to be told he had almost succeeded this time. I was on a plane by dawn and arrived exhausted at the hospital to be told he did not want to see me. This is a normal response for this situation, so I sat and waited until he was ready.

We didn’t talk for a long time, but he was discharged after too few days and I had to make sure medical visits were lined up and find someone to keep an eye on him. Those were rough times from a long distance.

Most of the articles I read were concerned with follow-up care after antidepressant drugs are prescribed. As a family caregiver, retired nurse and volunteer in the mental health community, I have seen firsthand the frustrations of consumers and professionals alike with follow-up care.

Most insurance plans are woefully inadequate for mental health provisions. The consumer who has Medicaid or has no insurance must spend precious time going through red tape to even see a psychiatrist, and then the hunt for affordable medication begins.

For the most part, I feel the hospital stays are too short to do much good and follow up visits can be weeks apart. Frustration sets in when questions are not answered understandably, phone calls are not returned for days and the medication starts to have side affects that become intolerable. It sometimes takes a very long time to get the right mix of medication and when someone is in any type of pain, mental or physical, they want relief.

Guidelines, studies and standards are wonderful, but the mental health community must work extra hard to streamline the time it takes for these vulnerable people to get the care they need. No, they can’t “snap out of it,” especially without help. Let’s make sure they get it.

Marilyn Lukach can be reached in care of the Daily Record, 800 Jefferson Road, Parsippany, N.J. 07054, or

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