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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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I am considering taking an anti-depressant. I have significant

Customer Question

I am considering taking an anti-depressant. I have significant stressors in my life right now due to job loss, loss of income and financial issues. I have had periods of extreme stress, crying a lot, etc. This has been affecting my health with high BP, poor sleep, etc. I know that this is situational depression/anxiety and not sure if an anti-depressant is what I need to do or if there are natural supplements that I can take to help with this. I am very concerned about the potential weight gain and possible side effects of them and as I do not want to take them long-term worry about weaning off the medication if I start. I have on medical issues and the only medication I am on is Estradiol-hormone replacement.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr John B replied 2 years ago.

Hi,

There isn't actually much evidence for anti-depressants being effective as a treatment for reactive or mild depression ('mild' is the term and not meant to downplay what you are experiencing). Given the major stresses that you are exposed to right now it would likely be more effective to focus on resolving these issues to the best of your ability (where possible) and use a Cognitive Behavioral Therapy (CBT) approach. The kind of strategies you are trying already are a step in the right direction and also using the cognitive strategies that form part of CBT should help you manage moments when your thinking/outlook becomes intensely negative or you begin to feel hopeless.

You can take what is known as a 'stepped approach' to addressing the low mood you are experiencing. A stepped approach simply means that you follow a sequence of strategies in a particular order (you try one approach and then move on to the next if it isn't working).

The recommended sequence of treatments to try is:

1) Self-help using a CBT based program

2) CBT with a therapist

3) CBT & an antidepressant medication (usually a Selective Serotonin Re uptake
Inhibitor) if you find that your mood is not lifting at all


You can confirm that this is the correct order by checking these treatment recommendations here.


CBT is a psychotherapeutic approach that aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure. Treatment is technique driven, brief, direct and time-limited
(normally 10-12 sessions). CBT is used in individual therapy as well as group settings, and the techniques are often adapted for self-help applications. I would
strongly encourage you to consider CBT as I would expect you get great benefit
from this approach.


Start by working through this excellent CBT based self-help program here. It should take several weeks to complete, is completely free and will teach you everything you need to know about Depression and what you can do about it. Alternatively, you could take a look at a book which will teach you some introductory techniques for dealing with Depression at home. I can recommend a well known manual titled Mind Over Mood and another book titled The Cognitive Behavioral Workbook for
Depression; A Step by Step Program
as good places to start. You can find them
both here.


If you find you aren't making the kind of progress you would like using a self-help approach I would then recommend you consult with a CBT trained therapist. CBT is usually offered by Clinical Psychologists (although not exclusively) and you can contact the American Psychology Association (APA) for assistance with locating a Psychologist; take a look at the APA locator service here. You can use this to find Psychologists in your area and there is a phone number you can contact if you want a referral arranged for you. Also, take a look at an article published by the APA here. It's an interview with a senior Psychologist and covers some of the things you should consider when you looking for a Psychologist.


In regards XXXXX XXXXX natural supplements there isn't really a lot of evidence that natural supplements are an effective treatment for Depression. However, there is no doubt that looking after your health greatly helps in manging any kind of psychological problem and thus any supplement you found helped you feel better may be useful. There is some limited evidence that St John's Wart may help lift mood however you would first need to clear this with your doctor as it can interact poorly with some medications (including anti-depressants). There is considerable disagreement as to the efficacy of St John's Wart and I mention it only as something you may wish to investigate further rather than make a recommendation for it.

I hop this has been of some help. Please let me know if you have further questions or would like me to clarify any part of my answer.

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
I appreciate your answer and recommendations. I have been working in the medical field for over 20 years as a medical office assistant, transcriptionist & was an EMT. I am familiar with the many side effects of anti-depressants/SSRIs, etc. Will definitely have some questions to ask my primary when I talk to him about this. I am working on trying to deal with the situation to resolve it but the stress has been significant and trying to stay positive is definitely the issue here.
Expert:  Dr John B replied 2 years ago.

There is a field of Psychology called Acceptance Commitment Therapy (ACT) that is particularly good at addressing pain/stress/loss in our lives that is unavoidable. That is, it approaches negative experience as a natural occurrence and suggests strategies for moving on without attempting to remove those parts of our lives causing us pain.

It's an excellent approach for anyone trying to manage problems that aren't likely to go away.

I can recommend a book titled 'The Happiness Trap' by Dr Russ Harris as a good introduction to this approach, otherwise you can find material on ACT quite easily through a Google search.

Good luck with getting through it all.

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
I will look into ACT. I have had down periods (as I am sure everyone has) and I always deal with it well and recover. I am just trying to avoid this becoming chronic & want to learn to recognize and symptoms and how to deal with what I cannot change without falling apart, picking myself up and taking care of the rest without being scared.
Expert:  Dr John B replied 2 years ago.
It sounds like ACT may be a very good fit for you. Good luck!
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
Thank you very much for your time. I would rather try and find a way to take care of it without medication if possible and if it does become more chronic will definitely looking into medication possibilities. Medication therapies do have their place, but often (I feel) are used for a quick fix or band-aid. Would rather do something that will help me cope with the situation and also help calm my anxiety while dealing with the situation (which also helps with self-esteem after job loss).
Expert:  Dr John B replied 2 years ago.

Take a look at this locator service - it lists ACT therapists by area.

http://contextualpsychology.org/civicrm/profile?gid=17&reset=1&force=1

Good luck!

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