Anonymous asked this question on 5/6/2000:

I am having severe problems in dealing with my depression at the moment. i am not at the lowest I have been, and have been seeing a doctor, but am not willing to start taking anti-depressants again, as it would seem that this is going to be a lifelong depression. I have seen psychiatrists and counsellors and the general consensus is that my depression is simply a lack of serotonin. I am looking for alternative means to stop myself cutting myself, being an insomniac, and generally being apathetic. I also have a tendency to overdrink and have been taking quite a lot of ecstasy. I would greatly appreciate any help or advice you could offer.

desertphile gave this response on 5/6/2000:

Hi. Please note that I am NOT a doctor.

I have read recently that people take drugs like "ecstacy" because they feel the need to "self-medicate." That need seems to be partly derived from depression itself. This is typically called "anhedonia" to use the technical term. One takes the "feel good" drugs because one does not get enough pleasure ("hedionic") in that life has to offer. Some psychiatrists have found that adding an anti-depressant to a drug addicts treatment helps decrease the urge to take "feel good" drugs.

Your depression is not so much a "lack of seretonin" than a decreased activity of existing serotonin in your central nervose system. The only way to get more "activity" is to effectively increase the amount of serotonin in the brain and thus boost the activity. One can actually do this with both the SSRI anti-depressants and psychotherapy. Either one alone will certainly help, but both together effects a more rapid and sustained recovery.

Yes, depression can be and is a life-long illness for a great many people. However, it really can be treated. I share your distaste for the anti-depressant drugs: Americans are actually less likely to take such drugs than the Europeans. It's a matter of "stigma." One is "supposed" to be able to not need such help to live. One is supposed to "list oneself by one's own boot straps."

I have never agreed with such a belief! When I get cut or break a bone, I get medical treatment. I do not just stand there and bleed; I do not try to walk on a broken leg. I go see a doctor and get the wound stitched and the broken leg set straight and put in a cast.

Please reconsider your hesitation in taking an anti-depressant if your doctor has suggested it. I know that the side effects can be uncomfortable, but the trade off is that the depression CAN BE TREATED and that treatment is very much worth putting up with the side effects for a few weeks.

It sounds like you suffer for the "major depression" that affects many hundreds of thousands of people. Treatment on a SSRI such as Prozac or Paxil may therefore take as much as 12 months, or as little as 6. Please consider the fact that if your doctor has suggested such a treatment, it is WELL WORTH the effort. No one needs to live with depression these days, since there are effective treatments.

If you do not have a doctor (psychiatrist or psychologist), there are state-financed counselors who do much the same work. These will be listed under the "Govermnet Offices" in the front of your phone book.

I think there is no "shame" in taking an anti-depressant when one needs it. Depression is an illness: it is not a "weakness" on your part.

PLEASE consider taking your doctor's advice.

And also feel free to ask me about anything related to depression, and perhaps I can offer some advice. I've lived with depression for 40 years, and I hate it: if I can help someone, I will certainly do what I can. I consider depression an enemy, and I help people fight that enemy when I can.

PLEASE talk to your doctor about this.