2022年4月28日

抑郁并非不可避免

The 7 key messages this psychiatrist emphasizes to patients struggling with depression

本文首次发表于 下一个大道.

是的,变老是很有挑战性的. 是的, COVID带来的隔离对老年人来说很艰难, many of whom were separated from their adult children and grandchildren for months, 一年, 或更多的. 是的, it is upsetting to watch one’s body age and no longer be able to perform the same skills it did so easily during youth. 是的,失去亲人的痛苦是毁灭性的.

沮丧的女人用手在她的脸上

但抑郁并非不可避免  not 后 divorce, 在被诊断出癌症之后, 而不是在失去爱人或工作之后. 是的,有悲伤、恐惧、担心、失去和遗憾. But no situation necessitates becoming paralyzed with unrelenting despair.

但抑郁从来都不是不可避免的——离婚后就不是, 在被诊断出癌症之后, 而不是在失去爱人或工作之后.

The word “depressed” can be confusing, as it’s used to describe different conditions. 当一些人感到沮丧时,他们说:“我感到沮丧.“但当我指的是一个临床诊断患有抑郁症的人, I am describing the person who can’t get out of bed in the morning, 有持续的消极想法, 和/或喜怒无常, 脾气坏的, 好辩的, 而且从日出到日落都很烦躁, 在小的事情.

无论你如何为这种心态和行为辩护, 不管你怎么解释, 如果某人处于这种状态两周或更长时间, 他们被诊断为抑郁症.

Sadness, mourning, anger, and other emotional states are the stuff of 心理治疗. 抑郁症源于心理生物学. 其实,往往只是 后 treating the biological component of depression that people can mourn.

抑郁症是可以治疗的

好消息是:抑郁症是可以治疗的. There is a vast array of psychotropic medications today that can be mixed and matched to offer relief for just about any person suffering from symptoms of depression, 几乎没有持久的副作用.

事实上, when patients are referred to me and described as having “treatment resistant” depression, 我经常发现它们根本不耐治疗. 而, their doctors had not yet found the best medication for them or failed to prepare them for what to expect during the course of treatment and so they became anxious and stopped treatment before it took effect.

Treating depression is not just a matter of better living through chemistry. 没有人需要在抗抑郁药中做出选择, 心理治疗, 冥想, 呼吸练习, 或者其他任何缓解抑郁的方法.

Medication is frequently the first essential step to relieve the most severe symptoms, 这时心理治疗, 正念, 冥想, 锻炼, 良好的营养, 睡眠, 精神世界杯开户实践, and other positive lifestyle habits all work to create and boost a positive sense of self. It is not an either/or proposition when it comes to drug treatment. 要么是/. 这是一种具有变革性的整体方法.

作为一个心理医生, psychopharmacologist, and psychoanalyst who has treated patients with depression for over 30 years, I strongly believe that providing a patient with psychoeducation is key to a successful outcome.

关于抑郁症的7条重要信息

These are the seven key take-home messages I emphasize to patients who come see me for depression:

  1. 抑郁症是有生物学根源的. (不,这不是你的错,你不需要感到羞耻.)
  2. Medication can take 6-12 weeks to have a full effect and can be tweaked and dosed to ensure that all symptoms are addressed with few, 如果有任何, 副作用.
  3. There is every reason to be hopeful that you will be successfully treated.
  4. Psychotherapy can thrive once the biological roots of depression are addressed.
  5. 身心实践, 喜欢冥想, 正念, 瑜伽, 和太极, 能否起到调节情绪和情绪的重要作用.
  6. 新的令人兴奋的进步, 像克他命, 经颅磁刺激, and psychedelic therapy (described by The 纽约 Times as “the hottest new therapeutics since Prozac”) provide alternative avenues for relief if, 因为任何原因, 有人对药物有抗药性.
  7. Many people who are successfully treated for depression become the happiest, 他们是最充分实现自我的人. Often individuals treated for depression come to realize that they have had a persistent low level of depression for years. Once the increased severity of their symptoms led them to take antidepressants, they discover 他们感觉比以往任何时候都好.

不要忽视抑郁症的迹象

Ignoring signs of depression is no less dangerous than overlooking signs of heart disease or cancer.

特别重要的是要警惕抑郁症 对于60岁以上的人, 抑郁症状包括喜怒无常, 乏力, 睡眠问题, 需求问题, 不耐烦, 挫折承受力较低, 性欲降低, and lack of interest in activities — are often ignored or misdiagnosed because they are erroneously attributed to aging, 生活环境的变化, 疾病, 或者是药物反应.

Ignoring signs of depression is no less dangerous than overlooking signs of heart disease or cancer.

At a time when most physicians work in medical centers or clinics where they are under time pressure to see a high volume of patients, it’s more essential than ever before to advocate for yourself and your loved ones about mental health concerns.

For most people that means making sure your primary care physician takes your concerns seriously. 这是相当惊人的, but the majority of people who are depressed see a primary care physician rather than a psychiatric specialist.

但无论你向谁求助, there’s one thing to remember: If you are not satisfied with the explanations, 治疗建议, 或者你咨询的世界杯开户服务提供者提供的指导, 再找一个. 每个人都应该——必须——采取实际行动, 教育, and emotional support and follow-up they need to recover from depression.

抑郁症是我们这个时代的心理世界杯开户祸害. 我们先进的治疗方法和全面的, 全面的方法, 治疗成功的潜力巨大.

没有理由因为沮丧而沮丧! 所有的抑郁症都是可以治疗的. But you must find the right health care provider to collaborate with and guide you on your road to recovery.

贡献者塞缪尔PaukerSamuel L. Pauker, M.D. 是一个心理医生, psychopharmacologist, and psychoanalyst practicing in 纽约 City and the author of a forthcoming book on treating depression. He is Assistant Clinical Professor of Psychiatry at Weill-Cornell University Medical College, 纽约长老会医院助理主治医师, and Adjunct Faculty at Columbia University Center for Psychoanalytic Training and Research. 阅读更多