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Selah R, M.S. LPC
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience:  Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
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ok. we have a history of depression and bipolar disorder in my family. i am the youngest

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ok. we have a history of depression and bipolar disorder in my family. i am the youngest of 6 kids, and am now 43. brother took his life at 33 (patent attorney, depression?), sister at 43 (Bipolar I). i think about death it seems moreso than most, and about the topic of suicide. it's not that i feel close to doing it, though it's sort of at the back of my mind generally. i am functional, but feel like to be this melancholly (?) generally is abnormal. seems like i function at a consistend low grade depression. never tried meds outside of experimenting with zoloft in low dose for 3 weeks which gave me consistent nausea, headache, dry mouth, and didn't see positive effect. i wonder that i should be medicated or not. i've lived like this all these years. don't want to incur a bunch of cost either, eg premium increases with an official diagnoses. thoughts?
Submitted: 3 years ago.
Category: Mental Health
Expert:  Selah R, M.S. LPC replied 3 years ago.
Thank you for trusting JustAnswer with your important question.

Having such a heavy family history with mood disorders greatly increases the probability that you will have a mood disorder, too. The key is to look at how it is affecting your life (your work, your relationships, your friendships, your self-esteem, your ability to do things you enjoy, etc.). If the symptoms are causing impairment in these areas of your life then it might be time to consider counseling or medication treatment (or both).

If you see a counselor and pay for it out of pocket, it will not affect your future premiums unless you admit to them that you've seen a counselor in the past. If you decide to use your insurance for therapy or medication, you can talk to the provider about your concern. Most providers are going to use the least stigmatizing diagnosis when dealing with insurance companies if possible, such as Adjustment Disorder with Depressed Mood instead of Major Depressive Disorder. We may need to escalate the severity of the treatment diagnosis when intensive, prolonged, or inpatient treatment is necessary. You may also consider seeing your family doctor for antidepressant medication, which may be put in your insurance records as stress related. Again, talk to your provider to find out the details.

Antidepressant medication is difficult in that everyone responds to them differently. What made you sick is someone else's miracle drug. Finding the right medication, and the right dose, can take time. Many people try 2 to 3 medications before they find the one that gives them the most benefit with the fewest negative side-effects. Some with medication-resistant depression may need more than one medication at a time to deal with their symptoms. So don't let your experiment with Zoloft scare you off of all meds.

Since you have a strong family history of Bipolar, you need to rule that out in yourself. Antidepressants used alone without mood stabilizers can make people with Bipolar disorder worse.

Most antidepressants have mild side-effects that begin to disappear after the first 2-4 weeks of use. Severe side-effects usually indicate that the medication dose is too high, or that that specific medication does not work well in your body. Most people begin to notice improvements in 2-4 weeks if the antidepressant is going to work, although the full effects can take 4-8 weeks to fully kick in. Many doctors will want you to stay on a medication for 2-4 weeks before they increase your dose if you are having some benefit but not enough benefit that should be expected from medication use.

The cost of treatment will really depend on what avenue you decide to pursue. If you live in an area that offers low cost therapy (such as at a university that trains counselors or psychologists), you may be able to find sessions for 5-20$. If you decide to pay out of pocket for a fully licensed counselor, fees typically run 50-100$. Medical doctors and psychiatrists for medication can run 80-200$ for your initial visit, with rates 25-50% lower for follow-up visits (usually monthly for the first few months until the medication seems stable, then every 3-6 months after that for maintenance). The actual antidepressant medication can run anywhere from $4 (the generic programs at Walmart, Target, and other big chains) to an average of probably 100-200$/mo for brand name medications or the more expensive generics.

Treating depression isn't cheap. But the damage depression does to your life can be huge. Treatment may be the best investment you can make in your own health and happiness, and can drastically change your future.

Best wishes,
Selah
Customer: replied 3 years ago.
couple issues/questions. 1. i have lived like this so long i am not sure if i'm overexxagerating (everyone and anyone would like to feel "happier", yet some degree of unhappiness vs happiness is normal)---or if it is worth the "risk" of taking meds and seeing what happens. the flipside is i wonder that if on the right meds, would i feel that much better opening up a whole new world. i have always felt to be in a dreamy state, out of touch with reality/ in a fog. 2. dysthmia? low grade consistent depression, for the most part. though i can relate to "hypomania" descriptions. bipolar II ?
Expert:  Selah R, M.S. LPC replied 3 years ago.
I think dysthymia may fit based on your descriptions, but it could also be chronic Major Depressive Disorder depending on the severity and what your life is like between depressive episodes (and how long those breaks in depression might last). I can't say if you are over-exaggerating but I can say that the deeper your depression the worse the world looks, the worse you feel, and the more negative your filter is for how you interpret current and past events. So in a way, exaggeration is part of depression. People who get stuck in long periods of depression can even feel like they might be manic during their short breaks out of depression when in reality they are just feeling good! It just seems so much more Intensely good compared to their depressive states.

Medication is a personal decision. Many people begin to see that depression has shrunk their world, ruined their relationships, decreased their ability to make positive changes in their life (like being healthy, exercising, losing weight, and taking care of basic self-care routines like hygiene). If you are seeing that type of creeping damage in many areas of your life, then the question becomes "why not try?" Medications are reversible, fairly affordable for most people, and can help you break free from the chronic lead overcoat that depression can wrap you in. Medication may help retrain your brain to better balance the chemicals involved in mood stabilization. But the biggest assets is that it can give you the energy, motivation, and confidence to make the healthy life changes that will help you take back your life.

For clients I work with who have long term depression, we usually talk about their concerns with medication, talk about the possible benefits, and then usually decide to give meds a 3-6 month trial. For most, they will see benefit. For a few they will see no real change. For a tiny few they will decide they prefer their non-medicated status (usually because they have other health problems that limit their medication options, or they are sensitive to medication and have worse side effects than they want to deal with).

Antidepressants don't change who you are, they don't give you a false sense of happiness. They just help you not be in such a deep pit, to not always get stuck om the negative emotions and negative thoughts. They help open you up to be more aware and more able to connect with the peaceful, neutral, and happy things in your world. It's more like a ladder up out of the hole, rather than a catapult that will throw you into a high and unfamiliar place.

Hope that makes sense. I think it's a worthwhile investment to try medications. If it works, it can make great changes. If it doesn't, at least you know you tried that avenue.

Selah
Selah R, M.S. LPC, Therapist
Category: Mental Health
Satisfied Customers: 582
Experience: Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.
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Selah R, M.S. LPC
Selah R, M.S. LPC
Mental Health Professional
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Licensed Professional Counselor; over 13+ yrs exp working with adults, teens, & families/couples.